I have a friend (really I do, this is not about me)  who just got disability from the VA.  He is a retired over 65 federal employee who has Medicare part B and kept his federal medical insurance.

He says he may drop Medicare part B since VA can cover his medical necessities and may also drop his federal medical insurance, in all saving approximately $800.00 a month.  

Is it a good idea to go strickly VA or keep one of the other insurance options?  He seems to be impressed with the service he's been getting from VA but I'd always heard horror stories on the waiting and quality of care.  

Anybody in the same boat?  Thanks for looking.

I assume he has Medicare A still?  Honestly it's pretty comprehensive to have both.  No ARFCOM pun intended.

For me it’s weird, I use Va for everything, but wanted to keep basic tricare to cover things like emergencies. To get my free tricare, I HAD to pay $100 a month to get Medicare.,as in tricare refused to cover me unless I bought Medicare first. Just weird.

Not expensive, just weird.

I am in a similar situation being 100% through the VA and have Medicare Part A and B. Mine is the standard Part A and B directly through Medicare and not a third party.

Your friend needs to read the VA regulations in depth. The VA requires you to keep Medicare Part A and B if you have it. And even the Medicare book sent out every year states the same. Even if you are rated at 70% UI or 100% through the VA, they will still bill Medicare for any treatment of non service connected injuries.

The most important piece of info is how high his SC% is. If it's less than 50%, he should keep his private insurance. If it's greater than 50% but less than 100%, the VA will cover basically everything but dental. at 100%, they cover everything across the board.

And even when rated at 70% UI or 100%, the VA will still bill Medicare or any other insurance you have for treatment of non service related injuries/illnesses.  

I can't say about private health insurance, but I do know for a fact that Medicare states in their annual book they send out to keep Medicare even if you are rated 100% by the VA.

if he has FEHB (federal employee medical), he could drop medicare part B and keep the FEHB.    there are plans under $150.    keeping FEHB would give him lots of options.   if he can afford it, keeping medicare B and a selected FEHB plan would provide great coverage, and he could choose from many doctors and hospitals.


why was he paying about 800 per month?   is he higher than average income?

Right now, I'm happy with the patient care from my VA being my only medical care. It sounds like it largely depends on what VA he has access to.

Yes it does depend on which VA hospital you go to. There is no way that I will ever go back to John Cochran VA Hospital in St Louis, Mo. That place is horrible. I do get excellent care at Harry S Truman Hospital in Columbia, Mo.

Medicare is a ripoff for people who have 50% or more VA disability.

When I got upped to 70% + IU, I also ended applying for SSDI (VocRehab pushed for the UI & SSDI). I did have to get a lawyer involved, but again, my councilor at VocRehab directed me to a good one. Still cost me a portion of my back pa, but I got my VA rating bump, UI, and SSDI all knocked out at one time. Medicare sent me the paperwork to apply for Part B, but since I'm not required to have it, I declined. Why give them money every month when I don't need to? I do have Part A, as its part of SSDI.
When I turn whatever age it's required to sign up for Part B, I will, but it will still be bullshit, and just a way to fuck veterans and steal our money.

On another note, I got a letter from the VA saying my UI is now Total and Permanent.

Maybe it was different when I got rated 70% UI right after getting SSDI. I had to keep both Part A and Part B. And every year the Social Security book still states that you need to keep both even if your disability is rated total and permanent by the VA. I was already at 70% but didn't get the UI designation until right after the SS judge granted SSDI. This all happened within a week of each other.

Now that you are rated 70% UI - Total and Permanent, make sure to get all of the benefits and health care that goes with that rating. Being 70% UI or 100% gives you free dental through the VA and also allows dependents that qualify to Get Chapter 35 Survivor and dependent education benefits.

Oh and depending on how long ago you got SSDI and rated at 70% UI, you will have to go in every three years to the VA for a physical. I had to go in twice until the VA finally stated that there was no need for further physicals since my injuries will never improve.

I didn't hire a lawyer when it came to SSDI. I just took the encyclopedia volumes of medical records from the Army and the VA to my hearing. The judge took about an hour or so looking through my medical records then asked three questions before granting me SSDI. The judge did question one of my diagnosis from the VA though. The VA has me as having readjustment disorder and the judge asked why that wasn't PTSD instead. I had DAV representing me with my VA claims and within a week of the SS judge's decision, the VA gave me the UI rating.

And for all of those that have the UI rating, remember that you can not be gainfully employed at all or you will use the UI and go back to your last rating. Gainful employment is basically any job that you get a paycheck. This includes part time work.

I have Tricare (blue card mafia) and blue cross from my state pension and Medicare (ssdi)
I play them against each other-but remember if ever travel overseas va for I’ll pay (possibly reimburse you for issues overseas 5that may be service connected (after you pay the foreign entity) most overseas hospitals will hold you hostage if you don’t or can’t pay or will run a credit card for double the estimated bill prior to seeing you. I have needed care in Costa Rica Colombia (COVID) and the Philippines.

VA will cover eligible vets abroad. You have to fill out some forms ahead of time. Never done it myself but know folks that have.

Yes for “some” things it has to be service connection related
https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp

i use the VA for everything i can but surgery. i maintain regular insurance just in case i ever need surgery

I'm rated 100% from Viet Nam and have dealt with VA for over 50 years.
Since they bill Medicare anyway, I don't bother with them any more.
The long delays, less than polite service and questionable services turned me off.
It's your call.
You can go there if you want.
But there is better care, more support and much faster access in the private sector these days.

Same here.
Why put up with weeks/months of delay  (less than polite and questionable services!)
if Medicare is going to pay for it anyway?

After WW-I there simply was not enough medical infrastructure in America to handle returning wounded vets.
VA had the latest greatest services and medical knowledge.
Same for WW-II and Korea.

But during Vietnam (and the Apollo space program) medical technology developed rapidly and  literally left VA
in the dust.
Now even more so.  

I'm 100% (for 23 years).
I'll take the money, but not all that interested in VA health services.

I just got rated 50% SC disabled.  I was told that even though I qualify for medical coverage, they WILL bill my private insurance first, before I get my "free" care.  If I cancel my private insurance and go full time VA, I guess they cant do that?

Also, I have a 6 year old.  Being 50%, does she get covered as well?

Unfortunately dependent do not qualify for medical through the VA. They may be able to get coverage through CHAMPVA though.

No CHAMPVA unless you're 100%, either schedular or TDUI.

I wasn't for sure about that. I know my wife qualifies for CHMPVA since I am rated 70% UI

Right. It's the TDUI that  gets dependents covered in that circumstance. For the benefit of those that aren't familiar TDUI (or TDIU interchangeably) is Totaly Disabled Unemployable Individual. A veteran can be paid at 100% if they are less than 100% if their service connected condition(s) makes them unemployable.

The main difference is a schedular 100% disabled veteran (qualifying for full disability compensation based solely on degree of injury or disability) is still able to work to whatever extent they can and choose.

And if you have the TDUI then you can not be gainfully employed at all which means no part or full time job where you get a pay check. I looked into it and I can only do odd jobs for cash and only up to 40 hours a month. The benefits out way not being able to work especially since I am also getting Social Security Disability. I get full dental and health coverage and my sons qualified for Chapter 35 Educational Benefits for Dependents. Yes straight 100% ratings is the same for Chapter 35 benefits.

Thanks fellers.  I have a supplemental and a few secondary claims pending so we'll see.

This has been a helpful thread.  After 17 years of appointments, exams, tests, MRI's, CT scans, painful procedures, etc., they finally decided I can't be repaired and things are just getting worse so they granted me 100%.
I am now in the process of trying to understand what 100% means and what I qualify for or if it benefits my family somehow.  Is there an age cutoff for the education benefits for dependents?

Yes there are age and time limits on using Chapter 35 benefits. There is too much to try and type so I will just post the link to the VA's webpage on Chapter 35 benefits.

https://www.va.gov/education/survivor-dependent-benefits/

Straight 100% means that you get full medical benefits and full disability compensation pay. You can also still work when rated at straight 100%. Medical benefits include dental coverage for yourself. Your spouse and children (up to a certain age) will also qualify for CHAMPVA coverage.

I don't know what the rating percentage cutoff is for free hearing aids. But if you qualify for them, the VA will give you a new pair every 5 years free of cost. Anyone rated at least 50% or higher also qualifies for a free pair of glasses every two years.

The benefits are the same for anyone rated at 70% UI and higher (with TDUI designation). I know having dental coverage through the VA has been a big help for me and also saved a ton of money. What the VA doesn't do at a VA hospital, they will send you to a private dentist and cover 100% of the cost.

Thanks for the info.  I did go drop off my letter at the county assessor's office so I will no longer pay property tax. I need to call and see what I need to do for the dental, that will be a huge help.

It's been a few years but if I remember correctly, your primary care doctor will have to put in a referral for you to see dental.

VA
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Inappropriate post for this thread.

Funny thing is when I went to the VA nobody cares…

I am 100% through IU and have been for over 5 years.  Wife has CHAMPVA.  I expected to get a letter that converts the IU to P&T after I turned 55, which was more than
a year ago.  Oh well.  I use VA only for medical, but have had some bad experiences.... Im not knocking the VA in general, but there can be some bad apples who work
for the VA, either within the VA itself or providers who offer veteran's choice.  Its easy to get bad stuff put into their "private" file on you, if you complain.

Example; I went to a dentist in another town not too far away to have a very small spot on a front tooth and a canine tooth fixed, and the guy literally ground about 40%
off of each front tooth on the sides, I had no idea it was being done at the time. (Numb)  Guy gets done and says ok, all finished.  I go out to my car and look at the work
in the mirror and he has completely re-profiled my two front teeth, and done nothing to the canine at all, so I went back in and asked him why.  Guy gets all pissy and sits
me back in the chair banging shit around and roughly rips into the canine.  The shots are wearing off and its hurting like hell, so I ask for another shot and pissed him off
even more.  He got it done, but my two front teeth were so sensitive after that that I couldnt bite through a hot dog for several months.  I was supposed to have a 2nd
appointment with the guy for a crown on a tooth I'd broken while deployed, but I cancelled through VA and asked them to schedule me with a different provider.

SO I go to provider #2, and he does his work, puts a temp crown on, sends off for the zircon crown, and I come back in 2 weeks to get it put on.  The crown is way too
big, so the guy ground off the enamel of two perfectly good teeth to fit the crown into the space, it made them sensitive as hell. Again, I had no idea what he was doing
until it was over and done with.  I went to a local dentist on my own dime just to have all this work looked at, and he just shook his head and agreed that the work these
dentists had done had done real damage to my teeth for the long run.  I get scheduled for a cleaning with provider #2 after that, and when he asks how Im doing I tell
him Id be better if you hadnt ground all the enamel off two perfectly healthy teeth just to get a cap between them. He had his tech clean my teeth, and about a week
later I got a letter from his office stating that I had been fired as a client.

Fast forward about a year and I go to the VA for my annual cleaning. My dentist has a butch haircut, like literally army reg flat top cut, dyed bright royal blue and is about
60yo.  I was polite as anyone can be, never complained about any of my other dentists, never complained about a thing at all- but after the tech was done cleaning my
teeth she sat right next to me and started entering information into a laptop.  I turned my head and clearly saw that she had typed "picky" into my file.  I said "wait,
you think I'm picky? I dont understand" and realizing she had been caught she fake laughed and made a joke like "haha yeah you're picky".  But I hadn't been, at all.

So, thats 3 providers in a row that did me bad, and evidently some or all of them put negative information about me into a file.

Now about 4 months ago I was trying to put a screw into the corner of a flapping metal roof on my boat dock, which I had pulled against the shore to do some repairs on.
I figured I'd get the screw in place before I cut the rotten part off the dock.  Ladder leg goes through the rotten deck, slides off the roof, dumps me out onto the bank,
and dislocates my left shoulder. I go to the local VA and get an xray which clearly shows posterior displacement, which is supposed to be immediately referred to an
orthopedic surgeon for reduction under anaesthesia.  Nurse practitioner says no displacement, however; so that did not happen.  I did get a referral to an ortho, however,
and after living with one arm for months (no joke)  I decided that my appointment had "fallen through".  Well, they wont answer the phone there, so I had to go in.
I discovered there is a "hub" or go between called Community something or other, that is between providers for the VA Choice Program.  VA >Hub>outside provider.
VA says well I see the referral, you should be hearing from the outside provider any day now.  SO I go to the office of the Ortho, and ask when I will be seen.  They tell
me they have no record of  a referral whtsoever. UH, OK.  SO I go back to the VA, who claims they should have it, and a very nice lady tells me to wait there until this is
cleared up because this is so wrong.  So I did. And was assured I would be called very soon with a scheduled appointment.  Well that was two weeks ago.

So that has been my experience as of late trying to use VA medical.  I guess its great as long as you don't need it, and as I understand it the VA hospitals and services
in other areas are better than where Im at.  I won't even go into the abuse I received from VA employees shilling the clot shot to me a couple years ago and shaming me
for politely turning it down.  After about 7 calls I blocked the number.
   

Having a 100% VA rating, would there be any reason to take enhanced Medicare, I guess parts c and d?