HEALTH CARE

COLUMN: Enrolling in Medicare with VA benefits

It looked like a story whose financial ending could not be good: The Salem-area resident was planning to retire, enroll in Medicare and move to a coastal county with alarmingly few good Medicare Advantage insurance choices.

She made an appointment with a Senior Health Insurance Benefits Assistance (SHIBA) counselor to obtain more information about Medicare insurance.

The county to which she planned to move has only one Medicare Advantage insurance plan, whose monthly premium is $90. By contrast, Marion and Polk counties have nine such plans with no monthly premium and 12 other plans with premiums of less than $90. 

But the individual, apparently a small-business owner, had unusual circumstances: She said she was already paying almost $400 a month for her current insurance. So even the most expensive Medicare insurance – plus the $170-a-month Medicare Part B premium – would be less than that.

The SHIBA counselor provided detailed premium and benefits information about both Medicare Advantage and Medicare supplement (Medigap) insurance for her to consider. It isn’t known what decision the individual made, but either way she was going to save insurance costs with Medicare. 

If you would like to make an appointment with a SHIBA volunteer counselor, or to ask a question to be answered here, please see the end of this column. 

I will turn 65 in a year and have VA medical benefits. Because of those VA benefits, shouldn’t I be able to skip enrolling in Medicare at 65?

You could do so, although it might cost you in the future. 

First, Medicare recognizes your VA benefit for prescription drugs as being as good as or better than what you would have with Medicare. So if you skipped buying Medicare drug insurance now and decided later to enroll, you would have no late-enrollment penalty.

VA medical benefits are different, however. Although you can skip enrolling in Medicare for medical, if you later decided to enroll in Medicare you would face a Part B late-enrollment penalty for the rest of your life. Not enrolling in Medicare would also mean you could receive your medical care only through VA facilities. And if you decided later to enroll in Medicare you could do so only during January, February or March. And the lifetime late-enrollment penalty could be substantial. 

If you do enroll in Medicare, you can of course keep your VA coverage, too, which may have benefits that Medicare doesn’t. 

For a detailed explanation, you might see the trusted MedicareInteractive.org website. For information about your circumstances, you might also call your veterans services officer in Marion County (971-707-4400) or Polk County (503-623-9188).

Why can’t I meet face to face with a SHIBA counselor?

At the outset of the coronavirus pandemic, SHIBA Medicare counselors began doing all counseling by phone. Many Medicare beneficiaries liked that because it meant they could obtain the information without driving to an office for a meeting.

Now that the pandemic’s complexion appears to have changed, some SHIBA counselors are again meeting Medicare beneficiaries in person at the Salem and Dallas offices of Northwest Senior and Disability Services. If you would prefer an in-person or Zoom meeting, please say so when you make your appointment. 

Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) program. To ask a question to be answered in this column, e-mail [email protected] To schedule a free SHIBA phone appointment with a volunteer Medicare counselor, call 800-722-4134.

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