Medi Advisors of Ohio

Other Medicare Beneficiaries

Veterans

I have VA benefits. Should I enroll in Medicare Part A and Part B?

“VA does not recommend Veterans cancel or decline coverage in Medicare (or other health care insurance programs) solely because they are enrolled in VA health care. Unlike Medicare, which offers the same benefits for all enrollees, VA assigns enrollees to enrollment priority groups, based on a variety of eligibility factors, such as service-connection and income. There is no guarantee that in subsequent years Congress will appropriate sufficient medical care funds for VA to provide care for all enrollment priority groups. This could leave Veterans, especially those enrolled in one of the lower-priority groups, with no access to VA health care coverage. For this reason, having a secondary source of coverage may be in the Veteran’s best interest.”

Excerpt from VA.gov help – https://iris.custhelp.com/app/answers/detail/a_id/3032/related/1

“VA health care depends primarily on annual Congressional appropriations, VA encourages veterans to retain any health care coverage they may already have, especially those in the lower enrollment priority groups. Veterans with private health insurance or with federally funded coverage through the Department of Defense (TRICARE), Medicare or Medicaid, may choose to use these sources of coverage as a supplement to their VA benefits.”

Excerpt from VA.gov help – https://iris.custhelp.com/app/answers/detail/a_id/555

Veterans should seriously consider enrolling into Part B when first eligible to avoid the Part B premium penalty.

Still unclear? Contact us!

Can I have Medicare benefits and still receive health care services at VA?

Yes. But having Medicare increases your health care delivery options and in many cases is more convenient for Veterans, especially those with lower priority groups. The VA may not cover medical services provided by non-VA physicians and in non-VA facilities. Medicare will not cover medical services provided by the VA.

We can help. Call us!

I have VA benefits and enrolled in Medicare Parts A & B, is that enough?

When you are enrolled in Medicare Parts A & B your healthcare options are increased. You can now select Medicare Plans that allow you to use doctors and facilities outside the VA and closer to home.

I have VA benefits. Do I also need a Part D prescription drug plan?

There are some prescription drugs not on the VA formulary. Having a Medicare Part D plan may allow additional formulary drugs to be filled at your local retail pharmacy. You will also have the convenience of filling your local doctor prescriptions at a pharmacy close to home.

We’re just a phone call away, call us today!

Public Employees

I’m STRS, what are my options?

We suggest you first contact STRS directly https://www.strsoh.org/ regarding coverage and reimbursement changes. Once you’ve learned of your STRS options you may find it beneficial for you and/or your spouse to enroll in your own healthcare plan outside of STRS.

This is where we can help! Contact us today!

I’m SERS, what are my options?

We suggest you first contact SERS directly http://ohsers.org/ regarding healthcare options for you and your spouse. We are happy to work with you to find a plan that suits your needs, budget, and lifestyle.

Give us a call.

I’m OPERS, what are my options?

We suggest you contact OPERS directly https://www.opers.org/ regarding the enrollment process through their contracted third party. Currently, to receive your health reimbursements the contracted third party must enroll you into your Medicare Supplement or Medicare Advantage plan; however, you are allowed to enroll into a Part D Prescription Drug plan through your personal licensed insurance agent. This can be an extremely confusing process.

We are happy to walk you step by step through the process.

Important Dates to Remember

Avoid costly mistakes!
Decisions regarding your Group & Health coverage involve adhering to the specific Medicare Program timelines to avoid Late Enrollment Penalties and unnecessary additional premiums.

Turning 62: For those with a higher net worth, contact your accountant and financial planner.
Turning 64: Start preparing for Medicare Insurance now to learn important timelines, coverage, costs & penalties.
Sept. 30: Annual Notice of Changes to your current plan mailed to beneficiaries. Contact your Licensed insurance agent to review these important changes.
Oct. 1 – 14: Pre-Annual Enrollment Period. This is your “First Look” opportunity to view next years plans with your licensed insurance agent
Oct. 15 – Dec. 7: Annual Enrollment Period for Medicare Advantage and Part D Prescription plans
Jan. 01 – Mar. 31: Medicare Advantage Open Enrollment Period. If you are already in a Medicare Advantage plan, you can make one change during this time to another Medicare Advantage plan, with our without drug coverage, or go back to Original Medicare and enroll in a Part D plan. This is also the same time frame as the General Enrollment Period for Part A and Part B if you did not enroll during your initial enrollment Period and do not have another valid election period available. Coverage takes effect the 1^st day of the month following enrollment.
Quarterly: Medicaid and Extra Help Beneficiaries may have the option to make quarterly changes to their Medicare Advantage and Part D drug plans from Jan 1 – Sept 30th.
Yearly – Oct. 1: For many beneficiaries, this is the Lock in period for Medicare Advantage plans and Part D drug plans unless your situation qualifies you for a Special Enrollment Period.
25th Month of Disability: Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans and Medicare Part D Prescription Drug plans.
Turning 65 – Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans, Medicare Part D Prescription Drug Plans and Medicare Supplements (Medigap).

Medi Advisors of Ohio

Other Medicare Beneficiaries

Veterans

Public Employees

Important Dates to Remember

Based on your personal situation, you may have other enrollment options available.