Jim’s Story

Jim was a proud veteran and a great man.  He served in the Navy in Viet Nam.  He then spent his life as a teacher and administrator in Christian schools.  He thought he had solid health insurance coverage since he had both Medicare parts A and B as well as VA coverage.  He was very pleased with the care he received from the VA.

But then an unforeseen accident occurred.  Jim had a heart attack while 20-feet up on a ladder and fell to the ground.  Unconscious, Jim was taken by ambulance to a non-VA hospital.  After one week in ICU, he went home to be with the Lord.

Sadly, Jim’s survivors have found that the VA is not paying for any of his medical care from the accident because it was provided in a non-VA facility without prior authorization.  The VA web site states that if a veteran has any additional health insurance besides the VA, including Medicare, then the VA will not pay for emergency care received in a non-VA hospital without prior authorization.¹  Therefore, the only health insurance coverage for Jim in this tragic scenario was Medicare parts A and B.  His survivors have had to raise money to pay tens of thousands of dollars towards their share of the cost of Jim’s medical bills.

What is the solution to this problem?  Medicare Advantage.  It has no impact on your VA coverage.  You can still go to the VA for medical care.  But Medicare Advantage replaces Medicare parts A and B and provides better benefits.  It gives vets much more affordable access to medical care in non-VA facilities, should the need arise.  Medicare Advantage has no or low premium.  Ask your local VA clinic, there is no reason not to enroll in Medicare Advantage.

Medicare Advantage benefits for veterans include:

• Potential cost savings on medicines
• Dental and vision reimbursement
• Access to a local fitness center

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To qualify for Medicare Advantage you must:

• Live in the plan’s service area
• Have Medicare parts A and B
• You cannot have end stage renal disease

Veteran, do you have a chink in your health insurance armor?  Don’t wait to find out the hard way.  Consider Medicare Advantage.

If you have questions about Medicare, call Aspire 65 at 888-819-2158.

1 https://www.va.gov/healthbenefits/access/emergency_care.asp