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jfrei

Eligible for Medicare due to ssdi

Question

Is it my understanding my family has to pay for this in May when I’m eligible? Is it worth it? So far it’s always been a call away to collections every time until I call ChampVA to pay each provider is that the norm? Scare the xxxx out the wives until we call after being put on hold for 45 minutes...

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Jfrei, I am on medicare and it is well worth it.  Medicare is the primary and your ChampVA is secondary so you should get your bills paid in a more timely fashion.

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Part b is an option which costs around 134 per month, where you are "automatically enrolled" when you reach age 65.   You have to opt out, if you dont want part b.  

Someone can look up the rules of champva, but Im pretty sure if you are over 65, then you have to opt in to part b, because champva depends on medicare to pay its share.  The 134 per month (more if you make lots and lots of money) will be deducted directly out of your social security check each month, again, unless you opt out of part b.  

If you do opt out of part b, then change your mind a few years later, there will be a penalty that is rather stiff.  I avoided it because I opted out the first time I was eligible for medicare (when you are classified as disabled and under 65), but opted into part b when I turned 65.  So, there is no penalty.  I pay 134 per month the same as everyone else for part b, again, unless you make lots of money.  

Having just been through this, here is my opinion.  I did not think I needed part b.  After all, I get my medical care at VA, so part b sounded like a wasted 134 per month.  However, as we all know, sometimes VA medical care is sub standard, and you need to go private.  Trying to get VA to pay for your private medical care because VA care sucks is like trying to stop a hurricane.  You pretty much need a referral from VA for "choice" but VA does not want to give you that if they have that department at your local VAMC even if its really bad.  

So, if you get real sick and need a specialist outside of VA, then you will need part b.  I felt it was worth 134 per month to "not to have to " use VAMC..but to have the choice.  With Champva, your spouse will have more medical choices than you do.  As far as Im concerned, I have to use VA or the hiway.  As I said, the exception for me is if I get real sick..then I will use outside care.  You see, you have deductables and copays with part b to put up with.  Some of those copays and deductables will be paid by champva..but only for your wife, not for you.  YOU wont have champva..you just have VA.  

The safe way is to opt in to part b.  Its risky to try not to.  I got away with it for a few years before I was 65, but realized that my age 65 was the last time I could opt out and not suffer a penalty.  

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Great info Broncovet-

I pay a 50$ annual co pay for the one  prescription med I take, but -if I chose Meds by mail- I will pay nothing for the med. My husband had a medication error 2 weeks before he died- Meds by mail- so I would rather pay the 50 bucks.

I used to get a few bills from hospital tests many years ago when I first went on CHAMPVA and paid them right away but then they (th hosps) would refund my money- as CHAMPVA kicked in-

these days it goes far smoother.No bills.

I did end up paying 4 bucks after my eye surgery-when we left the hosp after the first surgery I asked my daughter to pull in to the first pharmacy she saw because I didnt think the eye drop bottle could possible hold enough eye drops-and I got a refill - but it did hold enough eye drop antbiotic.

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forgot to add, Glen Johnson, CHAMPVA, has been a great Radio show guest here for years- he always gives out his contact info for anyone with questions- and also the CHAMPVA booklet you get annually has other contact info. You will get a real person ,if yu need to call them , who knows what they are doing......no Peggys at CHAMPVA.

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Thanks for all the info I’m looking into this mostly for my wife and two kids...

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