Still Need Medicare Coverage?

[Bruce Fox]

I currently am covered under Medicare Part 1, 2 & 3 because I was told that the VA would not reimburse for ER visits and a lot of the things that a local hospital visit ER would entail.

I just read an article saying that they now have to pay for ALL non-VA emergency care.  ( https://www.nbcnews.com/news/veterans/court-rules-va-must-pay-veterans-emergency-room-care-decision-n1052131?fbclid=IwAR39i1ses23bqJuV3prHoeEi2Xi4Pa_xKmWkAnx2OmlVAw4DWiXnuFb0BrE ).

Do I still need to have Medicare insurance???   I don't want to pay an extra $135 per month I don't have to!

[ToxicSgt73]

Here is a different direction.

I became eligible for Medicare in 2013 as disabled, I choose the Advantage plan that was a PPO, that let me choose specialist doctors without going through a gatekeeper (primary doctor). It is a regional PPO, but also allows me to travel, and I can still get care covered additional to my research studies that I participate at Mayo Clinic which is 1k miles from home. I also choose this one because of the balance between deductibles and prescription cost. (I currently take 17 drugs a day).  At one time scripts costs was about 1k a month for one drug. 

I bought the most expensive Medicare Advantage Plan available in my area. When you look at the Advantage Plans,  choose the best one for your situation in the list that is available in your area. You choose base on what you anticipate your situation will be? More doctors? or more medicine? Hardly any of either? or in my case lots of both. If you have a stash of cash, that you can use to pay higher deductibles,  you can get a good Advantage Plan with no monthly premium. Do you travel? Would an HMO suit you? 

I have read that, some of the care I receive, VA will not provide for the disease I have. So, for this one reason, I will retain Medicare. Also, I take name brand drugs that are not on VA's formulary. 

And once you have experienced the treatment at a teaching facility like Mayo Rochester, where they will spend as much as a month, 8 hours a day, sending you from planning sessions, to multiple tests, then to another strategy session, then to more tests, all nonstop, for a month to arrive at a diagnosis, its hard to give up on, the future opportunity to repeat that process if it becomes necessary. 

For the last couple of years, my medical costs are almost approaching 60% of SSDI over and above covered costs. 

My main reason for exploring VA medical care and finally getting around to getting my SC claim in is to let VA share the wealth. 

I will need both. 

You may too. 

 

I am facing the age 65 transition in about six months.  I can do nothing or change anything about medicare just like it was the first time, is my understanding, more cognitive loading that I don't need. 

[paulstrgn]

As we can see, there is no perfect answer. It comes down to what do you need, does not matter what works for me or someone else. It has to work for you! JMO