Information for Veterans About the New Medicare Prescription Drug Benefits
On January 1, 2006, Medicare prescription drug coverage (Medicare Part D) became available to everyone with Medicare Part A or B coverage. Veterans enrolled in the VA health care system may choose to enroll in Medicare Part D in addition to their VA benefits. The Medicare prescription drug coverage is wholly voluntary on the part of the participant. Each individual must decide whether to participate based on his or her own circumstances.
- You must decide whether to enroll in a Medicare Part D plan based on your own situation.
- Your VA prescription drug coverage will not change based on your decision to participate in Medicare Part D.
- VA prescription drug coverage is considered by Medicare to be at least as good as Medicare Part D coverage (“creditable coverage”).
- If your spouse is covered by Medicare, he or she must decide whether to enroll in a Medicare Part D plan regardless of your decision to participate.
Most entities that currently provide prescription drug coverage to Medicare beneficiaries, including VA, must disclose whether the entity’s coverage is “creditable prescription drug coverage.”
- Enrollment in the VA health care system is creditable coverage. This means that VA prescription drug coverage is at least as good as the Medicare Part D coverage.
- Because they have creditable coverage, veterans enrolled in the VA health care program who choose not to enroll in a Medicare Part D plan when they are first eligible for Medicare Part D (“initial enrollment period”) will not have to pay a higher premium on a permanent basis (“late enrollment penalty”) if they enroll in a Medicare drug plan during a later enrollment period.
- However, if you disenroll in VA health care or if you lose your enrollment status through no fault of his/her own (such as an enrollment decision by VA that would further restrict access to certain Priority Groups), you may be subject to the late enrollment penalty unless you enroll in a Medicare Part D plan within 62 days of losing your VA coverage.
- If you are a veteran who is or who becomes a patient or inmate in an institution of another government agency (for example, a state veterans home, a state mental institution, a jail, or a corrections facility), you may not have creditable coverage from VA while in that institution. If you think this applies to you, please contact the institution where you reside, the VA Health Benefits Service Center at 877-222-VETS (8387), or your local VA medical facility.
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