Information for Veterans About the Medicare Prescription Drug Plans (Medicare Part D)
The Department of Veterans Affairs (VA) administers the nation’s largest health care system. Many of the veterans enrolled in the VA health care system are also eligible for coverage by Medicare. With the advent of Medicare’s new prescription drug program (Medicare Part D), VA offers the following information about this new program and its impact on veterans.
Starting January 1, 2006, prescription drug coverage will be available to everyone with Medicare through Medicare prescription drug plans. All Medicare prescription drug plans will provide at least a standard level of coverage set by Medicare. Some plans might also offer more coverage for a higher monthly premium. VA has determined that its prescription drug coverage for veterans enrolled in the VA health care program is at least as good as the standard Medicare prescription drug coverage benefit, meaning that enrollment in VA health care provides veterans with “creditable coverage” for Medicare Part D purposes.
Veterans with Medicare can enroll in a Medicare prescription drug plan from November 15, 2005 through May 15, 2006. After that an annual enrollment period will be available each year, beginning in 2006, from November 15th through December 31st. Although some people who choose to enroll later may be subject to a penalty, veterans enrolled in the VA health care system can be assured that they can choose to delay enrolling in Medicare Part D until later enrollment periods without penalty because VA enrollment provides “creditable coverage.”
Veterans should remember that in addition to prescription drugs, VA’s Medical Benefits Package provides a full range of health care benefits. Veterans will still be eligible to receive all current health and prescription drug benefits if they choose to enroll in a Medicare prescription drug plan. Veterans do not have to choose between VA coverage and a Medicare prescription drug plan; they may participate in either or both. However, if a veteran decides to enroll in a Medicare prescription drug plan and disenroll from VA, he or she may not be able to re-enroll later if VA is not enrolling all priority groups.
If VA takes some action that causes a veteran to lose VA coverage (e.g., VA makes an enrollment decision that would further restrict access to certain Priority Groups), affected veterans can enroll in a Medicare prescription drug plan, without penalty, within 62 days of the end of VA coverage. Enrollment in the Medicare Part D program must be applied for within the 62 day time limit to avoid the penalty.
In addition, 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), may not have creditable coverage from VA while in that institution. Veterans who are unsure whether this may apply to them should contact the institution where they reside, the VA Health Benefits Service Center at 877-222-VETS (8387), or their local VA medical facility.
Individuals with limited income and resources may be eligible for extra help paying for a Medicare prescription drug plan. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.socialsecurity.gov, or call them at 800-772-1213 (TTY 800-325-0778).
This information is about coverage for veterans under the VA health care benefits. For information on how the Medicare prescription drug program may affect survivors and dependents of veterans eligible for benefits under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), please call 800-733-8387 or visit http://www.va.gov/hac/forbeneficiaries/.
Additional Link Resources:
Federal Benefits for Veterans and Dependents
VA National Means Test Income Threshold |
GMT Income Threshold
Viewers, Plug-Ins, & Readers |
VA Health Care Eligibility & Enrollment Site Map
For questions about Health Care Eligibility, please visit the VA inquiry website.
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