Ask Rusty – I Have VA Coverage; Should I Get Medicare Part B?

Dear Rusty: I am a 74 year old veteran enrolled with the VA. I have never had Medicare Part B. Should I? My only source of income is Social Security.

Signed: Retired Veteran

Dear Retired Veteran: First, thank you for your service to our country. Like you, I use the VA for certain healthcare needs but, unlike you, I am also enrolled in Medicare Part B. The decision on whether to have both is a personal choice only you can make, but I’ll give you some things to consider: 

If you are 100 percent satisfied with your VA coverage, and if that coverage is conveniently available to you, and if the VA provides all the health care you will ever need wherever you happen to be, then enrolling in Medicare Part B may not be needed in your personal situation. For me, the nearest full service VA facility is about 40 miles away, while just about every imaginable private healthcare service is nearby. Thus, for convenience reasons, I am enrolled in Part B so I can use any doctor or medical service provider I want within just a few miles of my home. I also travel a fair amount, and I like the convenience and flexibility of using any healthcare provider I happen to be near, without worrying about finding a VA facility or VA-affiliated private provider. So, for me, it all comes down to convenience and flexibility to use any healthcare provider I want. I use my VA coverage when it’s convenient for me, but otherwise use non-VA providers. But your needs may be different. 

Your choice may especially be different since your only source of income is Social Security. There is a premium associated with Medicare Part B ($170.10 per month for 2022) which would be taken from your Social Security payment, thus reducing it. That may create a financial issue for you, which is obviously an important consideration when deciding if you should also enroll in Part B to supplement your VA coverage. But there’s yet another concern if you enroll in Part B now. 

Since you’re 74 and have relied solely on the VA for your healthcare needs since turning 65, you’ll be subject to a Late Enrollment Penalty if you enroll in Part B now, and that penalty may make Part B even more unaffordable for you. Your VA health care coverage isn’t considered a “creditable” alternative to Part B, which means that a Late Enrollment Penalty of 10% additional premium will be assessed for each full year you went without Part B coverage. For example, instead of the standard Part B premium of $170.10, your premium with the late enrollment penalty could be about $323 per month. And, unfortunately, that penalty lasts for as long as you are enrolled in Part B and will increase along with any increases to the Part B premium as time passes. 

For your awareness, if Social Security is your only source of income, you may be eligible for your state’s Medicare Savings Program which can assist you with paying Medicare premiums and copayments. If your income falls below the required thresholds you may be eligible for the Medicare Savings Program as described at this website: www.benefits.gov/benefit/4396.  

Finally, the AMAC Foundation has a repository of helpful information for America’s veterans, which you can browse at this link: www.amacfoundation.org/veteran-resources/.

This article is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the AMAC Foundation’s staff, trained and accredited by the National Social Security Association (NSSA). NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity. To submit a question, visit our website (amacfoundation.org/programs/social-security-advisory) or email us at [email protected].