Medicare & ChampVA as supplement

[Yogi___Boo]

My DH was just awarded 100% P & T from the VA. One of the benefits is ChampVA for me. Of all the things I've read about it, I can't seem to find a simple answer to this: I currently have regular Medicare and a supplement from Mutual of Omaha at a cost of $175/mo. Has anyone dropped their supplement and replaced it with ChampVA? If so, is there a monthly cost involved? Are you happy with the results of that combination?

I certainly don't want to do something foolish just to save a few dollars, but not having to pay for a drug plan or meds anymore and not paying for Mutual of Omaha is tempting.

[garmp]

I also am 100% P&T and my DW is enrolled in the Champs program. To us it has been a God Send! DW is asthmatic with several complications. The way we use Champs is to collect her medication bills and turn them in to Champs twice a year. Being on Medicare, in mid-April she reached the do-nut hole. Champs reimbursed us to the dollar. Haven't used it for the Dr.s, but till now they have only been bi-yearly, but the maintenance medication is the expense.

[bsinmich]

donn0128 wrote:
DW has a suppliment that costs her 41 dollars a month. You MO plan must be really extensive. The problem with the VA is sadly the system is really overloaded and under staffed. I think you would be better served to go shopping for a more afordable plan.

There is a lot more to pricing than just price. From the fact she has had no out of pocket costs she probably has a plan F. I live in Holland, MI (W. side of Mich) and sell med supp. ins. The premiums for Detroit are almost double this side of the state.

[Yogi___Boo]

Retired & Loveit, that is what I was thinking also. Keep the supplement on DH, but drop mine. I am checking with our dentist today to see if they accept any dental plans. I guess it's little steps for some big decisions.

[Retired_andLove]

I have been 100% for some time now. I carry a supplement on myself but the wife does not. Typically anything not covered by Medicare is covered by Champ VA. The only thing that we have had to pay would be a deductible for medication. I though carry a supplemental policy on myself.

[sdianel_-acct_c]

I sent you a private message.

[Yogi___Boo]

Thanks for the info about dental! We haven't received the large packet with all the info in it. VSO said 2-3 weeks before it gets here. We did print from eBenefits the letter for the state that waives real estate taxes and personal property taxes, and have in fact already filed it.

I will check out dental coverage...

[Yogi___Boo]

Coverages are similar is what I found also. The VSO recommended that if I was happy with Medicare and Mutual I should probably just ignore ChampVA. As I said, it's tempting, but in 5 years with that combo, I've had 2 hospitalizations for heart issues and a knee replacement with absolutely NO OOP costs.

Typical of governments, they sometimes make it difficult to understand.

[sdianel_-acct_c]

We thank your DH for his service! I have Medicare as primary and ChampVA as secondary. ChampVA pays what Medicare doesn't. I rarely have to pay anything except prescriptions. I don't have a Medicare prescription policy since ChampVA pays 75% of prescriptions and I don't have that many prescriptions to fill. I just pay 25% for prescriptions. I have used the Medicare-ChampVA insurance at several clinics across the US with no problems. Most doctors that accept TriCare accept ChampVA. Not all Medicare doctors accept ChampVA so you do have to ask or check the ChampVA website for provider info. My primary doctor accepts both. There are no premiums for ChampVA. You can also get low cost Dental coverage through the VA. http://www.va.gov/healthbenefits/vadip/

[CarnationSailor]

My wife and I have Medicare as our primary insurance and Tricare for Life as our secondary insurance. We have no need for any supplemental insurance coverage. We pay the Medicare monthly premium for Part B, the Medicare and Tricare annual deductibles, and a minimal or no pharmacy copayment depending on the drug. We basically don't pay any co-payments for medical care because the Medicare co-payments are covered by Tricare.

I tried to research the coverage differences between Tricare for Life and ChampVA and all I could find was "coverages are similar" and most doctors that accept Tricare will also accept ChampVA. So you don't have to give up your "private doctors" by going with ChampVA.

I hope someone with Medicare/ChampVA responds to your post, but if not, my advice to you is to carefully consider this combination. Our "similar" combination of Medicare and Tricare has been very good for us.

[darsben]

With CHAMPVA as you say your meds are paid for. The only thing is paying the deductible each year for medicare Part A&B

Part B deductible $147 per year.

Part A hospital inpatient deductible

You pay:

$1,260 deductible for each benefit period
Days 1-60: $0 coinsurance for each benefit period
Days 61-90: $315 coinsurance per day of each benefit period
Days 91 and beyond: $630 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
Beyond lifetime reserve days: all costs.
SO If you plan to give up your private doctors and rely on the VA chamva doctors then fine drop it.
If you want to keep your private MD's shop for a basic supplement to pick up your deductibles as your doc may not accept CHAMPVA.



I AM A VA EMPLOYEE RETIRED.

EIDT EDIT EDIT> If you are on medicare and have CHAMVA you cannot repeat cannot use the VA facilities as medicare will not pay. I remembered and looked it up

http://www.va.gov/PURCHASEDCARE/programs/dependents/champva/CHAMPVA_faq.asp#Q3

Lots of good basic info at above
and at

http://va.gov/PURCHASEDCARE/docs/pubfiles/programguides/champva_guide.pdf

[donn0128]

DW has a suppliment that costs her 41 dollars a month. You MO plan must be really extensive. The problem with the VA is sadly the system is really overloaded and under staffed. I think you would be better served to go shopping for a more afordable plan.