Medicare Questions Answered – AUSA Benefits

This webinar, hosted by Susan Rubel from the Association of the United States Army (AUSA), focused on demystifying Medicare, especially for veterans and military families approaching or managing Medicare eligibility. The session was conducted by Medicare Mentors LLC founders, Pam and Rich Lewis, who bring personal military family experience and professional expertise in Medicare education and insurance. The presentation emphasized education, advocacy, and relationship-based service rather than transactional insurance sales.

Key Insights and Core Concepts

• Medicare Parts Overview:
  • Part A (Hospital Insurance): Covers hospital stays, skilled nursing facilities, and related services.
  • Part B (Medical Insurance): Covers doctors, outpatient care, physical therapy, and has a monthly premium (~$200+), a new cost for many military beneficiaries.
  • Part C (Medicare Advantage): Private plans that combine Parts A and B, often with $0 premiums, additional benefits, and administered by insurance companies contracted with Medicare.
  • Part D (Prescription Drug Coverage): Optional standalone plans or part of Medicare Advantage plans, essential for those without other credible drug coverage.
• Medicare Advantage Plans (Part C) Benefits:
  • Typically $0 monthly premiums due to government payments to insurers.
  • Reduced or no deductibles; many use co-pays instead of co-insurance.
  • Possible Part B premium “give back” programs that offset the Part B premium.
  • Added benefits not covered by Original Medicare, such as dental, vision, hearing, caregiver support, and fitness memberships.
• Military and Veteran-Specific Medicare Considerations:
  • Tricare for Life (TFL): Acts as a supplement to Original Medicare, often making traditional Medicare supplements unnecessary and an avoidable expense.
  • Veterans with TFL or Champ VA often do not need Medicare Supplements because these programs serve as secondary payers to Medicare.
  • Medicare Advantage plans can provide additional benefits and options alongside VA or TFL healthcare, including:
    • Greater access to care.
    • Reduced out-of-pocket costs (e.g., for second opinions).
    • Stability of coverage for a full calendar year, unlike VA coverage which may change based on policy or Congressional decisions.
  • Co-pays under Medicare Advantage are typically covered by TFL, resulting in no direct cost to the beneficiary.
• VA Healthcare and Medicare:
  • VA healthcare is a healthcare system, not insurance, and runs parallel to Medicare.
  • Beneficiaries may selectively use VA services and supplement with Medicare or Medicare Advantage coverage for additional benefits or options.
  • Medicare Advantage plans complement VA care by offering access to non-VA providers and services.
• Champ VA Program:
  • Provides health coverage for qualifying family members of veterans, especially spouses of 100% service-connected disabled veterans.
  • Acts as a secondary payer to Medicare.
  • Includes a mail-order pharmacy benefit (“Meds by Mail”), which influences the choice of Medicare drug coverage.
  • Supports out-of-network cost savings when combined with certain Medicare Advantage plans.
• Medicare Supplements (Medigap):
  • Generally unnecessary for those with TFL or Champ VA.
  • Available for others with Original Medicare to cover deductibles and co-insurance.
  • Premiums often increase annually and can be costly.
  • Various plans exist, identified by letters, with differing coverage levels.

Background and Mission of Medicare Mentors

• Founders’ Military Connection:
  • Rich Lewis is a retired Army veteran whose personal family experience highlighted the confusion and unnecessary expenses related to Medicare supplements when combined with TFL.
  • Pam Lewis has been a licensed insurance agent since the late 1990s, focusing on Medicare education and client relationships rather than sales alone.
• Medicare Mentors’ Mission:
  • To deliver no-cost, relationship-based education and services.
  • To ensure every Medicare-eligible person understands their options to optimize coverage and benefits.
  • To advocate for clients not only in the present but for their future healthcare needs.
  • The team includes over 50 agents nationwide, many with military or veteran backgrounds, emphasizing a community-centered and empathetic approach.
  • Supported by SparkCC, a back-office concierge team that helps resolve client issues like billing errors efficiently.

Summary Table: Medicare Parts and Coverage

Important Considerations for Military/Veteran Families

• Avoid unnecessary Medicare Supplements if you have Tricare for Life or Champ VA.
• Consider Medicare Advantage plans for added benefits and potential cost savings.
• Assess personal health needs and preferences; there is no one-size-fits-all solution.
• Utilize personalized needs assessments provided by Medicare Mentors to tailor coverage.
• Medicare Mentors emphasizes long-term relationships and ongoing support rather than one-time enrollment.

Conclusion

The Medicare Mentors webinar provided a clear, veteran-focused overview of Medicare options, emphasizing education and advocacy. The presenters highlighted the complexities of integrating Medicare with military healthcare benefits such as Tricare for Life and Champ VA, advising careful evaluation of supplemental plans and Medicare Advantage options. Their mission centers on empowering beneficiaries with knowledge and ongoing support to make the best-informed decisions for their healthcare coverage.

For personalized assistance, the Medicare Mentors team offers no-cost consultations aligned by zip code and supported by a dedicated back-office team to resolve issues promptly.