Thomas Crisp Contributing Columnist
April 15, 2014
To qualify for Medicare, it involves how long you have worked and paid Social Security and Medicare taxes from your payroll check. One has to work only 10 years or 40 quarters to qualify for Medicare Part A at no cost. You have to enroll in Part B which has a premium of $104.90/monthly for 2014 this year. Being a Veteran and using a VA facility does not disqualify anyone from enrolling in and using Medicare. In fact, VA encourages Veterans to enroll in Part B, the medical/doctor part of Medicare. Granted you do not need Part B to receive medical care from the VA, but if you go outside of the VA for any medical treatment you do need Part B. For example, you might be ambulanced to another hospital that is not a VA facility for a medical emergency or you may need to go to a cancer center like MD Anderson for treatment where you will have to pay 100 percent of the medical charges without Part B.
For care not received at the VA Part B covers 80 percent of the cost of all of your outpatient needs, doctor services such as office visits and even surgery, MRIs, chemotherapy and the list can go on. Without Medicare Part B, a veteran’s liability could be in the thousands or hundreds of thousands of dollars. Those who do not enroll in Part B when they are first eligible for Medicare and not working, must pay a “late enrollment” penalty of 10 percent for each full 12-month period that they could have had Part B, but did not sign up for it. For example, if you waited 55 months which is four full 12-month periods, then the Part B penalty is an additional 40 percent added to the current Part B premium ($164.50 monthly for 2014) for as long as you have Medicare. Not enrolling in Part D (Medicare Prescription Drug plan) is another story. Medicare considers the VA credible coverage and when you enroll in Part D at a later date, you do not get the late enrollment penalty and … guess what …no Part D donut hole!
The Department of Veterans Affairs (VA) is eliminating the annual requirement for most Veterans enrolled in VA’s health care system to report income information beginning in March 2014. Instead, VA will automatically match income information obtained from the Internal Revenue Service and Social Security Administration. “Eliminating the requirement for annual income reporting makes our health care benefits easier for Veterans to obtain,” said Secretary of Veterans Affairs Eric K. Shinseki. “This change will reduce the burden on Veterans, improve customer service and make it much easier for Veterans to keep their health care eligibility up-to-date.” Some Veterans applying for enrollment for the first time are still required to submit income information.
There is no change in VA’s long-standing policy to provide no-cost care to indigent Veterans, Veterans with catastrophic medical conditions, Veterans with a disability rating of 50 percent or higher, or for conditions that are officially rated as “service-connected.” VA encourages Veterans to continue to use the health benefits renewal form to report changes in their personal information, such as address, phone numbers, dependents, next of kin, income and health insurance. For more information, visit www.va.gov/healthbenefits/cost or call VA toll-free at 1-877-222-VETS (8387).
Veterans and active-duty military personnel with service-connected amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease, are now presumed medically eligible for grants up to almost $68,000 to adapt their homes, the Department of Veterans Affairs (VA) announced today. “VA is committed to eliminating barriers that keep Veterans and Service members from the benefits they have earned,” said Secretary of Veterans Affairs Eric K. Shinseki. “This change will make it easier for some of our most severely impaired Veterans to receive speedy assistance adapting their homes to their unique needs. ” The change affects recipients of VA’s specially adapted housing grants, which helps pay for the costs for building, buying or adapting a home, up to a maximum of $67,555.
Under the change, Veterans and Service members with service-connected ALS will be determined medically eligible for the maximum grant. The program provides grants to eligible service-connected disabled Veterans and Servicemembers to construct or modify a home to meet their unique housing needs. Grants are also available to help eligible individuals purchase adapted homes or pay down mortgages on homes that are already adapted. VA estimates this change will save approximately 12 months in the overall process of a Specially Adapted Housing (SAH) grant.
“This change automates and shortens our SAH grant delivery process for Veterans and Service members living with ALS,’ said Under Secretary for Benefits Allison A. Hickey “SAH is an important benefit giving beneficiaries the ability to adapt their homes and create a barrier free living environment- expanding their independence in their own homes.”
In 2008, VA established a presumption of service connection for ALS for any Veteran who develops the disease at any time after separation from service, making them eligible for monthly VA disability compensation benefits. VA amended its disability rating scale in January 2012, to assign a I 00-percent disability evaluation for any Veteran who has service-connected ALS. ALS is a rapidly progressive, totally debilitating, and irreversible motor neuron disease that results in muscle weakness leading to a wide range of serious disabilities, including impaired mobility.
VA adapted its rules so Veterans with service-connected ALS no longer have to file multiple claims with VA for increased benefits as their condition progresses. Prior to the new SAH regulatory change, many Veterans and Service members who were rated by VA for service connected ALS, but who did not yet have symptoms debilitating enough to affect their mobility to the degree required for SAH grant eligibility, were unable to begin the process of modifying their homes to accommodate their often rapidly progressing conditions.
VA’s SAH program provides grants to eligible service-connected disabled Veterans and Service members for the purpose of constructing or modifying a home to meet their unique housing needs. The ultimate goal of the program is to provide a barrier-free living environment that affords a level of independent living that the Veteran or Service member may not otherwise enjoy. Visit http://benefits.va.gov/homeloans/adaptedhousing.asp for more information.