Health Insurance


I'm coming up on 65 pretty soon and was wondering do you have a choice on taking Medicare Part A&B or not? I'm 100% P&T and the wife has Champ VA. I also have Blue Cross Blue Shield. I'm wondering if I should drop that and just take Medicare A&B? Thanks.


Jim's Reply:

As we get older health insurance becomes more complex. It also becomes a very personal choice where we must weigh risk/expense against benefit and our own comfort level with being over-insured (paying way too much in wasted premiums) or under-insured (willing and able to risk big out of pocket expenses).

Much of the decision must be based on what's available where you live. If you're within a short ride to a VA hospital and you're happy with your care, you're done. You won't need to spend money on other insurance. If you're like me and live a 3 hour trip from a VA hospital, then you'll have to look at alternatives.

You don't have any choice but to accept Medicare Part A when you begin to take your Social Security Retirement money. Part B is elective and if you don't take it the first opportunity, each year you delay will cost you more. The veteran who is 100% P & T rated and who is Medicare eligible is wasting money on private insurance. If you have BC/BS or similar, every provider wants to bill that because it pays the most...but you lose over the long haul.

I'm in a small community with a small, well equipped and staffed hospital (8 minutes from my house) that is a part of a larger system in a nearby city. My VA clinic is over an hour away, my VA hospital is almost 3 hours away. I see my VA primary care physician once or twice each year. My civilian primary care provider is about 5 minutes from home and I use Part B to pay for those visits.All that may become more frequent with the expanding use of telehealth. I use Medicare A & B for my local civilian care and I've found the Part B (outpatient) copays are affordable since my care has been routine, not acute. Part A (inpatient acute care) can become very expensive w/o a supplemental policy.

A relatively new option that I'm using is the VA Community Care Program. This new program allows civilian care in your region to be paid for in full by VA. It's a bit cumbersome with a lot of administrative approvals and re-approvals required but once you are in the program, it works well.

To add to the complexity, you are authorized to use a lot of urgent care clinics and they are everywhere!  You'll need to print your authorization and take it with you but this is a great way to get vaccinations, take care of colds and sore throats and so on.

There are new rules in place for using civilian emergency care facilities. These are the things you should think about now and discuss with your family way before the need arises. If you're unconscious, how will you explain all this to the EMTs when you'd rather go one facility than another?

Putting a little thought into it now will save you a lot of money and worry in the future. Good luck.