Four Ways Medicare Advantage Plans Complement VA Benefits


With one in every five people¹ who are eligible for Medicare being a Veteran, Agents should understand how Humana’s Medicare Advantage (MA) plans can complement Veteran Affairs (VA) and Medicare benefits.² Whether a Veteran needs expanded coverage or wants additional benefits, Humana’s MA plans can help. The VA recommends all Veterans enroll in Medicare no matter their type or level of government Veteran benefits since Congressional funding can fluctuate.²

1. Additional Coverage

Congress designed VA benefits to care for those who have honorably served the nation. While these benefits cover many medical services, they don’t cover everything, much like Original Medicare. Two main coverage gaps in VA benefits include emergency care and dental care.

VA and Emergency Care

While Veterans do not need to contact the VA before seeking emergency care, they do need to notify the VA within 72 hours of admission. For non-service-related emergency care to be covered by the VA, Veterans have to meet all of the eight requirements³, not just a few. Having an MA plan opens up additional care options for Veterans while mitigating financial risk of admissions that are not covered.

MA and Emergency Care

Humana’s MA plans help to free Veterans from the complexities of VA emergency care. With a broad network, MA plans enable Veterans to seek care that may be more convenient with less financial risk. Most Humana plans also include urgent care access.

Medicare, VA and Dental Care

Medicare will not cover most dental care such as cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. The VA offers dental care only to qualifying Veterans based on service history, current health and financial situation and benefit class. Yet maintaining good oral health is important for overall health from good nutrition to communication to self-esteem.Poor oral health is associated with chronic diseases such as diabetes and heart disease.5 Most oral-health conditions are largely preventable and can be treated in early stages.6

Humana MA and Dental Care

Many Humana MA plans include dental coverage. Humana’s Honor plans provide robust dental coverage not only for regular cleanings but also for more involved procedures like crowns and dentures. With dental insurance, Veterans can rest easier knowing their out-of-pocket costs could be lower and therefore more manageable.

2. Expanded Network

While the VA is the nation’s largest integrated healthcare system,7 Veterans may be inconvenienced by either wait times8 or travel distance, especially in the western half of the country.9 The Mission Act opened up additional private-sector care possibilities, but Veterans could still need more options depending on their health needs. Humana’s MA plans offer more access to providers, including those with value-based care models, which are more similar to VA healthcare with their coordinated care teams than traditional fee-for-service providers.

3. Additional Benefits

Many MA plans offer additional supplemental benefits for health and wellness such as vision and hearing, SilverSneakers® and OTC allowances for select products. These supplemental benefits put the whole Veteran, body and mind, front and center. As Alan Wheatley, president, Retail Segment at Humana, said “Humana’s plans reinforce our ongoing commitment to support the total care our Veterans need, not just in the doctor’s office.”

4. Potential Savings

Humana’s MA plans could mean more savings for Veterans. More than 40 percent of Humana’s plans have a $0 premium across markets, including the Honor plans. Humana now has 70 Part B Giveback plans for 2020, including 16 of the 17 Honor plans.10 With increased dental coverage, Veterans might have fewer financial liabilities. Moreover, MA plans help cap total expenses with maximum annual out-of-pocket limits.

Your Mission to Serve Veterans

Now that you know how Humana’s MA plans can help increase access to healthcare and reduce costs for Veterans, make it your mission to educate Veterans about their healthcare options. Be a life-long champion of their health by confirming your commitment to them.

If you need more training, be sure to register for the Veteran Healthcare Training webinar and check out our new suite of Veteran resources. Attend one of the virtual Veteran Roadshow events to connect with local support. Peruse MarketPoint University for modules and courses. Finally, leverage the Veteran-facing sales and marketing materials on the Marketing Resource Center.

 

1National Center for Veterans Analysis and Statistics population model.

2The VA recommends all Veterans enroll in Medicare no matter their type or level of government Veteran benefits since Congressional funding can fluctuate.

3The episode of care cannot be paid under another VA authority, and based on an average knowledge of health and medicine (prudent layperson standard), it could be reasonably expected that a delay in seeking immediate medical attention would have been hazardous to the Veteran’s life or health, and a VA or other Federal facility/provider was not feasibly available, and the Veteran received VA medical care within a 24-month period preceding the non-VA emergency care, and Veteran is financially liable to the healthcare provider for the emergency care, and the services were furnished by an emergency department or similar facility that provides emergency care to the general public, and Veteran has no other coverage under a health plan (Medicare, Medicaid, or Worker’s Compensation) and Veteran has no contractual or legal recourse against a third party that would, in whole, extinguish Veteran’s liability.

4 https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Oral-Health

5 https://www.cdc.gov/oralhealth/basics/index.html

6 https://www.who.int/news-room/fact-sheets/detail/oral-health

7 https://www.va.gov/health/FindCare.asp

8 https://www.usatoday.com/in-depth/news/investigations/2019/02/07/where-every-va-hospital-lags-leads-other-care/2511739002/

9 https://www.fastcompany.com/90355253/veteran-population-map-shows-unequal-access-to-va-healthcare

10 https://firstlook.humana.com/WhyHumana.aspx