CHAMPVA and MAPD?

[kennethbroyles]

This past AEP, I met "Dolly" a widow, who has CHAMPVA and had a PDP with a $320 ded. and quiet a few Rx's... just over limits for LIS. I remember comparing plans for the better MAPD for her Rx's and helped her enroll in HS's MAPD. She has just called and said she was told by CHAPVA to keep her Medicare and "they" will be secondary. I have talked to HS local Manager who confirmed HS will coordinate with CHAMPVA with a good Rx coverage. I told her we will meet 1-3-2012 and do what ever she chooses, but in my mind because all of her Dr's. are contracted and no cost for the MAPD she has a good plan for her circumstances. Has anyone else had any experience or thoughts on this? I know many of you dont like MAPD's but in my mind this is her best option for her budget.

Thanks in advance.

 

[Millwood]

She doesn't need a Medicare drug plan either. ChampVA covers her meds as well. No copay if she does mail order. An agent who doesnt know what he's doing can harm someone as bad as an dishonest one. Champ VA acts as her supplement so it benefits her in no way to take out a MA plan. No network, no provider list, any provider who takes Medicare if she stays on original Medicare and uses ChampVA like a supplement.

 

[shepnerd]

Newby question: What's CHAMP VA?

 

[senior-advisor-indiana]

Newby question: What's CHAMP VA?

CHAMPVA Overview | Military.com

 

[Chazm]

I ran across my first champ VA client this year and she hated it. She claimed that she had a deductible at the beginning of every year and had to pay 20% of everything else. Sounds like it just left her with Medicare co pays and deductibles

 

[senior-advisor-indiana]

I ran across my first champ VA client this year and she hated it. She claimed that she had a deductible at the beginning of every year and had to pay 20% of everything else. Sounds like it just left her with Medicare co pays and deductibles

Some people are never happy....

 

[jdeasy]

She doesn't need a Medicare drug plan either. ChampVA covers her meds as well. No copay if she does mail order. An agent who doesnt know what he's doing can harm someone as bad as an dishonest one. Champ VA acts as her supplement so it benefits her in no way to take out a MA plan. No network, no provider list, any provider who takes Medicare if she stays on original Medicare and uses ChampVA like a supplement.

It may be in a person's interest to have an MA plan over ChampVA. That is different than Tricare or even ChampUS.

I would agree that a Tricare for life person should never be moved to anythong. ChampVA and ChampUS need to be looked at individually at to what medical facilities are available and what the co-pays are.

 

[SportsNut]

I ran across my first champ VA client this year and she hated it. She claimed that she had a deductible at the beginning of every year and had to pay 20% of everything else. Sounds like it just left her with Medicare co pays and deductibles

Sounds like she was describing CHAMPVA for under age 65... 50 ded, plus 25% of medical care up to 3K oop max per yr. It appears that they encourage a recipient to have OHI... other health ins, which pays primary, then Chumps pays 2nd.ary... and then it would be more comprehensive. Also more comprehensive if treatment is received in a VA facility for under age 65.

As a med supp it looks pretty decent... pays for almost everything (except for that one recurring phrase: "You pay $ 0 in most cases"). Basically it looks pretty much like a cross between a Plan D & G... Some excess chgs included, not all. It also has Rx covg... @ 75% even w/o Part D... with Part D it should cover nearly everything on Rx.

Bottom line here, if you run into one of these with a Sup client, say good day Madam or Sir, and be on your way.
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It may be in a person's interest to have an MA plan over ChampVA. That is different than Tricare or even ChampUS.

I would agree that a Tricare for life person should never be moved to anythong. ChampVA and ChampUS need to be looked at individually at to what medical facilities are available and what the co-pays are.

Suggest you review pgs 47 & 48 of the actual attachment (pdf pg #'s 51 & 52), for coordination with M'care.

After doing so I think you will abandon your suggestion above. Co-pays, restriction on who you can see, etc, etc. Orig M'care and C'Va, with lowest cost Part D covg is superior.

See pg 47 & 48 HERE

 

[senior-advisor-indiana]

It may be in a person's interest to have an MA plan over ChampVA. That is different than Tricare or even ChampUS.

I would agree that a Tricare for life person should never be moved to anythong. ChampVA and ChampUS need to be looked at individually at to what medical facilities are available and what the co-pays are.

So are you suggesting boxers or briefs?

I don't think I have ever ran into someone on ChampVA. I was thinking of ChampUS.

 

[jdeasy]

So are you suggesting boxers or briefs?

I don't think I have ever ran into someone on ChampVA. I was thinking of ChampUS.

Yeah, I ain't the best secretary in the world.
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Sounds like she was describing CHAMPVA for under age 65... 50 ded, plus 25% of medical care up to 3K oop max per yr. It appears that they encourage a recipient to have OHI... other health ins, which pays primary, then Chumps pays 2nd.ary... and then it would be more comprehensive. Also more comprehensive if treatment is received in a VA facility for under age 65.

As a med supp it looks pretty decent... pays for almost everything (except for that one recurring phrase: "You pay $ 0 in most cases"). Basically it looks pretty much like a cross between a Plan D & G... Some excess chgs included, not all. It also has Rx covg... @ 75% even w/o Part D... with Part D it should cover nearly everything on Rx.

Bottom line here, if you run into one of these with a Sup client, say good day Madam or Sir, and be on your way.
- - - - - - - - - - - - - - - - - -


Suggest you review pgs 47 & 48 of the actual attachment (pdf pg #'s 51 & 52), for coordination with M'care.

After doing so I think you will abandon your suggestion above. Co-pays, restriction on who you can see, etc, etc. Orig M'care and C'Va, with lowest cost Part D covg is superior.

See pg 47 & 48 HERE

What I was saying is that it's not a hard and fast rule to not ever move them to an MA plan. Look at the situation as a whole and then decide what may be in their best interest. For me I don't sell MA plans, so it would have to be clearly better for me to tell them to contact an MA agent.