Jeffrey Wade
Virginia Premier is a health insurance provider that offers plans and services to members in over 100 counties across Virginia. It was previously known as a regional Medicaid insurance provider, but has since expanded its offerings to include Medicare Advantage plans. The company has been in operation for over 20 years and has recently undergone a rebrand, changing its name to Sentara Health Plans to reflect its growth and commitment to innovation in the healthcare industry. Virginia Premier's Medicare Advantage Elite (HMO SNP) plan is a dual-eligible plan that offers benefits and services designed for individuals with both Medicare and Medicaid coverage. This plan provides additional benefits not typically covered by Medicare or Medicaid, such as inpatient hospital care, outpatient services, prescription drugs, and more. While VA health care benefits can be used alongside other forms of health care coverage, including Medicare and Medicaid, it is important to understand how these programs work together to make informed enrollment decisions.
| Characteristics | Values |
|---|---|
| Type of Insurance | Medicaid and Medicare |
| Parent Company | VCU Health |
| Year of Launch | 1995 |
| Year of Rebranding | 2023 |
| New Name | Sentara Health Plans |
| Number of Members | 220,000+ |
| Area of Operation | Virginia |
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What You'll Learn
- Virginia Premier is a regional Medicaid insurance provider
- VA health care benefits can be used with other plans, including Medicare
- Medicare Part B covers doctors and outpatient services
- Medicare Part A covers inpatient care, nursing facility care, home health care, and hospice care
- VA coverage is only applicable to healthcare services received at a VA facility
Virginia Premier is a regional Medicaid insurance provider
Virginia Premier's services extend to members in over 100 counties across Virginia, and its membership base has doubled in the past 10 years. The company strives to simplify the health insurance experience for its employees, providers, and members. It is the first and only university-based, non-profit managed care organization in the state.
Virginia Premier has undergone a recent rebrand, unifying with Optima Health under the Sentara Health Plans brand. This evolution represents the company's growth and commitment to innovation and adaptability in the healthcare industry. The new brand identity aims to strengthen its connection with its parent company, VCU Health, and increase awareness and credibility.
Virginia Premier, now known as Sentara Health Plans, continues to serve the Virginia community with the same dedication and commitment. The company works closely with its members to coordinate Medicare and Medicaid services, ensuring they receive the focused care and support they need to manage their health effectively.
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VA health care benefits can be used with other plans, including Medicare
However, it is important to note that VA benefits and Medicare do not typically work together. For VA coverage to apply, you generally need to receive health care services at a VA facility. Similarly, for Medicare to cover your care, you must receive services at a Medicare-certified facility.
If you receive pre-authorization to get services in a non-VA hospital or other care setting, Medicare may pay for other services you need during your stay. Additionally, if the VA authorizes services in a non-VA hospital but does not pay for all the services, Medicare may pay for the Medicare-covered services that the VA does not.
If you have Medicare Part D, you can use it to obtain medications from non-VA doctors and fill prescriptions at your local pharmacy instead of through the VA mail-order service. Enrolling in Medicare Part B provides similar flexibility, allowing you to seek healthcare outside the VA system.
It is recommended to sign up for Medicare as soon as possible, as funding for VA health care may change in the future. Additionally, delaying Medicare Part B enrollment may result in penalties and a longer wait time for coverage.
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Medicare Part B covers doctors and outpatient services
Medicare Part B, also known as medical insurance, covers medically necessary doctors' services and outpatient services. It also covers preventive care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services.
Medicare Part B is an important option for veterans who wish to seek healthcare outside the VA system. While VA health care benefits can be used alongside other forms of health care coverage, such as private insurance plans, Medicare, and Medicaid, VA coverage typically applies only to healthcare services received at VA facilities. Thus, enrolling in Medicare Part B provides veterans with the flexibility to seek healthcare from non-VA providers.
It is important to note that Medicare and VA coverage rarely work together. Medicare does not pay for any care received at a VA facility, and VA coverage generally requires individuals to receive healthcare services at VA facilities. However, in certain cases, Medicare may pay for services received during a stay at a non-VA location.
Veterans who choose not to enroll in Medicare Part B and rely solely on their VA coverage may face limitations in their healthcare options. If funding for VA health care changes or becomes insufficient, veterans in lower priority groups could lose their VA health care benefits. Therefore, enrolling in Medicare Part B can provide veterans with additional options and ensure they have access to healthcare outside the VA system if needed.
To summarize, Medicare Part B covers doctors and outpatient services, along with various other medically necessary and preventive services. For veterans, enrolling in Medicare Part B can be a valuable option to expand their healthcare choices beyond the VA system and ensure they have continuous access to healthcare services.
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Medicare Part A covers inpatient care, nursing facility care, home health care, and hospice care
Medicare is federal health insurance for anyone aged 65 and older and some people under 65 with certain disabilities or conditions. On the other hand, Medicaid is a joint federal and state program that provides health coverage for certain low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Virginia Premier was previously known as a regional Medicaid insurance provider. The company has been around for over 20 years and is the first and only university-based, non-profit managed care organization in the state. Its plans and services extend to members in over 100 counties across Virginia.
Medicare Part A, also known as hospital insurance, covers inpatient care, nursing facility care, home health care, and hospice care. Inpatient care is covered in hospitals, critical access hospitals, and skilled nursing facilities. Hospice care is also covered, including inpatient respite care. However, Medicare does not cover room and board for hospice care received at home or in a nursing home or inpatient facility.
If you have other forms of health care coverage, such as private insurance, Medicare, Medicaid, or TRICARE, you can use VA health care benefits alongside these plans. VA health care benefits can be especially useful for covering health care services and items not covered by Medicare, such as over-the-counter medications, annual physical exams, and hearing aids.
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$6.23 $14.99
VA coverage is only applicable to healthcare services received at a VA facility
Virginia Premier was previously known as a regional Medicaid insurance provider. However, it has rebranded itself and is now known as Sentara Health Plans. It is the first and only university-based, non-profit managed care organisation in Virginia, with services extending to members in over 100 counties across the state.
Virginia Premier has been supporting the Virginia community for over 20 years and currently serves over 220,000 Medicaid members statewide. In 2016, they launched the Medicare Advantage Elite (HMO SNP) plan, a dual Medicare and Medicaid-eligible plan. This plan offers benefits not covered by either Medicare or Medicaid, including inpatient hospital care, outpatient care, skilled nursing facility care, home health care, and prescription drugs.
On the other hand, VA coverage refers to health benefits provided by the Department of Veterans Affairs. VA coverage can be used alongside other forms of health care coverage, such as private insurance plans, Medicare, Medicaid, or TRICARE. However, it is important to note that VA coverage is only applicable to healthcare services received at a VA facility or a non-VA location pre-authorized by the VA. If you choose to keep only your VA coverage and not enroll in Medicare, you will not have health insurance coverage for facilities outside the VA health system.
Medicare Part B, for example, covers doctors' services, preventive care, hospital outpatient care, and other medically necessary services. Enrolling in Medicare Part B provides flexibility to receive healthcare outside the VA system. Additionally, Medicare Part D covers prescription drugs, allowing individuals to fill prescriptions at local pharmacies instead of through the VA mail-order service.
In summary, while VA coverage can be used with other insurance plans, it is limited to healthcare services received at VA facilities or pre-authorized non-VA locations. Choosing to forgo Medicare and solely rely on VA coverage may result in a lack of health insurance coverage outside the VA health system. Therefore, it is essential to consider your healthcare needs and the coverage provided by each plan when making enrollment decisions.
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Frequently asked questions
Virginia Premier Insurance is a non-profit health insurance provider based in Virginia. It has been around for over 20 years and currently serves over 220,000 members across the state.
Virginia Premier Insurance offers both Medicare and Medicaid plans. It launched its Medicare Advantage Elite (HMO SNP) plan in 2016, which is a dual Medicare/Medicaid-eligible plan.
VA stands for Veterans Affairs.
Yes, you can have both VA and Medicare coverage. However, they rarely work together. For VA coverage to apply, you generally need to receive healthcare services at a VA facility. Medicare does not pay for any care received at a VA facility.
