Medicare and VA Benefits

You can use your Veterans Affairs (VA) health care benefits along with Medicare. Enrolling in Medicare will not affect your VA benefits. If you have VA benefits, you are not required to enroll in Medicare when you turn 65, but the VA recommends Medicare enrollment to cover non-VA medical expenses.

Do You Need Medicare If You Have VA Benefits?

Having both VA benefits and Medicare increases your options for where and how you receive health care services.

VA benefits only cover health care you receive at a VA medical center, other VA location or a VA-approved facility. If you go to a non-VA authorized facility, Medicare may pay for health care you receive there.

Did You Know?
The U.S. Department of Veterans Affairs encourages veterans with VA benefits to sign up for Medicare as soon as they are eligible. Enrolling in Medicare will not affect your VA benefits. But having both increases your health care options and reduces your risk of unexpected health care expenses in the future.

You may also lose your VA benefits if Congress fails to provide enough money to pay for them in the future, according to the Department of Veterans Affairs website.

If you delay enrolling in Medicare and lose your VA coverage, you will have to pay a Medicare late enrollment penalty when you do sign up. The penalty for Medicare Part B medical insurance gets larger each year you delay and you’ll have to pay the larger fee for the rest of your life.

How Do VA Benefits Work with Medicare?

Medicare and VA benefits seldom work together. This is a major reason the VA recommends that veterans enroll in Original Medicare even if they have VA benefits.

In most cases, VA benefits and Medicare can’t pay for the same services. The VA pays for VA-authorized health care services or items while Medicare pays for Medicare-approved health care. You generally have to choose which to use.

There is no coordination of benefits between the two health care programs.

In some cases though, the VA can authorize health care services in a non-VA hospital. If the VA did not authorize all the medical care you received while there, Medicare may step in to pay for Medicare-approved services you received.

You may still have to pay for health care services that neither the VA nor Medicare cover.

Prescription Drug Coverage Through VA Benefits or Medicare Part D

If you have both VA and Medicare Part D prescription drug coverage, you have the option of using either to pay for your prescriptions.

VA drug coverage is usually less expensive than a Medicare Part D plan. As long as you have VA drug coverage, you can put off buying a Medicare Part D prescription drug plan without having to pay a penalty.

Things for Veterans to Consider About Medicare Part D Drug Coverage
  • If you use your VA prescription drug coverage, you have to use the VA’s mail-order pharmacy.
  • By going through Medicare Part D, you can get prescriptions from non-VA doctors and have them filled at your local retail pharmacy.
  • Medicare Part D may also pay for medications that the VA doesn’t cover.
  • If you ever lose VA coverage, you have two months to sign up for Medicare Part D before the late enrollment penalty kicks in.

If you have Original Medicare you may be able to find a Medicare Part D prescription drug plan with low or no monthly premiums.

Using Medigap or Medicare Advantage and VA Benefits

Medicare supplement insurance plans — also called Medigap — and Medicare Advantage plans are sold by private insurers that contract with Medicare.

Medigap plans can cover out of pocket expenses if you have Original Medicare.

When Veterans Should Consider a Medigap Plan
  • You are enrolled in Original Medicare and have out-of-pocket expenses.
  • You are enrolled in a lower priority VA group — and could lose benefits in the future.
  • You don’t live near a VA hospital or other VA facility.
  • You want to use local, non-VA hospitals.

Medicare Advantage plans offer an alternative to having both Medicare Part A and Part B.

Medicare Part A covers hospital costs and Part B covers doctor visits and other medical costs. Medicare Advantage plans cover everything Original Medicare covers, but may have extra benefits such as vision, hearing and dental coverage.

It’s important to remember that you cannot have both a Medigap and Medicare Advantage plan. You have to choose one or the other.

Last Modified: October 23, 2020

11 Cited Research Articles

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