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Do I Need Medicare if I Have Veterans Benefits?


For veterans approaching Medicare eligibility, it is common to have questions about whether it is necessary to enroll in Medicare alongside Veterans Affairs (VA) benefits. The short answer is that Medicare does not coordinate with VA benefits. However, you can have both types of insurance at the same time and benefit from doing so. Below, we answer the most frequently asked questions about Medicare for veterans.

Medicare and VA Benefits

There are several insurance programs available to those who are also eligible for Medicare. The most popular of these programs include FEHB for federal employees and TRICARE for those serving in the military and their families.

When it comes to VA benefits and Medicare, understanding who pays for the services you receive is simple. You use VA benefits when receiving care at a VA hospital or facility. Yet, when the facility where your services take place is Medicare-certified, Medicare will pay. In some instances, non-VA facilities may authorize VA coverage. In this case, Medicare would pay for any Medicare-covered services that VA benefits do not pay for.

Keep in mind, Medicare does not pay for care received at a VA facility. Likewise, VA benefits do not pay secondary to Medicare. This means VA benefits will not cover any Medicare cost-sharing expenses.

Do Veterans Have to Sign Up for Medicare?

Medicare is not mandatory. However, there is significant value to signing up for this coverage when you become eligible.

If you only have coverage through VA benefits, you may only receive care at a VA facility, unless otherwise approved. Often, approvals can take weeks or months to process. On the other hand, Medicare offers coverage in nearly every facility and from almost every provider throughout the nation.

Thus, having both Medicare and VA benefits allows individuals to access well-rounded health care coverage with a wide variety of eligible doctors and hospitals.

Do I Need to Pay for Medicare if I Have VA Benefits?

For individuals who have worked at least ten years or 40 quarters paying Medicare tax, Medicare Part A is premium-free. Therefore, it is beneficial to enroll in the hospital insurance you earned through Medicare.

However, like other beneficiaries, veterans with VA benefits will need to pay a standard Medicare Part B premium for Medicare’s outpatient coverage. You will want to enroll in Medicare Part B as soon as you are eligible. Delaying Medicare Part B coverage can result in a lifelong late penalty. The penalty occurs because, unlike group health insurance through a large employer, VA benefits are not creditable coverage for Medicare.

As a result, you save money long-term when you enroll during your Initial Enrollment Period. If you are looking to enroll in Medicare Part B but are in need of financial assistance with your Medicare Part B premium, you may qualify for a Medicare Savings Program.

Do I Need Part D if I Have VA benefits?

VA benefits include prescription drug coverage. Unlike VA health coverage, VA drug coverage is creditable for Medicare Part D. This means if you delay Medicare Part D coverage due to VA drug coverage, you will not be responsible for the Medicare Part D penalty in the future.

However, most beneficiaries with both Medicare and VA benefits do not need to enroll in prescription drug coverage through a Medicare Part D plan. If there comes a time when you choose to cancel your VA coverage, you will want to pick up a Medicare Part D plan as soon as possible.

Additionally, there are some situations in which an individual with Medicare and VA benefits could benefit from signing up for Medicare Part D. These circumstances include residing in an area where VA facilities are inaccessible or wanting more options for pharmacies at which to pick up prescriptions.

For individuals who struggle to pay for their prescriptions, a Medicare Part D plan could also be a good option. If you qualify for Medicare Part D Extra Help, your prescriptions may have lower copays than they would through VA benefits.

Can a Veteran Get a Medicare Advantage Plan?

Those who have both VA benefits and Medicare Part A and Part B have the option to enroll in a Medicare Advantage plan. Private insurance companies offer these plans. When you enroll in this coverage, the carrier you choose pays instead of Medicare.

The monthly costs for Medicare Advantage plans are relatively low. Sometimes, Medicare Advantage plans even come without premiums. Thus, Medicare Advantage plans are a good option for extra coverage when you already have VA benefits. In an emergency scenario where you would need care at a civilian facility, Medicare Advantage plans can help with costs.

Do I Need a Medicare Supplement if I Have VA benefits?

A Medicare Supplement (Medigap) plan can benefit anyone who has Original Medicare, regardless of what other coverage they may have. Medicare Part A and Part B do not cover 100% of your care. However, when you have a Medicare Supplement plan, it covers the costs Original Medicare leaves behind, leaving you responsible for few-to-no out-of-pocket costs.

When you have this type of policy in addition to your Original Medicare and VA coverage, your visits to civilian facilities and hospitals that accept Medicare will receive full coverage after you meet your Medicare Supplement plan’s deductible. Although the VA doesn’t bill Medicare, they may bill your Medigap plan for services the plan covers (which are the same as those Medicare covers).

FAQs

Do veterans lose their VA when they sign up for Medicare?
No, you will not lose your VA benefits when you enroll in Medicare.
Do disabled veterans need Medicare?
Disabled veterans under 65 eligible for Medicare due to collecting SSDI for at least two years should enroll in Medicare. Regardless of disability status, everyone qualifying for Medicare should enroll in at least Medicare Part A if they can get it premium-free.
Who pays first, Medicare or Veterans benefits?
The only case in which both the VA and Medicare pay is if the VA partially authorizes care you receive from a non-VA hospital. So, if the balance of services is Medicare-eligible, Medicare will pay for what the VA doesn’t.
Can the VA be secondary insurance to Medicare?
VA benefits aren’t secondary insurance to Medicare, as they cover care at different types of facilities. Yet, if you are eligible for both, enrolling in both can round out your health care.
Is VA drug coverage creditable for Medicare Part D?
Medicare considers prescription drug coverage through the VA creditable for Medicare Part D.

How to Get Help with Medicare for Veterans

We understand that there is much to learn about how your health care works when you have coverage through both Medicare and VA benefits. That's why we are here to help with any questions you have about how to get the most out of your coverage.

Our agents look forward to helping you achieve your goal of obtaining the most complete coverage possible. Instead of calling each company individually to learn about your options, call the phone number above and get all your quotes in one place – or fill out our online rate form to see options available in your area.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

46 thoughts on “Do I Need Medicare if I Have Veterans Benefits?

    1. Hi Ray! Yes, it’s highly recommended that a veteran supplements their VA benefits with a Medigap plan. That way, you’re covered outside a VA hospital.

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