For veterans approaching Medicare eligibility, it’s common to have questions about whether Veterans Affairs (VA) benefits will work with this new health care coverage. The short answer is that Medicare doesn’t coordinate with VA benefits. However, you can have both types of insurance at the same time and benefit from doing so. Below, we’ll answer the most frequently asked questions about Medicare for veterans.
Medicare and VA Benefits
Many people who qualify for Medicare are also eligible for other health insurance through the government. 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, knowing who pays for the services you receive is straightforward. Simply, you’ll use your VA benefits if you’re receiving care at a VA hospital or facility. Likewise, when the facility where your services take place is Medicare-certified, Medicare will pay.
Do Veterans Have to Sign Up for Medicare?
Medicare isn’t mandatory. However, there is significant value to signing up for this coverage when you become eligible.
If your only health insurance is through VA benefits, you’ll only have coverage within the VA health system. On the other hand, Medicare offers coverage in nearly every facility and from nearly all providers throughout the nation. Thus, having both Medicare and VA benefits allows individuals to access well-rounded health care coverage. Keep in mind that once you enroll in Medicare, you’ll want to update your health information with the VA.
Do I Need to Pay for Medicare if I Have VA Benefits?
For individuals who have worked enough quarters, Part A is premium-free. Therefore, it’s beneficial to take this hospital insurance through Medicare.
However, like other beneficiaries, veterans with VA benefits will need to pay a standard Part B premium for outpatient coverage through Medicare. The premium is subject to increase the longer you go without Part B coverage after you’re eligible, via a lifelong late penalty. The penalty occurs because, unlike group health insurance through a large employer, VA benefits aren’t creditable for Medicare.
As a result, you’ll save money long-term when you sign up as soon as you’re eligible. If you need financial assistance with your Part B premium, you might qualify for a Medicare Savings Program (MSP).
Do I Need Part D if I Have VA benefits?
VA benefits include prescription drug coverage. Additionally, this coverage is creditable for Medicare Part D. Meaning, it’s comparable to the level of prescription drug coverage Medicare requires companies offering Part D policies to provide.
Consequently, those with Medicare and VA benefits don’t need to worry about getting prescription drug coverage through a Part D plan. Although, if there comes a time when you choose to cancel your VA coverage, you’ll want to pick up a Part D plan as soon as possible. Otherwise, you’ll face a different type of late penalty on top of your premium, for lacking creditable coverage. This amount will be higher the longer you go without creditable coverage.
Additionally, there are some situations in which an individual with Medicare and VA benefits could benefit from signing up for 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 Part D plan could also be a good option. If you qualify for 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 Parts A and B of Medicare have the option to replace the latter two with a Medicare Advantage plan. Private insurance companies offer these plans, and when you have one, the carrier pays instead of Medicare.
The monthly costs for Advantage plans are relatively low. Sometimes, Advantage plans come without premiums. So these plans aren’t a bad option for extra coverage when you already have VA benefits. In an emergency scenario where you’d need care at a civilian facility, Advantage plans can help with costs, as they involve maximum out-of-pocket limits that Original Medicare (Parts A and B) doesn’t include.
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 might have. Part A and Part B don’t cover 100% of your care, but when you have a Medigap plan, it pays for the balance you’re responsible for after Medicare pays. When you have this type of policy in addition to your Medicare and VA coverage, your visits to civilian facilities and hospitals that accept Medicare will receive full coverage. 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).
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 the VA. That's why we're here to help with any questions you have about what you can do to make these programs work best for you.
Our agents look forward to helping you achieve your goal of obtaining the most complete coverage possible. We'll work with you to find the plans that best suit your budget and health needs. Instead of calling each company individually to learn about your options, call the phone number above and get all your quotes in one spot – or fill out our online rate form to see options available in your area.