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Do I Need Medicare if I Have Veterans Benefits?


Medicare can be beneficial for Veterans. As you know, Veteran benefits only apply to Veterans’ facilities and doctors. So, if you want to see a civilian doctor, Medicare can help with some of the costs. Having both Medicare and Veterans benefits gives you the opportunity to see a wide range of doctors and specialists. The Veterans Association recommends you enroll in Part A and B when you’re first eligible. Below we’re going to go over everything you need to know about Medicare and Veterans Administration benefits.

Should I Get Part A if I have Veterans Benefits?

Most people get premium-free Part A benefits. Those that contribute to Medicare taxes for 10 or more years are eligible. When an emergency happens, the VA hospital isn’t always an option. Having benefits at civilian facilities could save you thousands of dollars. The real question here is, why wouldn’t you enroll in Part A?

Do I Need Part B if I have Veterans Benefits?

While Part B is NOT mandatory, the Veterans Administration strongly recommends you still enroll. Delaying enrollment in Part B will result in a late enrollment penalty should you need the coverage in the future. This is because the Veterans’ benefits are not considered creditable coverage under Medicare.

Medicare will provide coverage outside a Veterans facility, this can come in handy in the case your Veteran benefits are dropped or if your local Veteran facility does not cover all your health services, you could pay up to 100% of your medical costs out of pocket if you don’t enroll in Part B.

Medicare Advantage and Veterans Administration Benefits

Many veterans are going to find Medicare Advantage a practical solution to coverage. Most plans boast a $0 premium and extra benefits beyond Medicare. Some plans may include prescription drug coverage. Depending on the service area, an Advantage plan could include telehealth, dental, vision, and a gym membership.

Although, it’s not realistic to expect comprehensive benefits from this type of policy. You can expect to pay more out of pocket as you use these benefits than you would with a Medigap plan. If you can’t afford a Medigap policy or if you don’t qualify, Medicare Advantage is better than nothing.

Part D for Veterans

Even though you can get prescriptions through the Veterans Administration, sometimes it’s more convenient to have Part D. For example if a civilian doctor prescribes a medication, the Veterans Administration doctor needs to approve the medication for the Veterans Administration to cover.

But, if you have Part D, you can go fill your prescription at a local drug store. If you do choose to delay Part D, there is no penalty since VA drug coverage is considered “creditable coverage” through Medicare.

Do I Need a Medicare Supplement if I Have Veterans Benefits?

Many people think paying a premium when you already have Veterans benefits is unnecessary. While Medigap could be over-insurance for some, for others it could be the extra coverage you’ve been looking for.

Those that don’t live close to a Veterans facility or want to use local doctors would reap many benefits from a Medigap plan. Also, if you’re in a low priority group you should consider Medigap, especially for those with a higher income that could find it difficult to obtain insurance if Veterans benefits were gone.

A Medicare Supplement is a policy that covers the portion of Medicare you’d otherwise be responsible for paying. Such as deductibles and coinsurances.

When should I use Veterans benefits vs. Medicare?

Veterans Administration benefits are only valid at Veteran facilities. Further, Medicare is only going to cover doctors that accept Medicare. So, if you have a heart attack while grocery shopping and the nearest hospital isn’t a Veterans facility, you’re going to want Medicare coverage.

Do disabled veterans need Medicare?

While it’s not mandatory, the Veterans Administration suggests all veterans, disabled or not, have Medicare. It’s especially beneficial to have Medicare when the need for civilian coverage arises. You might be thinking you’re fine without it, but delaying Part B will result in penalty charges when you do enroll. Signing up for Medicare when you’re initially eligible is a smart move.

Who Pays First, Medicare, or the Veterans Administration?

The simple answer to the question of who pays first is both. When you go to the Veterans facilities, the only coverage you have is Veterans Administration coverage. Then, when you go to civilian facilities, you only have Medicare coverage. Unless, of course, you enroll in Medigap.

FAQs

Can a Veteran get Medicare?
Yes, when you become eligible at 65 years of age or after receiving Social Security benefits for 24 months due to disability. Also, ESRD and ALS are qualifying conditions.
Can you have Medicare and Veterans Administration benefits?
Yes. If you qualify for Medicare and Veterans health care, you can have both. You’ll use Medicare at civilian facilities and your Veterans coverage at Veterans facilities.
Does the Veterans Administration bill Medicare for services?
No. Civilian facilities will bill Medicare for the care you receive there, and your Veterans benefits will cover treatment at Veterans facilities.

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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

  1. I have just been awarded 100% T&P from VA. I’m going to need to sign up for CHAMPVA for my dependents and I saw something about needing to have Medicare. Clueless on all of this and have no idea where to start researching.

  2. NEED HELP! I will be receiving Medicare on May 1st this year. When should I enroll in Medicare and apply for Medicare Advantage?

  3. I use the VA and am 100 percent disabled, so I’m in the highest priorty group. L also have medicare A and B. with their now being Vetrans choice for care, do I need supplamental insurance?

  4. I am 40% disabled through the V.A. If I don’t want to enroll in Medicare will I lose my V.A. medical? Social Security automatically is taking $144.00 out of my check for coverage. I want it stopped.

    1. Hi Michael! Medicare is not mandatory, you will not lose your VA benefits if you choose to not enroll. However, VA benefits are not considered creditable under Medicare. The $144 coming out of your social security check is for Part B. If you disenroll, and choose to reenroll later in the future, you will be penalized since you delayed without having creditable coverage. The $144 premium will be increased by 10% for every year you delayed enrolling in Part B. The VA does recommend having both Part A and Part B in addition to your VA benefits.

  5. Thanks Thanks Thanks, for uncomplaining this process. I am probably 1 month away from getting my Medicare cards. I have been totally- totally confused on the issue of Medicare since I have am a veteran and I am currently getting medical care thru the Veterans Administration. Medicare options are confusing to the average person like myself. Can you give me any advise with Medigap (supplemental policy).

  6. I enrolled with Part A when required. I have Veteran Medical coverage and advised in addition to qualified annual OBAMACARE and IRS, I received the annual forms proving medical coverage. NOW.. registering at a local SS Office for Part B, I am told that he U.S. Veterans Administration, Medical Treatment Facility Primary Care coverage is NOT good enough for Medicare to qualify – and I will be penalized from 2015. ???? What is the LAW seeing that I have NOT been informed that the Veteran Medical Facility does not qualify. I have NEVER seen nor been told by the SSA that the VA is NOT medically qualifying as Part B Coverage. Reading your FAQ Page, it is (RECOMMENDED) that Medicare eligible veterans apply for Medicare Part B medical coverage…..” and “will give you peace of mind…” which i MY decision. Therefore, WHERE is the LAW that gives the local SSA Office the purpose to tell my I am going to be PENALIZED 30% per MONTH based on MY Life Benefits.

    1. Hi EH, unfortunately your local SSA office is correct. If you search on va.gov, you’ll see on this page that VA healthcare coverage is NOT considered creditable coverage under Medicare Part B. The VA does not recommend Veterans decline Medicare Part B when their first eligible to enroll for this reason. Since you missed your Initial Enrollment Period, your opportunity to enroll in Part B is during the General Enrollment Period, which is now. The GEP runs annually between January 1st – March 31st. If you don’t enroll during this GEP, you’ll face a higher penalty than you have already come next year. That penalty will continue to increase each year you go without Medicare Part B coverage.

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