VA Health Care and Medicare

There is a lot to consider when you are signing up for VA Health Care.  One consideration is carrying other eligible insurance, such as Medicare.

VA Health Care

If you have VA coverage and are eligible for Medicare, you’re not required to enroll in Part B.  When you look at your options you may quickly realize you have have good reasons to do so. The VA itself strongly recommends that all veterans with VA health care also enroll in Medicare Parts A and B as soon as they become eligible. The exception to enrolling in Medicare would be if the Veteran is eligible for or already participating in a private or employer sponsored program.

VA Health Benefits

Can You Have Both VA Health Care and Medicare?

The short answer is yes. But, as with everything insurance related it is important for you to determine if the levels of coverage is right for your specific situation. Keep in mind these two options do not work together, even though you can have both at the same time.

  • For VA Health Care you must seek treatment at an approved VA facility.
  • To receive treatment covered by Medicare, you must seek treatment at a Medicare approved facility.
  • VA will not pay for Medicare Cost Sharing which includes deductibles, copayments, and coinsurance.

Should I Enroll in Medicare Part A and Part B if I have VA Benefits

Depending on your situation, it’s generally a good idea to join Part A and Part B if you’re eligible for it at age 65.  Medicare Part A and B will cover inpatient hospitalizations, hospice, skilled nursing care, and outpatient care from non-VA providers. Enrolling in Medicare to supplement your VA benefits generally covers and “gaps” you may have in your coverage.  Most people are able to get Medicare Part A for free, though Part B does have some monthly costs associated with it.

The other consideration you should keep in mind, even if you feel you do no need Medicare now, is if you plan to use it in the future.  By enrolling at age 65 you can avoid penalties should you decide it is a good idea to join later. 

Keep in mind, if you are enrolling in TRICARE For Life you must be enrolled in Original Medicare (Parts A & B).

What Plan Pays the Bills?

VA Health Care

Because both plans are separate from one another, the answer really depends on where you seek treatment.  Every time you want to receive any form of healthcare, you will need to make a decision which system to use.  There are benefits to being able to have more than one option based on wait times, type of treatments offered, and the proximity of the facilities to you.

Do I Need Medicare Part D if My Prescriptions come from VA Health Care?

Generally speaking, Veterans prefer to get prescriptions from the VA because the out of pocket costs are lower than those from Medicare Part D.  Anyone who is enrolled in Medicare Part A or Part B can enroll in Part D.  You may want to think about enrolling in Medicare Part D even if you receive VA Heath Care if any of these situations apply to you:

  • Your current prescriptions are not approved by the VA.
  • You are seeing a physician outside of the VA S system and filling prescriptions yourself at a local pharmacy.
  • You qualify for Medicare Extra Help, which in turn makes the Part D out of pocket costs lower than your current VA Health Care.


Verus Health Partners Can Help

At Verus Health Partners, we advocate for all of our clients.  Our goal is to ensure you have the proper coverage for your situation.  Contact us today to learn more about combined VA Health Benefits and Medicare solutions.  We will help you determine the right combination for you based on your specific needs.  You can follow us on Facebook for other helpful information.