Veterans play a special role in society. If you served in the military, you may already have Veteran’s Administration (VA) or TRICARE benefits when you become eligible for Medicare. Enrolling in Medicare for veterans can help you receive more benefits and better care in the next stage of your life. Learn about the difference between VA and Medicare plans, including how you can make the most of each service.
Are Veterans Eligible for Medicare?
Most veterans are eligible for both VA and Medicare benefits. You can qualify for both programs if you meet the following requirements:
- You’re age 65 or older and enrolled in Medicare Part B
- You’re any age with a qualifying disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS) and are enrolled in Medicare Parts A and B
Medicare for veterans isn’t mandatory. Some people decide to delay enrolling in Medicare or decline coverage entirely. They prefer to use their VA benefits instead. You shouldn’t make this decision lightly. VA benefits can vary, so this program might not provide all the coverage you’ll need. You’ll also need to withdraw from Social Security benefits if you decline Medicare entirely. Coverage2Care experts can help you learn more before choosing this path.
Medicare and VA Coverage
Medicare for veterans is different from VA benefits.
These programs are both operated by the federal government and provide benefits for millions of Americans. However, VA and Medicare each have a unique focus.
VA Healthcare Coverage
Your VA benefits cover a wide range of services. You can use these benefits for conditions that are service-related or non-service-related. Treatment is covered at 100% if you visit a VA hospital or clinic. Most care outside of a VA facility is subject to a copay. The VA may authorize some outside treatments ahead of time.
Medicare Coverage
Your VA benefits include great coverage at VA facilities, but what if you want to visit a different provider? This situation is when VA and Medicare benefits can work together to provide more comprehensive coverage.
The Medicare system is made up of various parts. Each part offers a different form of coverage. You can sign up for each part to create a more robust, well-rounded health plan. This coverage also reduces the out-of-pocket costs you might be charged.
Medicare for veterans is the same program as Medicare for civilians. Everyone eligible for Medicare can sign up for the following parts.
Medicare Part A
Medicare Part A is hospital insurance. This plan covers hospital stays as well as some other services like long-term nursing facilities or hospice care. Medicare Part A is free to most qualifying members and doesn’t have premium costs.
This part of Medicare of veterans is especially useful for covering non-VA hospital stays. If you don’t live near a VA facility, or if you have an emergency, Medicare Part A can cover your costs.
Medicare Part B
Medicare Part B is medical insurance that covers doctor’s appointments, out-patient visits, and other services. This plan also covers some forms of durable medical equipment.
Part B does have some patient costs. It’s also important to watch the enrollment period for Part B. You could face higher Part B costs If you don’t sign up when you’re first eligible.
Medicare Part C
Medicare Part C is coverage purchased through private insurers. These plans include all the same benefits as other Medicare for veterans packages, but can also feature more coverage. For example, you can find Medicare Advantage plans that cover dental, vision, and hearing care.
Medicare Part D
Medicare Part D covers prescription medications. One difference between VA and Medicare benefits is that Medicare Part D often has higher drug prices. However, it also covers some drugs that the VA doesn’t allow.
Medigap Plans
Medigap coverage is supplemental insurance that goes beyond standard Medicare benefits. A Medigap plan can be helpful if you face an emergency, need treatment while traveling overseas, or simply live far away from a VA facility.
Frequently Asked Questions
Do veterans lose their VA when they sign up for Medicare?
No, you won’t lose your VA benefits when you sign up for Medicare. You can have both plans at the same time.
Do disabled veterans need Medicare?
If you’re a disabled veteran under the age of 65 and have been collecting SSDI for at least two years, you’re eligible for Medicare. Everyone should sign up for at least Medicare Part A if they’re eligible for premium-free services.
Does Medicare or the VA pay first?
It depends on where you seek treatment. All treatments at a VA facility or clinic are 100% covered by the VA. If the VA approves payment for care at a non-VA hospital, the VA will pay their portion first. Medicare will pay second in this case.
If you’re not approved for VA payments at a non-VA facility, Medicare will pay first and the VA won’t pay at all.
Can the VA be secondary insurance to Medicare?
No, your VA and Medicare benefits cover different treatment facilities. They’re not secondary insurance to each other.
Does Medicare pay for care at a VA facility?
No. Your VA benefits pay for services at a VA facility.
Do VA benefits include cost-sharing for Medicare?
No, VA benefits can’t apply to Medicare costs. This includes copays, premiums, and deductibles. However, Medigap policies can help with these costs.
Is VA drug coverage creditable for Part D?
Yes, your prescription drug coverage through the VA is creditable for Medicare Part D.
Some other important things to note about Medicare when you have VA benefits:
If you decide to drop your Medicare Part B coverage, you can’t change your mind until January of the following year. You may also be required to pay a penalty to reinstate your coverage.
Medicare Part D allows you to fill medicines from non-VA doctors at local pharmacies instead of using the VA’s mail order medication service.
How do I enroll in Medicare?
Enrolling in Medicare is easy. Most people become eligible when they turn 65. You can first sign up for Medicare during your initial enrollment period. This time starts three months before you turn 65, includes the month of your birthday and lasts another 3 months after your birthday.
If you want to change your coverage or enroll after your initial enrollment period, you can sign up each year. The Medicare open enrollment period is from January 1 to March 31 of each year.
Medicare can be a valuable addition to your VA benefits. To get started with enrollment, you can get free help from a licensed Coverage2Care agent told.
