Both VA Benefits and Medicare provide comprehensive medical coverage for a variety of needs. However, they work in different places. If you go to a VA facility for your medical care, your VA medical benefits will apply. However, outside that system, you have to pay the full cost yourself, even in an emergency. With Medicare coverage, if you get care outside the VA but at a Medicare-certified provider, you can use your Medicare benefits. As a result, Medicare can be a vital coverage if you don’t live close to a VA facility or if you travel frequently. In addition, VA care is based on your priority level. If you have a lower assigned priority level and VA funding drops, you may not be able to get VA medical benefits anymore. That’s why having Medicare if you’re eligible is an important backup!

In a word, the answer is no, they do not work together. Instead, your coverage will depend on what medical facility you go to. If you go to a VA facility, your VA benefits will take care of your needs. Any non-VA but Medicare-certified care will be covered by Medicare. Sometimes the VA will authorize care at a non-VA facility. This generally means that they will cover the costs of those services, but if they don’t, Medicare may pay for the Medicare-eligible services left over.

Medicare only applies to non-VA doctors. So in the VA, your VA benefits are primary. Everywhere else, Medicare is primary.

In general, you’ll get the same benefits from both Medicare and VA benefits, though your coverage amounts, copays, and other factors may differ. Your access to VA care, along with the out-of-pocket costs you have in the form of copayments, can vary depending on your priority level. If you have a lower priority number, you might have to wait for care at the VA or have to pay more for services or medications. Medicare gives you another option that isn’t dependent on your VA priority. Instead, you can get non-VA care when you need it. You can also choose a Medicare Advantage plan that brings additional benefits, such as vision, dental, and other care. However, Medicare Advantage plans have a limited network, so you’ll have to see the approved providers. Every Veteran 65 and over should, at least, consider the benefits of combining Medicare and VA benefits.

Yes. VA eligibility and Medicare eligibility are separate. To qualify for VA care, you need to be a veteran and meet the VA benefit requirements. For Medicare, you need to be a U.S. resident or citizen who has lived in the country for at least five years, along with being 65 years of age or older, or having specific health conditions. You can qualify for VA but not Medicare, or you might qualify for both. VA benefits are only applicable to VA medical centers. That’s why having Medicare as a secondary coverage can help.

You don’t have to, but you may face penalties if you don’t enroll during your initial enrollment period but decide to sign up later. Most Americans get Part A automatically and it’s free. For Medicare Part B, you might be automatically enrolled, or you may have to sign up. There is a monthly fee for Medicare Part B, but it will be higher if you skip enrollment and then change your mind later. Check out our FAQ on this website to learn the difference between Medicare Part A and Part B in further detail. We highly recommend signing up for Medicare when you are initially eligible. It expands your available medical options and can bring peace of mind if you have a lower VA priority level.

If you are not on active duty and are entitled to premium-free Medicare Part A, then you must also enroll in Part B in order to keep TRICARE coverage. You must also be enrolled in both Medicare Part A and Part B (Original Medicare) to have TRICARE For Life. The lone exception is when the beneficiary is the spouse of an active-duty service member, in which case Medicare Part B enrollment is not necessary.

Absolutely! Medicare Advantage, or Medicare Part C, is a full replacement for Original Medicare. Medicare Advantage plans may cover some additional benefits that Original Medicare doesn’t. Some of these additional benefits can include coverage for: • Dental • Hearing • Vision • Prescription drugs Many Medicare Advantage plans may also come with $0 premiums, though $0 premium plans may not be available in all locations.

It does not. Instead, you use the plan that applies to the medical provider you see. If you are eligible for Medicare, you can sign up for Medicare Advantage, even if you have VA benefits. As we’ve noted, VA benefits only apply at a VA health center. Medicare Advantage can be used anywhere within the plan’s medical network. Keep in mind that, unlike Original Medicare, a Medicare Advantage plan will have a limited network of providers, generally within a single geographical area. Make sure your non-VA doctors are part of the network and that the plan covers the prescriptions you need.

VA coverage includes prescription drug benefits, and for this reason, many VA members may choose not to enroll in Medicare Part D (Medicare prescription drug plans). And because VA drug benefits are considered “creditable coverage” by Medicare, VA members are not required to pay a late enrollment penalty if they choose to sign up for Medicare Part D at a later date. However, there are a few instances in which enrolling in a Part D plan or a Medicare Advantage plan with prescription drug coverage may make sense: • VA coverage includes its own drug formulary (a list of drugs covered by the plan). If the VA does not cover a specific drug that you need to take, you might consider enrolling in a Medicare Part D plan that covers that drug. • A drug prescribed by a doctor at a non-VA facility may not be covered by VA benefits without authorization. • A non-VA pharmacy may be a more convenient way to obtain your drugs, especially if you reside in a nursing home or other long-term care facility. If you qualify for Medicare Extra Help, your overall drug costs may be lower with a Part D plan than under VA coverage.