Do Veterans Need Medicare if They Get VA Benefits?

Should You Enroll in Medicare If You Have VA Benefits?

In Short: Yes. 

Even the Department of Veterans Affairs encourages beneficiaries to enroll in Medicare as soon as they’re eligible.

Scenarios to consider

  • VA funding can change at any time. Depending on your priority level, you may lose your VA benefits. Then you’d be left without health coverage.
  • The VA often does not cover emergency medical care received in a civilian medical facility. Without Medicare Part A, this could leave you footing 100 percent of the bill.
  • Having both Medicare and VA benefits greatly widens your coverage. VA coverage pays for medical services if you go to a VA hospital or doctor. If you need to go elsewhere, you’ll probably end up having to pay the full cost yourself, even in emergencies. With Medicare, you’re covered if you need to go to a non-VA provider. This is an especially important point to consider if you live some distance from the nearest VA facility.
  • You may be subject to penalties in the future. At some point, when you’re well past 65, you might lose VA coverage, or otherwise decide that you need Medicare. If you are not already signed up for Part B (and don’t have insurance through an employer or other source), you’ll likely have to wait a while for coverage, and you could be liable for late penalties that are permanently added to your Part B premiums.

How Does it Work if You Have Both Medicare and VA?

If you have both VA and Medicare benefits here is how it works.

-To use your VA benefits, choose a VA facility for your healthcare.

-To take advantage of your Medicare coverage, use a Medicare-approved provider who accepts assignment.

-If you have a Medicare Advantage (MA) plan, the provider must also accept your plan.

 

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Note: you cannot use your VA benefits to pay your out-of-pocket Medicare costs, such as deductibles and co-insurance. In addition, Medicare will not pay for services received in a VA facility. These two systems do not coordinate coverage.

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