Enrolling in Medicare with VA Benefits: What you need to know

Yes, a veteran over 65 can be covered by both Medicare and VA benefits. However, Medicare does not coordinate with VA benefits. This is a good thing: you can choose when you want to use your Medicare benefits, and when you want to use your VA benefits.

Still, how the two benefits work is fairly simple. VA benefits pay when you receive healthcare at VA facilities, and Medicare benefits are for Medicare-approved services at civilian healthcare providers participating in Medicare.

Generally, the VA should be the primary source for your health care needs if you are enrolled in both systems. Medicare plays a secondary role and helps cover costs when the VA does not cover them. It can also help bridge any gaps that may occur due to a change in billing procedures or requirements when receiving services from a VA healthcare facility.

However, there are some exceptions where Medicare might be the primary payer of certain benefits depending on an individual’s qualifying circumstances. For example, if you are receiving VA benefits but your health improves significantly and you receive a different disability rating, your VA coverage may change. In which case, using Medicare benefits at civilian hospitals or medical facilities may be the better option to ensure full coverage.

Yes, if you have VA benefits, you can also have a Medicare Advantage plan (Part C) or a Medicare supplemental plan (Medigap) for your Original Medicare (Part A & Part B). Veterans are treated no differently than anyone else, and are fully eligible for all Medicare Advantage or Medigap plans in their area – even if they are already receiving healthcare benefits through the VA.

The monthly costs for Medicare Advantage plans are relatively low, and there are times when Medicare Advantage plans even come without premiums. So there is very little downside to enrolling in Medicare Advantage or Medigap plans when you already have VA benefits. Some Medicare Advantage plans may have lower copays for things like prescription drug coverage than what the VA may offer.

There are several Medicare Advantage plans specifically designed for people that also have VA benefits. These plans include things like dental, vision, and hearing benefits. They also provide you with a reduction in your Part B premium.

In some scenarios, having both benefits can save veterans a lot of money. For example, in an emergency scenario – such as a heart attack or car accident – where the closest medical facility is civilian, Medicare Advantage or Medigap plans can help with costs, as VA benefits are only useful at VA facilities.

If you receive care at a VA center, the VA may bill your Medicare Advantage or Medigap plan for services the plan covers (which are the same as those Medicare covers), even though the VA doesn’t bill Medicare directly. In some cases, the VA may partially authorize care you receive from a non-VA hospital, with Medicare paying the remainder, which could also save you money.

Insurance Professionals of Arizona are experts in all things Medicare in Arizona. We can go over your current benefits and help you understand what your costs and coverage would be for different plans, and which one might make the most sense for you.

Arizona is home to countless retired veterans, so this is an area we take particular pride in our experience and expertise in. We understand there are different needs, and that some retired veterans may be disabled and require special medical attention. We know some veterans may be on limited incomes and need to keep costs to a minimum, while still having medical requirements such as prescription medicines.

We have helped countless veterans in Arizona, and would be honored to help you as well. Ensuring that you have the best coverage available is the least we can do for those who have sacrificed so much for us.