Medicare  and VA Benefits

Medicare and VA Benefits

Medicare generally does not coordinate with VA benefits. You can have both Medicare and VA benefits, and many people choose to use both benefits in order to have access to more providers and services.

However, with few exceptions, Medicare and VA benefits do not work together. Medicare generally does not pay for care that you receive at a VA facility.
In order for Medicare to cover your care, you usually will have to receive care at a Medicare Certified Facility that works with your Medicare coverage. In order for your VA coverage to cover your care, you must generally receive health care services at a VA facility. Exceptions can be made, such as

if you receive prior authorization from the VA to receive VA-covered services at a Medicare-approved facility. If an emergency occurs that requires you to receive such care, the VA may cover some of those costs until you can be moved to a VA facility for continued care.

If you are Medicare eligible, you may want to enroll in Medicare Part B ($134 monthly premium), even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. Without Part B, you will not have Medicare coverage for physician, outpatient, and ambulance services. In addition, if you don’t enroll into Part B when you are first eligible to do so, but later decide to enroll in Part B, you will likely face a late enrollment penalty for Part B for each 12-month period you were without Medicare Part B coverage.

Drug coverage offered by the VA is considered, “credible”. This means that it is as good as or better than Medicare Part D prescription drug coverage, and as long as you remain enrolled in drug coverage through the VA, you can delay enrolling in Medicare Part D without a late enrollment penalty, or just keep your VA drug coverage indefinitely.

Stephanie Frisch

Stephanie Frisch is the owner of Insurance 101 and is an independent insurance broker dedicated to helping others make “educated decisions” about their insurance choices when it comes to Medicare, Long-Term Care Planning, The Health Insurance Marketplace-Covered California and Life Insurance. For answers to your questions, or an in-home, no-fee consultation, call (949) 351-2443.