10 Questions Every Veteran Should Ask About Medicare

If you’re a veteran approaching Medicare eligibility, you may have questions about what to do and how this transition will affect your healthcare coverage. We’re here to help. We’ve collected some frequently asked questions about VA and Medicare coverage — and answered them for your quick and convenient reference.

Question #1: Are veterans required to enroll in Medicare?

If you have Veterans Administration (VA) benefits, you are not required to enroll in Medicare to keep them. However, the VA recommends enrolling in Medicare when you become eligible. Enrolling in Medicare gives veterans more coverage choices when choosing hospitals or medical care.

The VA has stated in the past that coverage for aging veterans may fluctuate due to congressional budgetary constraints. By enrolling in Medicare, you have secured coverage no matter what happens in Washington, D.C.

Question #2: Do I have to enroll in Medicare if I plan on working after 65?

If you have creditable insurance coverage from an employer and plan to work past 65, you may be able to delay Medicare Part B enrollment without penalty. Without creditable coverage, delaying enrollment can lead to late enrollment penalties.

Question #3: Do I need to enroll in Medicare if I have TRICARE?

If you currently have TRICARE and meet the eligibility criteria, then your Medicare enrollment can be delayed. It’s worth noting that you can have both Medicare and TRICARE coverage at the same time.

If you have TRICARE when you become eligible for Medicare, you have 90 days to change your TRICARE health plan — and your plan options will depend on several different factors. They may include how you qualify for Medicare (by age, medical condition or disability), your or an eligible family member’s active-duty status and which TRICARE plan you’re currently enrolled in.

Most people with TRICARE who get Medicare Part A must also have Medicare Part B to be able to remain eligible for TRICARE benefits. Part D is not required to maintain eligibility.

Question #4: Can Medicare and VA benefits overlap?

You can have both VA benefits and Medicare. However, coverage does not typically overlap. You will need to choose which coverage you use for each service you receive.

To use your VA benefits, you’ll still need to see a VA doctor or get care at a VA medical center or other VA location. The VA will also cover care if it’s been pre-authorized for services in a non-VA hospital or other care facility.

If you go to a non-VA facility or do not have prior VA authorization, Medicare may provide coverage for services the VA doesn’t cover. What Medicare covers will depend on the Medicare coverage or plan you have.

Question #5: Will Medicare and the VA coordinate coverage?

Medicare and the VA do not coordinate coverage. This means they will not jointly pay for a medical bill. The only scenario where they might team up to provide dual coverage is when the VA approves care to be received at a non-VA facility. But even under that circumstance, dual coverage is not guaranteed and should not be relied upon.

Question #6: Can I be penalized if I have VA coverage and enroll in Medicare after age 65?

As with any other American who is eligible for Medicare and does not sign up during their Initial Enrollment Period, you may be subject to late enrollment penalties if you decide to sign up later.

Question #7: Will my VA coverage stay the same forever?

One of the most important reasons the VA recommends enrolling in Medicare as soon as you become eligible is because your VA coverage is subject to change. That could leave you without the health insurance coverage you need when you need it most.

VA health benefits are funded by Congress, and there may come a day when that funding is unable to fully cover all veterans in the system. To help secure your coverage, it is recommended that you enroll in Medicare as soon as possible.

Question #8: Will my prescription drug coverage be affected?

Your VA prescription drug coverage will not be affected. Many VA members choose not to enroll in Medicare Part D 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 a Part D plan later.

Question #9: What kind of Medicare plans are best for veterans?

Due to their variety of coverage and flexibility, Medicare Advantage plans are a coverage option that appeals to some veterans. These plans are sold by independent carriers and typically provide more benefits than Original Medicare (Parts A and B). For veterans who are used to receiving additional benefits, MA plans may be a good fit.

Of course, there is no “right” answer for everyone, and coverage needs vary. Talking with a licensed insurance agent is a smart and simple way to learn more about how these coverage options work together for you.

Question #10: How can I learn more about my coverage options?

To learn about your VA options, reach out to your local VA office. You can find your nearest VA office by visiting https://www.va.gov/find-locations.

To learn more about your Medicare options, talk to us. We’re here to answer your coverage questions and help address concerns you might have about Medicare. Contact us today for a free, no-obligation consultation. We are ready to help you!

Ede’m Now Health Marketplace is a brand operated by Integrity Marketing Group, LLC and used by its affiliated licensed insurance agencies that are certified to sell Medicare products. Ede’m Now Health Marketplace is not endorsed by the Center for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency.