Medicare Advantage for Veterans
As a veteran, you have unique healthcare options. Learn how Medicare Advantage works alongside your VA benefits, TRICARE for Life, and other military healthcare programs to maximize your coverage.
How Medicare and VA Benefits Work Together
Many veterans are surprised to learn that VA healthcare and Medicare are completely separate programs. You can have both, but they do not work together the way primary and secondary insurance typically do. VA will not bill Medicare, and Medicare will not pay for care received at VA facilities.
However, having both programs available to you can provide significant advantages. You can use VA care for service-connected conditions, prescriptions, and specialized veteran services, while using Medicare or a Medicare Advantage plan for care from non-VA doctors, specialists, and hospitals closer to home or when VA wait times are long.
If you are approaching age 65 or are already eligible for Medicare, it is important to understand your enrollment options and deadlines. Delaying Medicare Part B enrollment when you don't have other qualifying coverage (VA benefits alone do not count as creditable employer coverage) can result in permanent late enrollment penalties.
Coverage Options for Veterans
VA Benefits Only
You can continue using only VA healthcare, which covers service-connected conditions and general healthcare based on your priority group. No Medicare enrollment is required to use VA care.
Medicare Only
Enroll in Medicare Part A and Part B (or a Medicare Advantage plan) and receive care from any Medicare-accepting provider. VA facilities will not bill Medicare for services.
VA + Original Medicare
Use VA care for some services and Medicare for others. This gives you more providers and locations to choose from. Medicare and VA do not coordinate benefits, so each covers its own services.
VA + Medicare Advantage
Enroll in a Medicare Advantage plan for non-VA care while keeping your VA benefits. This provides extra benefits like dental, vision, and prescription drug coverage outside the VA system.
TRICARE for Life + Medicare
Military retirees with 20+ years of service can use TRICARE for Life as a Medicare supplement. You must enroll in Medicare Part A and Part B, and TRICARE covers most remaining costs.
VA + Medicare + Medigap
Some veterans pair Original Medicare with a Medigap supplement for non-VA care, keeping VA benefits for service-connected conditions and prescriptions.
Why Veterans Should Consider Medicare Advantage
While VA healthcare provides excellent care, there are several reasons a Medicare Advantage plan can be a valuable addition to your coverage:
- More providers and locations: Medicare Advantage gives you access to thousands of private doctors, specialists, and hospitals outside the VA system. This is especially helpful if you live far from a VA facility or face long wait times.
- Extra benefits: Many Medicare Advantage plans include dental, vision, hearing, fitness, over-the-counter allowances, and telehealth services that may not be readily available through the VA.
- Prescription drug coverage: If you receive medications outside the VA pharmacy system, a Medicare Advantage plan with Part D coverage can help cover those costs. Note that VA prescriptions are typically less expensive than retail pharmacy costs.
- Travel and snowbird coverage: If you spend part of the year outside Florida, a PPO-type Medicare Advantage plan can provide coverage when you're away from your local VA facility.
- Emergency backup: If you need urgent or emergency care and a VA facility is not nearby, a Medicare Advantage plan ensures you're covered at any hospital or emergency room.
- Spousal coverage coordination: If your spouse is not a veteran, a Medicare Advantage plan can help coordinate your healthcare so you can visit some of the same providers.
TRICARE for Life and Medicare
TRICARE for Life (TFL) is a program for military retirees, their spouses, and survivors who have 20 or more years of uniformed service. TFL works as a supplement to Medicare, covering most out-of-pocket costs after Medicare pays its share.
To use TRICARE for Life, you must be enrolled in both Medicare Part A and Part B. Once enrolled, Medicare serves as your primary insurance and TRICARE for Life pays most of the remaining costs, including deductibles and coinsurance for Medicare-covered services.
Important: If you enroll in a Medicare Advantage plan, TRICARE for Life will not cover costs from your Medicare Advantage plan. TRICARE for Life only works as a supplement to Original Medicare. If you are considering Medicare Advantage, it is essential to understand how this affects your TRICARE for Life benefits before making a decision.
Our agents at MAC Insurance have experience working with veterans and military retirees and can help you understand the interaction between TRICARE for Life, Medicare, and VA benefits so you can make the most informed choice.
Medicare Enrollment Tips for Veterans
- Enroll in Part A at 65: Medicare Part A is premium-free for most people and should be enrolled in at age 65 regardless of your VA status. There is no downside to having it.
- Don't delay Part B without employer coverage: VA benefits are not considered creditable employer coverage for Medicare purposes. If you delay Part B past your Initial Enrollment Period without qualifying employer coverage, you may face a permanent late enrollment penalty of 10% for each full 12-month period you were eligible but not enrolled.
- Annual Enrollment Period: Each year from October 15 to December 7, you can enroll in, switch, or drop a Medicare Advantage plan. This is a good time to review how your VA benefits and Medicare coverage work together.
- Special Enrollment Periods: You may qualify for a Special Enrollment Period if you experience qualifying life events such as moving to a new service area or losing other coverage.
Get Expert Help Navigating Your Benefits
As a veteran, you've earned exceptional healthcare options. Our licensed agents understand how VA benefits, TRICARE, and Medicare Advantage work together and will help you get the most from your coverage.