You can use VA healthcare benefits alongside other healthcare plans such as Medicare, Medicaid, or TRICARE. These plans can help cover non-service-related health conditions and non-VA doctors or hospitals.

If you’re a veteran, it’s important to have all the services you’re eligible for working together to meet all your healthcare needs. However, the world of veteran benefits can be confusing, and it can be difficult to know how much coverage you have or need.

Supplementing your veteran’s healthcare coverage with a Medicare plan may be a good idea, especially because Veteran’s Administration (VA) healthcare coverage can vary drastically from person to person and over time.

This article reviews how different Medicare and TRICARE plans work with VA medical benefits to broaden your coverage.

You can have both VA coverage and Medicare if you are:

Medicare is not mandatory, so you may be considering delaying or declining Medicare coverage and relying only on your VA benefits.

If you’re thinking about deferring Medicare, it’s best to discuss the pros and cons with a VA representative. It’s important to know how or whether your current plan will work with Medicare so you can choose the most comprehensive overage possible.

Declining Medicare completely is also possible, but you will have to withdraw from your Social Security benefits and pay back any Social Security payments you have already received.

Additional resources for veterans

To learn more about how the VA interacts with other health insurance, visit the VA website.

If you have another form of healthcare coverage — like a private insurance plan, Medicare, Medicaid, or TRICARE — you can use VA healthcare benefits along with these plans. When enrolling in VA healthcare, you’ll need to let them know about your other healthcare coverage.

The VA may bill your private insurance company for care, supplies, or medications provided to treat non-service-connected conditions. This can result in significant out-of-pocket costs for you, especially if you haven’t met your private health insurance deductible.

So, if you receive care in a non-VA facility for a condition that’s not service-related and isn’t covered by your VA insurance plan, Medicare can help.

By opting into each part of Medicare, you’re building more comprehensive healthcare coverage for yourself. You’ll also be less likely to pay high out-of-pocket costs.

Let’s take a look at the different parts of Medicare.

Medicare Part A

Medicare Part A is usually free and doesn’t have a premium. This part covers non-VA hospital care if you have an emergency or if you live far away from a VA facility.

Medicare Part B

Medicare Part B offers more coverage options for non-VA healthcare providers as well as other things that your VA healthcare plan may not cover.

It is important to note that if you do not sign up for Medicare Part B right away and later lose your VA coverage, a late enrollment fee will apply.

Medicare Part C

Medicare Part C, also known as Medicare Advantage, offers healthcare coverage that the VA and basic Medicare do not. This includes dental, vision, hearing, prescription drugs, and more.

There are some potential disadvantages to consider as well, including additional plan costs, having to stay within a provider network, and lack of coverage while traveling.

Consider your specific coverage needs and budget when deciding which type of plan will work best for you.

Medicare Part D

Medicare Part D is a prescription drug plan. Although it generally has higher drug prices than the VA plan, it may cover drugs that are not covered by the VA. Part D plans also allow you to go to your preferred retail pharmacy and fill prescriptions from non-VA doctors.

Medigap plans

Supplemental plans, such as Medigap, are useful for covering emergency situations or for when you are traveling outside the United States. They are also helpful if you do not live near a VA-approved health professional or medical facility or if you are in a lower priority VA benefit group.

How do you enroll in Medicare?

You can easily enroll in Medicare online. There are just a few things to remember:

  • If you are approaching age 65 years, you may enroll during the initial enrollment period. Enrollment in Medicare parts A and B begins 3 months before you turn age 65, continues during the month of your birthday, and ends 3 months after you turn 65 years old.
  • If you are not enrolled, want to make changes to an existing Medicare Part A or B, or are over age 65 but still looking to enroll, you can use the following enrollment periods:
    • Medicare open enrollment period: October 15 to December 7 every year
    • Medicare Advantage open enrollment period: January 1 to March 31 every year

To get started with enrollment, visit Medicare’s enrollment page and follow the prompts.

When you have VA healthcare coverage, the VA pays for doctor visits, prescriptions from VA providers, and visits to a VA facility. Medicare will pay for any services and prescriptions from non-VA healthcare professionals and facilities.

At certain times, both the VA and Medicare will pay. This may happen if you go to a non-VA hospital for a VA-approved service or treatment, but you need additional procedures that aren’t covered by the VA healthcare plan. Medicare will pick up some of those additional costs.

Remember though, with Medicare you are still responsible for some costs, such as your Part B premium and 20% copay or coinsurance fees.

When in doubt, you can always contact the VA and Medicare for any specific coverage questions.

How to contact your coverage providers
  • For VA healthcare coverage questions, call 844-698-2311.
  • For Medicare coverage questions, call 800-MEDICARE.

TRICARE is the military’s medical insurance provider. It’s broken down into several different plans based on your military status. These plans include:

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Select
  • TRICARE Select Overseas
  • TRICARE For Life
  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult
  • US Family Health Plan

After you retire from military service and reach age 65 years, you will be eligible for TRICARE for Life if you are enrolled in Medicare parts A and B.

Tricare for Life is considered a second payer. This means that your Medicare plan is billed first for any medical services you receive. After Medicare pays, Tricare will pay the rest if it covers those services.

If you have TRICARE and Medicare, who pays your healthcare bills?

Let’s say you go to your annual physical and you’re referred to a cardiologist for the first time. At the cardiology visit, you are told you need to have an echocardiogram and a stress test.

Your primary care doctor, cardiologist, and the facility where you receive those tests will all bill your Medicare plan first. Once Medicare pays for everything that is covered under your plan, the remainder of the bill automatically gets sent to TRICARE.

Your TRICARE plan will cover the leftover costs that Medicare did not pay for, as well as any coinsurance and deductibles you may owe.

If you have VA healthcare and TRICARE coverage, you can use the VA for service-connected conditions and TRICARE for everything else.

You can be eligible for both VA healthcare and TRICARE. However, the systems are separate and don’t coordinate services.

When comparing VA and TRICARE for a given health procedure, you may want to consider:

  • costs
  • access to care
  • convenience
  • whether it’s for a service-connected condition

You can also have TRICARE and private health insurance. When seeking care, you must submit claims first to your private insurer. TRICARE will pay the remaining billed amount, up to an allowable maximum.

You can also combine any TRICARE plan with Medicaid. In this case, TRICARE is the first payer and Medicaid covers the remaining amount.

How to enroll in TRICARE

You may enroll in Tricare for Life during TRICARE’s open enrollment season, which begins in November. You may also enroll outside of the open season if you have a qualifying life event, such as retirement from active duty, marriage, or death of a family member.

You have 90 days after a qualifying life event to change your coverage or enrollment.

If you are a veteran with VA healthcare coverage and are over 65 years, enrolling in a Medicare plan can provide more well-rounded coverage.

VA and TRICARE plans can be supplemented with Medicare plans. Additional supplemental plans are available through Medicare, and you can choose one that meets your specific cost and benefits needs.

You have many options to help you create a more balanced healthcare program after you turn 65 years old.