Medicare and VA benefits do not work together. But they can sometimes complement each other. For example, if the VA pre-authorizes treatment at a non-VA hospital but not certain services you get during the hospital stay, Medicare may pay for those services. For specifics, contact your Medicare plan.
Full Answer
How do Medicare and the VA work together?
Dec 10, 2019 · It's worth noting that you can’t use VA benefits and Medicare simultaneously. In other words, if the VA covers a treatment or office visit, Medicare can’t cover services rendered at the same time. The only exception occurs when you’re sent to a non-VA hospital by the VA.
What happens if you have both Medicare and VA health insurance?
Nov 30, 2021 · Medicare and VA benefits do not work together. But they can sometimes complement each other. For example, if the VA pre-authorizes treatment at a non-VA hospital but not certain services you get during the hospital stay, Medicare may pay for those services. For specifics, contact your Medicare plan.
How much does Medicare Part a cost with VA benefits?
How VA Benefits and Medicare Work Together. Generally speaking, VA benefits and Medicare do not directly affect one another. If you are enrolled in both, each plan will pay for its covered benefits—if you have VA benefits and want to see doctors and receive care not covered by your plan, you may consider enrolling in Medicare as well, then.
How does the VA prescription drug plan compare to Medicare?
Jan 06, 2022 · Combining VA Benefits, Medicare and a Medigap Plan Just because you have both VA benefits and Medicare doesn’t mean all of your medical costs will be covered free-of-charge. In addition to the 2022 Medicare Part A deductible of $1,556 per benefit period, coinsurance for hospital stays lasting longer than 60 days starts at $389 per day in 2022.
When can veterans enroll in Medicare?
Like other Americans, veterans become eligible for Medicare at age 65. (Those with a qualifying disability may enroll earlier.) The best time to sign up is during your initial enrollment period. That begins 3 months before the first day of your birthday month and lasts for 7 months.
Do you have to enroll in Medicare if you have VA benefits?
You don’t. But without Medicare coverage, you’ll be uninsured for any treatment you get at non-VA facilities or care from providers not authorized in advance by the VA. You’ll be billed for the full cost of those services, at serious risk to your net worth. That’s why the VA recommends that veterans sign up for Medicare as soon as they can.
What are the benefits of combining Medicare and VA benefits?
Enrolling in Medicare could fill in gaps in the coverage you get through the VA benefits. That’s because you’ll be able to go either to VA facilities for treatment (covered under VA benefits) or to Medicare-approved doctors and facilities (covered by Medicare). Also, VA benefits are not guaranteed, so your coverage could change in the future.
Which areas of Medicare coverage and VA benefits can you combine?
Medicare and VA benefits do not work together. But they can sometimes complement each other. For example, if the VA pre-authorizes treatment at a non-VA hospital but not certain services you get during the hospital stay, Medicare may pay for those services. For specifics, contact your Medicare plan.
How does VA disability affect Medicare?
VA benefits — including disability payments — don’t affect Medicare. At age 65, you are eligible for Medicare regardless. Before that, you may receive Social Security Disability Insurance (SSDI) while you’re on VA disability. After 2 years of SSDI payments, you can enroll in Medicare. Your VA disability benefits remain in place.
What do you have to do to manage Medicare and VA benefits?
You will have to pay the premiums for Medicare Part B or Medicare Advantage as well as any cost-sharing copayments. For VA benefits, there typically aren’t enrollment fees, monthly premiums, or deductibles. But some veterans may have copayments for healthcare or prescription drugs.
Where can you get help coordinating Medicare and VA benefits?
Various government-supported offices have staffers to help you combine and manage your health plans:
Why Should You Combine VA Benefits with Medicare?
VA benefits cover specified hospitals, physical exams, prescriptions, etc. Veterans often find, however, that these benefits do not cover all of their needs. In that case, a Medicare plan may provide the necessary additional coverage.
Medicare Supplements or Advantage with VA Benefits
Most VA programs encourage their beneficiaries to enroll in both VA and Original Medicare. Original Medicare, or Parts A and B, cover hospital care and medically necessary services.
Contact Go Medicare Compare
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Does the VA pay for Medicare Part A?
The VA usually encourages veterans to enroll in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). You typically don't have to pay a premium for Part A, while the standard Part B premium for 2019 is $135.50 or higher, depending on your income. Part B covers Medicare-approved doctor’s services and outpatient services, ...
Can veterans get Medicare?
How Veterans Can Make Sense of Medicare and VA Benefits. Veterans who receive health care benefits through the U.S. Department of Veterans Affairs (VA) can also enroll in Medicare upon turning 65. Because each offers different benefits, having both at your disposal will broaden your health insurance coverage options.
Why is it important to understand VA and Medicare?
Because each offers different benefits, having both at your disposal will broaden your health insurance coverage options. If you’re a veteran, it’s important to understand how VA benefits and Medicare work in tandem before you make the choice.
How long do you have to serve in the military to get VA benefits?
The minimum duty requirements for VA benefits call for 24 months of continuous service, which also applies to members of the National Guard and the Reserves. But because there are many exceptions ...
Does Medicare cover long term nursing care?
While the VA’s plan provides veterans with benefits that Medicare does not offer, such as dental coverage and long-term nursing care, your medical costs are only covered if you receive care at a VA facility, or at a non-VA facility with prior authorization from a VA doctor. Having both VA benefits and Medicare insurance broadens your coverage ...
Do you have to pay a premium for Medicare and VA?
The VA usually encourages veterans to enroll in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). You typically don't have to pay a premium for Part A, while the standard Part B premium ...
Does the VA cover all priority groups?
The VA health plan depends on the annual appropriation of funds by Congress. From year to year there is no guarantee of sufficient funds to cover all priority groups. Even if all your medical needs are presently met by VA doctors, there may come a time when you will require care from a non-VA provider.
Is Medicare and VA separate?
The Medicare and VA systems are entirely separate, with no coordination of benefits between them. You would use your VA identity card at VA facilities and your Medicare card anywhere else. You'll find more information at the VA website on how VA care works with other insurance . Return to Medicare Q&A Tool main page >>.
Does Medicare cover VA?
Having both Medicare and VA benefits greatly widens your coverage. VA coverage pays for medical services if you go to a VA hospital or doctor. If you need to go elsehwere, you'll probably end up having to pay the full cost yourself, even in emergencies. With Medicare, you're covered if you need to go to a non-VA provider.
Can Medicare cover non VA?
With Medicare, you're covered if you need to go to a non-VA provider. This is an especially important point to consider if you live some distance from the nearest VA facility. You may be subject to penalties in the future.
Is VA coverage less expensive than Medicare?
VA coverage for prescriptions is typically less expensive than Medicare Part D drug plans, and you won’t be hit with late penalties if you lose VA coverage in the future, provided that you sign up with a Part D plan within two months of that coverage ending.
Is VA health coverage the same for everyone?
VA health coverage isn’t set in stone and isn’t the same for everyone. The VA assigns enrollees to different priority levels according to various factors, such as income and whether they have any medical condition that derives from their military service.
What happens if you don't have Part B insurance?
If you are not already signed up for Part B (and don't have insurance through an employer or other source), you'll likely have to wait a while for coverage, and you could be liable for late penalties that are permanently added to your Part B premiums.
Does Medicare Advantage Plan conflict with VA?
Coverage through a Medicare Advantage Plan does not conflict with VA health care services and would increase your flexibility and options in terms of how and where you receive health care. Second opinion. With Important health issues, you may want to get a second opinion. Having two separate health care sources— the VA and a Medicare Advantage plan ...
When is Medicare enrollment for VA?
Medicare Annual Enrollment, which runs from Oct. 15 to Dec. 7 , is nearly upon us. It could be a great time to shop, and check out the costs, limitations and specific details. Here are seven things to consider as you weigh a decision to supplement your VA health care with a Medicare Advantage Plan:
Does Medicare Advantage cover hearing?
Some Medicare Advantage plans offer hearing, dental and wellness programs that aren’t paid for under Medicare. It also could be that many Medicare recipients want the peace of mind that comes with limiting maximum out-of-pocket outlays. That’s a feature of Medicare Advantage plans not available through traditional Medicare which does not put ...
Does Medicare cover vacations?
And while Medicare doesn’t cover you if you’re on vacation outside the U.S., a Medicare Advantage plan could provide worldwide emergency coverage.
Is VA coverage guaranteed?
Eligibility for VA health coverage is not guaranteed and could change over time. This could be true, especially, at times when budgetary issues are top-of-mind in Washington. A Medicare Advantage plan could be your fallback. You can have both.
Do you need a second opinion on Medicare?
Second opinion. With Important health issues, you may want to get a second opinion. Having two separate health care sources— the VA and a Medicare Advantage plan — could provide the means to do that. It’s important to remember that not all Medicare Advantage plans are created equal.
What is the number to call for Medicare?
Details for 2018 plans become available Oct. 1, so beat the rush and give them a call at 877-699-2654.
Does Medicare cover VA?
VA health care benefits typically only cover services received at a VA facility, and for Medicare to cover your care , you must visit a non-VA facility that accepts your Medicare coverage. Having coverage through both the VA health program and Medicare gives you wider coverage and more choices of where you can be treated.
Is Medicare Part B a VA benefit?
Medicare Part B (Medical Insurance) and VA Benefits. Medicare Part B can provide you with medical coverage and services outside of the VA health system. Therefore, it is recommended that you enroll in Medicare Part B in addition to your VA benefits. If you wait to enroll in Part B when you are first eligible, you will likely experience gaps in ...
Why is Medicare important for VA?
Therefore, Medicare coverage may be particularly important if, say, you don’t live near a VA facility or your local facility has long wait times.
What is Medicare Advantage?
Medicare Part C (Medicare Advantage) and VA Benefits. If you need additional services or coverage not offered to you through your VA benefits, you may consider a Medicare Advantage plan. Most Medicare Advantage plans offer additional coverage, like vision, hearing, dental, prescription drug coverage, and/or health and wellness programs. ...
How to contact Medicare.org?
For further information about finding a Medicare plan that works with your VA health benefits and individual needs, call (888) 815-3313 – TTY 711 to talk with an experienced Medicare.org licensed sales agent.
What happens if you wait to enroll in Medicare Part B?
If you wait to enroll in Part B when you are first eligible, you will likely experience gaps in coverage and incur a penalty for each 12-month period you were without Medicare Part B coverage. Learn more about Medicare Part B.
Does Medicare affect VA?
And remember, signing up for Medicare does not affect your VA health-care benefits. Medicare Part A, which provides hospital coverage, costs nothing. The standard premium for Part B, which is for outpatient care and medical equipment, is $135.50 for 2019. (Those with higher incomes pay more. See chart.)
How long does it take to get VA health care?
The VA encourages those who receive health care through its network to sign up for Medicare when they are first eligible. You get seven months to enroll, starting three months before the month in which you turn 65 and ending three months after your birthday month. If you get health care through the Veterans Health Administration ...
How long does it take to sign up for Medicare?
You get seven months to sign up; the enrollment period starts three months before the month in which you turn 65 and ends three months after your birthday month. For example, if the big day is June 15, your signup window begins March 1 and ends Sept. 30. And remember, signing up for Medicare does not affect your VA health-care benefits.
What is the guarantee issue period for Medicare?
After that window, unless your state allows special exceptions, you have to go through medical underwriting. And depending on your health, that process could cause the Medigap insurer to charge you more or deny coverage altogether .
Is there harm in not signing up for Medicare?
And, there’s no harm in not signing up: If you don’t do it when you’re first eligible for Medicare and then change your mind later, you won’t pay a penalty because it is considered “creditable” by the Centers for Medicare and Medicaid Services. VIDEO. 14:58. 14:58. How American health care got so expensive.
Does Medicare cover VA?
VA care is limited to providers who accept VA treatment, and having Medicare coverage will expand your doctor network as well as provide supplemental coverage opportunities. If you’re nearing Medicare eligibility, you should decide whether or not to add to your VA coverage by enrolling in Medicare.
Can you get Medicare Advantage with VA?
However, a private insurance plan called a Medicare Advantage ( MA) plan may offer supplemental benefits that you can’t receive with just VA benefits. For example, some Medicare Advantage plans have a $0 monthly premium ( like this Humana plan) and some even come with a fitness benefit. That could mean that your Medicare Advantage plan provides ...
Do veterans need Medicare?
Technically, veterans do not need Medicare because many veterans qualify for VA benefits and TRICARE. However, a private insurance plan called a Medicare Advantage (MA) plan may offer supplemental benefits that you can’t receive with just VA benefits. For example, some Medicare Advantage plans have a $0 monthly premium ( like this Humana plan) ...
Does Medicare Advantage have a gym membership?
For example, some Medicare Advantage plans have a $0 monthly premium ( like this Humana plan) and some even come with a fitness benefit. That could mean that your Medicare Advantage plan provides a gym membership. VA benefits and TRICARE do not.
Does Medicare help veterans?
Even if you already have veterans benefits through the VA, Medicare can help you expand your provider network (more doctors and pharmacies, shorter wait times) and potentially provide more financial coverage.
How long do you have to serve to get VA benefits?
Almost everyone who has served in active military duty is eligible for VA benefits. Since 1980, you must have served for 24 continuous months or for the full time for which you were called to active duty or you must have been honorably discharged to be eligible.
Do veterans have health insurance?
In many cases, family members of deceased veterans can receive veteran health insurance as well. Some veterans may have to pay a copay for doctor visits and prescription drugs, ...
