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Veterans, VA Benefits, and Medicare

When it comes to VA health benefits, signing up for Medicare is like topping off a gift with a fancy ribbon.

That’s because unlike some other insurance plans, you can keep your VA health benefits and add on Medicare too.

  1. How Does Medicare Work with VA Benefits?

    Medicare doesn’t cover any VA-related costs. If you have VA health benefits and Medicare, you can choose to get care at a VA facility or at any facility that accepts Medicare.

  2. Doesn’t That Cost More?

    Yes, you can save money if you just keep your VA health benefits and not enroll in Medicare. But here are a few questions to consider.

    What priority group am I in? Your priority group affects when benefits start and what’s covered with VA benefits. Priority groups range from 1 to 8 and are based on the following.

    • Military service history
    • Disability rating
    • Income level
    • Whether or not you qualify for Medicaid
    • Other benefits being received like a VA pension

    Veterans in the highest priority groups (1 and 2) receive the most benefits. Those in lower priority groups (7 and 8) can lose their VA benefits if their income goes up. Copay rates are higher in the lower priority groups. Plus the VA may not cover a non-service-connected condition.

    What VA benefits will I have in the future? Medicare is a safety net in case VA benefits change.

    What happens if I wait to enroll in Medicare? The U.S. Department of Veterans Affairs encourages veterans to sign up for Medicare when eligible. Why? First, most won’t pay a premium for Medicare Part A. Second, when waiting to sign up for Medicare Part B, you pay a penalty every year for the rest of your life. That penalty gets larger every year you wait to sign up. If you miss your Initial Enrollment Period (IEP) for signing up, you may need to wait until the General Enrollment Period (GEP). This period runs every year from January 1 to March 31. Coverage starts the first day of the month after you sign up.

    How close am I to a VA facility? If you don’t live near a VA facility, Medicare is a good choice. It will provide a closer, Medicare-approved facility.

  3. What About Prescriptions?

    There’s no major difference between benefits received from either a VA or a Medicare prescription drug plan.

    If you have a VA drug plan, you must fill your prescriptions at a VA pharmacy. That’s why some people add a Medicare Part D plan. They can then go to a nearby pharmacy if the VA pharmacy isn’t close.

    Here’s some good news. If you have VA drug benefits, you won’t pay a late-enrollment penalty if you sign up for Part D later. If you do lose your VA drug benefits, you must sign up for Part D within 63 days to avoid a penalty.

  4. Put a Bow on It

    Want to package together your VA health benefits with Medicare but have questions? Talk with one of our licensed insurance agents today.

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MR653 11/2022