In order for Medicare to cover your care, you will need to receive care at a Medicare-certified facility. With your VA benefits, you generally need to receive your health care from a VA facility.
Medicare Part B and VA Coverage
Many veterans use their VA health benefits to get coverage for health care services and items that aren’t covered by Medicare, like over-the-counter medications, dental care and hearing aids. You might still want to consider enrolling in Medicare Part B, even if you have VA coverage.
Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. If you don’t enroll into Medicare Part B when you’re first eligible, you will fall under the Part B premium penalty for each 12-month period you were without Medicare Part B coverage.
Medicare Part D and VA Coverage
Some veterans only use their VA drug coverage to get their medications, since VA drug coverage may offer more generous prescription drug coverage than Medicare Part D, the Medicare prescription drug benefit. Since VA drug coverage is considered creditable, meaning it is as good as or better than the Medicare prescription drug benefit, you can delay enrolling into Medicare Part D without penalty. If you do lose VA drug coverage, make sure you enroll into a Part D plan within 63 days of losing your VA benefits.
You may want to join a Part D plan in certain situations. You may want to enroll in a plan if you move into a nursing home outside of the VA health system and need coverage for medications from the nursing home pharmacy. You may also want to enroll in a Part D plan if you qualify for Extra Help, the federal assistance program that helps people with Medicare afford their Part D drug costs.
Medigap and VA Coverage
You may also want to also sign up for a Medicare Supplement Plan (Medigap). It will help fill in the unpaid gaps in coverage such as deductibles, copays, and coinsurance.
Medigap is a great way to protect your wealth, but it does come with premiums. Make sure to speak with your VA, Tricare or CHAMPVA representative before enrolling in any supplemental plan to ensure that it is your best course of action.
If you have questions about VA benefits and coverage, contact the VA Health Administration Center at 1-800-733-8387 or 1-877-222-VETS.