VA Benefits vs MedicareVA Benefits vs Medicare

If you’re a senior veteran, you have some experience with confusing benefits. Navigating the wide world of which benefits are available, who qualifies for what, which benefits are compatible with other benefits and how to make sure you get what you should is an often overwhelming and frustrating task. One of the nice side effects of providing service to our country is that you do get access to a lot of special benefits. You just have to jump through some frustrating hoops to figure them all out.

If you’re already 65 or older or approaching it, then you’ve probably starting thinking about where Medicare fits into everything. Should you apply? Will it work against any of the other benefits you get? How does it compare to your veterans benefits? It’s a tricky world to navigate, but here are some of the main things you should know.

Should I Apply for Medicare?

Yes! Parts A and B for sure, possibly D as well in some cases. Each part of the program covers different types of care:

  • Part A is for hospitalization, stays in skilled nursing facilities (in some cases), home health care (in some cases), and hospice.
  • Part B covers doctor’s bills and outpatient costs, like laboratory work, medical equipment, and physical and speech therapy.
  • Part C functions like a private insurance plan that replaces the need for Parts A and B (as a veteran, you probably shouldn’t worry about part C, unless you feel your VA benefits are too limited for your needs)
  • Part D covers prescription drugs. Most veterans will get better coverage for drugs under your VA plan, so the only reason to consider Part D is if you want more options in terms of who prescribes your drugs and where you can get them filled.

Part A won’t cost you anything extra, so there’s really no reason not to sign up. Part B costs a little over $100 a month, and C and D will both have varying monthly premiums based on the plans you consider.

But the VA Offers Everything I Need. Do I Really Need to Pay More for Part B?

It’s the smart move, for sure. If you don’t sign up for Part B when you turn 65 and you decide you actually do want it after all at some point later, you’ll pay a penalty for it at that time. It’s hard for you to know now what health services you’ll need in the future and you may well find that the VA doesn’t provide everything you need. Part B allows you to seek out services elsewhere instead of relying on the VA exclusively.

What’s the Difference Between My Veterans Benefits and Medicare Coverage?

Short answer: nearly everything. They’re two different systems entirely.

Your veterans’ coverage will only cover you when you go to doctors, facilities, and pharmacies included in the VA system. Medicare will only cover you when you go to doctors, facilities, and pharmacies that are covered under Medicare. While there’s overlap in what types of health care needs the two types of benefits cover, the where and how of the treatment that’s covered under each are totally different.

Having Medicare doesn’t mean you can’t go to the VA anymore; you simply increase your choices by having both.

So, Should I Stick With Going to the VA, or Go Somewhere Covered By Medicare?

It depends. If you’re happy with the care you’re getting at the VA hospital, are familiar with the doctors and staff, and like to stick with what you know, no one will stop you from continuing to go there for most of your care. On the other hand, if your local VA hospital has a backlog or other issues that make you less than thrilled with your care there, you can branch out and try other facilities.

You may also start to find yourself having healthcare needs that the VA isn’t as qualified to help you with as other local doctors and facilities are. If you need a specialist that the VA hospital can’t offer, you can go to any doctor in the area that takes Medicare.  

Having both options gives you a lot of leeway to shop around and seek out the care that’s best for your needs.

This Is All So Confusing!

Yep. But are you really surprised? Any time the government picks up the tab for something, they want to at least try to be careful they’re doing things right and not misspending the allotted funds. Hence all the rules and bureaucracy. Sometimes that means that even those who have earned the benefits have to do some work to be sure they get them.

Of course, if you have experience in the military, you’re probably used to dealing with some bureaucracy. Between all the benefits available to you, you should be able to get much of the care you need largely covered. Trust me, some of your non-veteran peers are having a much harder time of it.

Kristen Hicks is an Austin-based copywriter and lifelong student with an ongoing curiousity to learn and explore new things. She turns that interest to researching and exploring subjects helpful to seniors and their families for SeniorAdvisor.com.

9 Comments

  1. Gerald Spencer February 18, 2016 Reply

    The VA will only treat a veteran if the veteran is disabled from the military or if the veteran is very low income. Anywhere near a median income, even if retired, will disqualify a veteran from VA care. THAT is the first thing to watch for.

  2. Gary July 13, 2017 Reply

    That is not my experience at all. I am neither disabled, retired military nor low income and enjoy full VA medical due to the dates of my service (“Vietnam Era.”)
    Income only affects co-pay levels in may case.

  3. Jack Stewart January 8, 2018 Reply

    I am rethinking medicare B vs VA health coverage. I now of course have both, but after five years I was hoping on a social security increase (2.0%) and medicare ends up taking nearly all of it in increase medicare premiums. Now at $134 per month, it is making me think whether I should just go to VA and save that $134 that I must pay for medicare part B.

  4. Pat February 16, 2018 Reply

    VA as always treated m well, every 3 months or so I get a call, hey Pat time for a check up, or yuuukkk conoloscopy time yukkkkk, but the VA treats me as deserved and will always use them, thank you VA and vets for your services, We love you

  5. dennismckeeferysr February 28, 2018 Reply

    vietnamveteran in country cost of medicare -medicaresupplement-rx payments total 376.65amonth plus copayswondering if I should drop them and use the va benefits only

  6. dennismckeeferysr February 28, 2018 Reply

    dennis mckeefery sr us army 1970-1971 Vietnam 1 year have medicare-medicare supplement-rx program totaling 376.65 wish to drop all of the above need sound advice please recommend me a positive answer

  7. Dave March 11, 2018 Reply

    Left the Marine Corps in 1972. I have full medical benefits and have been using them for the last 40 years with no problems. if you have an illness such as a spider bite they send you to an outside specialist and the VA took care of it I was sent to an outside specialist for heart care and ended up needing 3 stints for blocked arteries and the VA took care of it. the VA has their game on point when it comes to taking care of us. This article is full of half truths and hearsay and needs to be deleted and rewritten by someone who knows how to do their homework more thoroughly.

  8. Juana Hernandez October 2, 2018 Reply

    My husband has both VA and Medicare, he pays for part B, but when ever he’s needed the VA it’s always treated him well and with the respect he deserves. Also he’s been seen by specialist at the VA. Never paid a dime, only for prescriptions, and it is based on your income. If your income is low you pay less.

  9. Kay Steed November 2, 2018 Reply

    I have no problem with VA. If I need specialist I am sent to an outside provider if the VA cannot provide the service I need. My only problem is getting through to the telephone lines.

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