Veterans can enroll in Medicare once they become eligible, even if they have Veterans Affairs (VA) benefits or TRICARE. Doing so ensures comprehensive coverage and more flexibility over where veterans can receive medical services.
People who have served in the United States military are usually entitled to VA benefits and TRICARE. Once they reach the age of 65 or qualify for another reason, they can choose to:
- retain VA and TRICARE benefits and enroll in Original Medicare or a Medicare Advantage plan
- retain VA benefits and enroll in Medicare Part A without Part B, which means forfeiting TRICARE
- retain VA benefits only without enrolling in Medicare
This article explains when veterans qualify for Medicare and how Medicare works alongside VA benefits and TRICARE. It also describes the Medicare coverage veterans can choose and how to enroll.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Veterans can sign up for Medicare if they meet any of the following criteria:
- They are 65 years or older.
- They are under 65 years with certain disabilities.
- They have end stage renal disease (ESRD), amyotrophic lateral sclerosis (ALS), or mesothelioma.
If veterans have VA health benefits, they can choose whether they sign up for Medicare once they are eligible. If they choose not to sign up, they will not be covered for medical services outside of the VA health system.
If veterans choose not to sign up for Medicare, they will not lose their VA benefits. However, enrolling in Medicare Part B is essential if they want to keep their TRICARE benefits.
VA healthcare eligibility
People may be eligible for VA health benefits if they served in the military, naval, or air service without receiving a dishonorable discharge.
The minimum duty requirement for VA benefits is 24 continuous months in the military or for veterans to have completed the full period of active duty required of them. In some circumstances, this minimum duty requirement is not necessary.
Who to call for support
Veterans can check whether they qualify for VA benefits by calling 877-222-8387 Monday through Friday, between 8 a.m. and 8 p.m. ET.
All veterans receive VA benefits coverage for most medical care and services. However, only some qualify for extra benefits such as dental care. A veteran’s VA coverage will depend on:
- their priority group
- the recommendations from their VA primary care professional
- the treatment required for any health conditions they may have
Medicare and VA benefits do not work together, so Medicare will not pay for any services a veteran receives from a VA facility. For the VA to pay for services, a person must receive them from a VA facility. For Medicare to pay for services, a person must receive them from a Medicare facility. Exceptions to these rules may be possible but require pre-authorization.
TRICARE eligibility
TRICARE is government-sponsored medical insurance for the military. It is available for active or former personnel, their dependent family members, surviving spouses, and certain former spouses. Once a veteran turns 65, they become eligible for TRICARE for Life.
Unlike the VA, Medicare coordinates with TRICARE so veterans can receive medical services from either Medicare or non-Medicare participating facilities.
For services covered by both plans, Medicare pays its share of the cost first, then TRICARE pays its share. People typically do not have to pay out-of-pocket costs.
For TRICARE to cover a veteran’s healthcare costs, they must be enrolled in Medicare Part B and have a current military ID card. People eligible for Medicare Part A who choose not to enroll in Part B will lose their TRICARE eligibility.
Coordinating health benefits for veterans
Veterans can ensure comprehensive coverage by enrolling in Medicare, VA benefits, and TRICARE. While Medicare pays for most medical services, VA benefits and TRICARE may pay for services Medicare does not cover.
Some veterans with VA benefits choose to enroll in Medicare Part A because there is no monthly premium. They may choose not to enroll in Part B because it carries a monthly premium of $174.70 for 2024.
However, the VA healthcare system could change if Congress reduces funding, so the VA recommends that veterans enroll in Original Medicare, comprising parts A and B, as soon as they qualify.
Alternatively, veterans can enroll in a Medicare Advantage plan from a private insurer. Medicare Advantage, or Part C plans, comprise parts A, B, and usually D. Part D covers prescription drugs. They may also provide additional benefits not covered by Original Medicare, including dental, vision, and hearing care.
Part D is available to people with Original Medicare. It may cover medications the VA health benefit does not cover.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
The process for enrolling in Medicare is similar for veterans and nonveterans.
Veterans can enroll via the Social Security Administration during the Initial Enrollment Period (IEP). The IEP lasts for 7 months and begins 3 months before a person’s 65th birthday.
If veterans delay signing up and miss the IEP, they may have to wait until the next General Enrollment Period, which runs from January 1 to March 31 each year. They may also face a late enrollment penalty.
An exception to this is if a veteran or their spouse is still working and has health insurance from their current employer. In that case, they can delay enrollment and will not be issued a late enrollment penalty.
Veterans can apply for Part D during the IEP or the Annual Enrollment Period, which runs from October 15 to December 7.
Veterans who wish to have full health insurance coverage can have VA benefits, Medicare, and TRICARE at the same time. This means they will be covered for most medical services and can receive care from both VA and Medicare facilities.
Once a person qualifies for Medicare, they may choose to enroll in Original Medicare (with or without prescription drug coverage) or a Medicare Advantage plan. The timing of enrollment is important to avoid late enrollment penalties and ensure there are no gaps in coverage.