Is VA insurance primary over Medicare?

Asked by: Valentine Stiedemann I  |  Last update: February 11, 2022
Score: 4.6/5 (61 votes)

The short answer is that Medicare doesn't coordinate with VA benefits. However, you can have both types of insurance at the same time and benefit from doing so.

Are VA benefits primary over Medicare?

VA health benefits always provide primary coverage in VA facilities. If you have VA benefits and become eligible for Medicare, you should consider the benefits of both types of insurance and whether you should enroll in Medicare now or delay enrollment—and the potential consequences of delayed enrollment.

Is Medicare primary or secondary to VA?

The VA pays for VA-authorized services or items . For active-duty military enrolled in Medicare, TRICARE pays first for Medicare- covered services or items, and Medicare pays second . For inactive-duty military enrolled in Medicare, Medicare pays first and TRICARE may pay second .

How does VA and Medicare work together?

You can have both Medicare and Veterans Affairs (VA) benefits, but Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility. ... VA benefits will not pay for Medicare cost-sharing (deductibles, copayments, coinsurances).

Is VA primary over Medicaid?

We don't bill Medicare or Medicaid, but we may bill Medicare supplemental health insurance for covered services.

VA or Medicare? Do you need both?

43 related questions found

Can VA be billed secondary to Medicare?

VA benefits aren't secondary insurance to Medicare, as they cover care at different types of facilities. Yet, if you're eligible for both, enrolling in both can round out your health care.

Do Veterans need Medicare Part B?

The VA itself strongly recommends that veterans with VA health care also enroll in Medicare Parts A and B as soon as they become eligible (unless they have group insurance from a current employer). Here's why: VA health coverage isn't set in stone and isn't the same for everyone.

Does the VA count as health insurance?

All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. ... VA health care is NOT considered a health insurance plan.

Are veterans eligible for Medicare?

Veterans can receive both Veteran Affairs (VA) health care benefits and Medicare when they become eligible. It's recommended for veterans to enroll in Medicare so they have more coverage options when seeking care from non-VA health care facilities.

Do veterans get free healthcare?

The VA will provide you free health care for conditions that are caused or made worse by your military service. ... You can also receive more care from the VA if you have an income below certain limits. If you are a 50% or greater disabled veteran or a former POW, all your medical care from the VA is free.

How do you determine which insurance is primary?

Primary insurance is a health insurance plan that covers a person as an employee, subscriber, or member. Primary insurance is billed first when you receive health care. For example, health insurance you receive through your employer is typically your primary insurance.

What insurance is primary or secondary?

Primary insurance pays first for your medical bills. Secondary insurance pays after your primary insurance. Usually, secondary insurance pays some or all of the costs left after the primary insurer has paid (e.g., deductibles, copayments, coinsurances).

How do I know if my Medicare is primary?

Medicare is primary when your employer has less than 20 employees. Medicare will pay first and then your group insurance will pay second. If this is your situation, it's important to enroll in both parts of Original Medicare when you are first eligible for coverage at age 65.

Can you go to any hospital with VA benefits?

Once enrolled, veterans can receive treatment at a VA healthcare facility anywhere in the country.

Do I need Medicare Part D if I have VA benefits?

No. Drug coverage from the VA (Veterans Affairs) is considered creditable prescription drug coverage, which means the coverage is at least as good as what Medicare drug plans provide, so you do not need to enroll in a Medicare Part D plan.

Do veterans have to pay for prescriptions?

Typically, VA drug coverage has no premiums and no or limited copayments for prescriptions—but you must use VA pharmacies and facilities. You may want Part D coverage if you: Live far from a VA pharmacy or facility, or do not want to use a VA provider to get prescriptions.

What happens to my VA disability when I turn 65?

Even after veterans reach full retirement age, VA's disability payments continue at the same level. By contrast, the income that people receive after they retire (from Social Security or private pensions) usually is less than their earnings from wages and salary before retirement.

Do I need TRICARE if I have VA benefits?

If you retire and qualify for VA benefits, you can use your TRICARE and VA benefits together. You will see the VA for service-connected conditions and use TRICARE for everything else.

How does VA healthcare work?

The VA's system is separate from the health-care system that the military uses for active-duty personnel, retirees, dependents, and military families. ... The system prioritizes active-duty personnel, but, when available, it can also provide care to retirees, dependents, and former spouses.

Who Pays First TRICARE or VA?

Other federal insurance includes medicare, medicaid, VA healthcare, or Indian Health Service coverage. If you are covered by one of these plans they pay before Tricare first. If you are treated for a non-covered condition, Tricare pays first.

Do military retirees pay for Medicare?

When a military retiree or spouse reaches 65, they are eligible for Medicare and TRICARE for Life medical coverage. ... Medicare pays first for Medicare-covered services. TRICARE for Life will pay the Medicare deductible and coinsurance amounts and any service TRICARE for Life covers that Medicare doesn't cover.

Do military retirees pay for Medicare Part B?

If you're 65, but have an active duty sponsor, you don't have to have Medicare Part B until your sponsor is retired. ... You're automatically entitled to Medicare Part A and are enrolled in Medicare Part B starting the first day of the month you turn 65.

Can I have VA health care and TRICARE?

Does VA participate in the TRICARE Network? Yes, since 1995, all VA health care facilities have participated as TRICARE Network Providers. VA can provide care for Active Duty Service Members, military retirees, & family members under their TRICARE benefit - on a space available basis.

How do I change my Medicare from secondary to primary?

If you're in a situation where you have Medicare and some other health coverage, you can make Medicare primary by dropping the other coverage. Short of this, though, there's no action you can take to change Medicare from secondary to primary payer.

Can I opt out of Medicare if I have VA benefits?

If you have VA benefits, you do not have to enroll in Medicare in order to keep your VA benefits. That being said, the Veterans Administration actually recommends veterans enroll in Medicare when they become eligible.