Is VA primary to Medicare?

Asked by: Dr. Hertha Grady MD  |  Last update: February 11, 2022
Score: 4.4/5 (73 votes)

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 .

Is VA insurance always primary?

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.

Does the VA pay 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.

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).

When would the VA pay primary to Medicare?

Should I Enroll in Medicare if I Have VA Coverage? The U.S. Department of Veterans Affairs recommends that you enroll in Medicare when you turn 65 even if you have VA coverage. This will ensure that you have additional coverage options when seeking care outside of VA facilities.

VA or Medicare? Do you need both?

26 related questions found

Can the VA bill Medicare?

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

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.

Can you go to any hospital with VA benefits?

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

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 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.

Do veterans pay for VA health care?

We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of at least 50%, as well as for those who can't afford to pay for care.

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.

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.

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.

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.

Does VA cover ER visits?

In general, VA can pay for emergency medical care at a local ER for a Veteran's service-connected condition, or if the care is related to a Veteran's service-connected condition. VA can also pay for emergency medical care for a Veteran's non-service connected condition.

Do VA benefits affect Social Security?

If you receive VA compensation, this will not affect your Social Security benefits.

Who qualifies for free VA health care?

Normally, if you have an injury or disability caused by your military service you are eligible to be treated for that condition by the VA for free. If your disability or injury is severe enough for the VA to rate you at least 50% disabled for compensation benefits, all your medical care is free from the VA.

Can I use my VA health care anywhere?

You may select any VA facility that is convenient for you. If the facility you choose cannot provide the health care that you need, VA will make other arrangements for your care based on administrative eligibility and medical necessity.

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.

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.

Is it mandatory to have Medicare?

Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever. You may have good reasons to want to delay signing up, though.

What insurance is the VA?

TRICARE For Life (TFL) & Veterans Affairs (VA) Benefits - California Health Advocates.