Medicare Advantage for Veterans

Medicare Advantage can be used for veterans, even if they are receiving benefits from TRICARE or Veterans Affairs (VA). While the healthcare plans can be used interchangeably, they do not work together. If you receive care from a VA facility, then your VA benefits will only cover those services. If you receive care outside of a VA facility, Medicare will cover those services.

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Medicare Advantage and VA Benefits

By having both a Medicare Advantage Plan and VA health coverage, you’ll receive more benefits compared to having just one or the other. However, both plans, technically, do not work together. Still, by having both, you extend your range from strictly receiving care from VA facilities to going outside the VA network and still receiving coverage. If you happen to have an emergency and need to go to the closest hospital outside of the VA network, you won’t have to worry about covering all of the costs. The Medicare Advantage Plan will provide coverage for most, if not all, of the services you receive.

VA benefits are also not guaranteed and are subject to change. If you have both VA and Medicare Advantage, you’ll still be able to keep your Medicare Advantage Plan even if you lose your VA benefits. However, you will not be able to receive treatment or care from a VA facility.

Enrolling with Medicare

If you become eligible for Medicare and are looking to invest in a Medicare Advantage Plan to assist in coverage outside of your VA benefits, you must enroll in both Medicare Part A and Part B. For most, a monthly premium payment for Part A is waived. However, Part B requires a monthly premium to be paid. Once you’re enrolled in both, you can switch to Medicare Advantage. If you miss the enrollment period for Medicare, you may receive penalties if you choose to enroll later.

If you are enrolled in TRICARE and are not on active duty, but you’re entitled to Part A, you’ll be required to enroll in Part B to keep your TRICARE coverage. If you want to have TRICARE For Life, you must also be enrolled in Part A and Part B.

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Prescription Drug Coverage

VA has a specific formulary list regarding what drugs it covers, but it may not cover everything needed. If you enroll in a Medicare Advantage Plan that offers prescription drug coverage, you could receive coverage for prescriptions that you need that aren’t covered under VA.