VA Benefits and Medicare Eligibility

The U.S. Department of Veterans Affairs (VA) recommends that veterans with VA benefits choose to enroll in Medicare when they are first eligible. Doing so gives you more options for health care services—both inside and outside of VA facilities.

VA health insurance and Medicare coverage are two separate systems. It’s important to understand how they work together so you can make informed decisions about your care.

Applying for VA benefits

VA medical insurance is based on your service and needs. You must apply to find out:

• If you qualify for VA benefits
• What priority group you’re placed in
• What covered services you can get

Once your eligibility is confirmed, you can look at how your VA coverage works with Medicare.

How VA benefits and Medicare work together

You can have both VA benefits and Medicare. Here’s how they work:

• VA benefits cover care at VA facilities
• Medicare covers care at non-VA providers

You don’t have to enroll in Medicare to use your VA benefits. But if you delay enrolling in Medicare during your Initial Enrollment Period, you may face an enrollment penalty later.

Should I enroll in Original Medicare or a Medicare Advantage plan?

If you choose to enroll in Medicare, you have two main options:

Original Medicare

• Includes Medicare Part A (hospital) and Part B (doctor visits)
• You can add prescription drug coverage (Part D) if needed

Medicare Advantage plan

• Combines Part A and Part B into one plan
• Often includes Part D, vision, dental, hearing and other benefits
• May offer extra services like transportation or fitness programs

If you enroll in a Medicare Advantage plan, make sure your VA coverage still meets your needs. Medicare Advantage plans can help you access care outside the VA system, but your VA doctor and civilian doctor may need to coordinate care.

Using both VA and Medicare coverage

Having both types of coverage allows you to:

• See both VA doctors and non-VA providers
• Get care at a VA facility or outside of it
• Use both systems to cover more services and reduce out-of-pocket costs

Tell your providers if you have both. This helps them:

• Use the right benefits for each service
• Share information between VA and civilian doctors
• Help you find the right location for your care

Learn more about your Medicare options

Want help understanding your Medicare coverage or enrolling in a plan? Banner Health is here to help.

• Learn more about Banner Health’s Medicare Advantage plans

Call 833-516-1007, TTY 711 to speak with a licensed sales agent

October 1 – March 31:  8 a.m. to 8 p.m., seven days a week
April 1 – September 30:  8 a.m. to 8 p.m., Monday through Friday