| Tue, May 12, 2020 @ 09:00 AM

Medicare Enrollment for Veterans

Posted by Medicare Made Clear

When a veteran becomes eligible for Medicare, he or she may already have other insurance such as from an employer, the Veterans Administration (VA) benefits or TRICARE. Because of this, you may ask the following:

  • As a veteran, do I have to enroll in Medicare when I first become eligible?
  • Is Medicare required for veterans?
  • Do Medicare and TRICARE work together?
  • Can Medicare work with my VA benefits?

Let’s start with Medicare overall for veterans before diving in deeper into how Medicare may work with VA benefits and TRICARE.

Are Veterans Required to Enroll in Medicare?

Nobody is required to enroll in Medicare, but if you do so outside of your Initial Enrollment Period without creditable coverage from an employer, you could face late enrollment penalties. It’s important to note that neither VA benefits nor TRICARE will qualify you to delay Medicare enrollment without financial penalty.

Q: Do I need Medicare if I’m a veteran who’s planning to work past 65?

A: If you have creditable drug coverage from an employer and plan to work past 65, you may be able to delay Medicare enrollment without penalty. Click here to learn about Medicare when working past 65.

Q: Is Medicare mandatory for veterans with VA benefits?

A: Medicare is not mandatory for anyone, but if you enroll outside of your Initial Enrollment Period and don’t qualify to delay, you could face late enrollment penalties. 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. Enrolling offers veterans more coverage choices and options for medical and hospital care, as well as for prescription drug services if they also enroll in a Part D plan. Finally, the VA has also cautioned veterans that it’s uncertain whether or not they’ll be able to continue to cover all veterans in the future. Please click here to read the important statement from the VA about why you should sign up for Medicare at 65.

Q: Do you need to get Medicare when you have TRICARE?

A: If you have TRICARE, unless you meet certain exceptions, you will need to get Medicare to remain eligible for TRICARE. Keep reading for more information about Medicare with TRICARE.

Medicare & TRICARE

If you have TRICARE when you become eligible for Medicare at 65, you can have both. You have 90 days after you become eligible for Medicare to change your TRICARE health plan, and your plan options will depend on your specific situation including how you qualify for Medicare, you or a family member’s active duty status and which TRICARE plan you’re currently enrolled in.

Most people with TRICARE, who become Medicare eligible and get Medicare Part A, must also have Medicare Part B to be able to remain eligible. Part D is not required to maintain eligibility.

You can remain eligible for TRICARE without enrolling in Medicare Part B only if you are:

  • An active duty service member
  • An active duty family member
  • Enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult or the US Family Health Plan.

Another important note is that when you become Medicare eligible, the age of your spouse and covered family members, as well as the TRICARE plan you all were on, each play a role in your coverage options. Read more about this here under the “Family Members” section on TRICARE’s website.

 Medicare and Veterans Administration Benefits Can Work Together

You can have both VA Benefits and Medicare. However, you will need to choose which benefits you use when you receive health care services or get health care items.

To use VA benefits, you’ll have to see a VA doctor or get care at a VA medical center or other VA location. The VA will also cover care if it’s been pre-authorized for services in a non-VA hospital or other care location.

If you go to a non-VA or also VA authorized care facility, Medicare may pay for the services you may need, or if the VA has only pre-authorized some services at the non-VA location, then Medicare may provide coverage for other services the VA doesn’t cover. What Medicare does and doesn’t cover will depend on the plan you have, what kind of health care facility you receive services at, and which benefits you designate to use if you can use both.

Some other important things to note about Medicare when you have VA benefits:

  • If you have Part B, and then you drop it, you won’t be able to get it back until January of the following year. Also, if you drop it and decide you want it back later on, you may have to pay a penalty to reinstate the coverage. (VA source)
  • VA benefits often include prescription drug coverage; however, if you sign up for Medicare Part D, you can also get your medicines from non-VA doctors and fill prescriptions at local pharmacies instead of only through the VA mail-order service.

For more information about Medicare, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

For more information about VA benefits, visit www.va.gov.

For more information about TRICARE and Medicare, visit www.tricare.mil/medicare.

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