Dear Marci,

I am retired and I receive most of my health care through Veterans’ Affairs (VA) benefits. I will be turning 65 soon. Will Medicare work with my VA benefits? Do I need to take Medicare Parts B and D?

-Domingo (Tempe, AZ)

Dear Domingo,

Medicare generally does not coordinate with Veterans Affairs (VA) benefits. You can have both Medicare and VA benefits, and many people choose to use both benefits in order to have access to more providers and services. However, with few exceptions, Medicare and VA benefits do not work together. Medicare generally does not pay for care that you receive at a VA facility.

In order for Medicare to cover your care, you usually have to receive care at a Medicare-certified facility that works with your Medicare coverage. In order for your VA coverage to cover your care, you must generally receive health care services at a VA facility. Exceptions can be made, such as if you receive prior authorization from the VA to receive VA-covered services at a Medicare-approved facility. If an emergency occurs that requires you to receive such care, the VA may cover some of those costs until you can be moved to a VA facility for continued care.

Many veterans receive their VA health benefits to get coverage for health care services and items not covered by Medicare, such as over-the-counter medications, annual physical exams, and hearing aids.

However, you may want to consider enrolling in Medicare Part B even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. Without Part B, you will not have Medicare coverage for physician, outpatient, and ambulance services. In addition, if you do not enroll into Part B when you are first eligible to do so, but later decide to enroll in Part B, you will likely face a Part B premium penalty for each 12-month period you were without Medicare Part B coverage. In addition, you may also experience gaps in coverage.

Drug coverage offered by the VA is creditable. This means that it is as good as or better than Medicare Part D prescription drug coverage. As long as you remain enrolled in drug coverage through the VA, you can delay enrolling in Medicare Part D without penalty. If you are interested in enrolling in a Part D plan in addition to your VA coverage, compare your options first. Some things to consider are the costs of a plan’s premiums, deductibles, and copays, the drugs that are available on a plan’s formulary (list of covered drugs), and the pharmacies that you can go to.

If you have a limited income, you may qualify for programs that help with some of the costs associated with Medicare. The Medicare Savings Program (MSP) pays the part B premium, and sometimes pays the Medicare Part A premium and Parts A and B coinsurances and deductibles. The Extra Help program can pay for most or some of your prescription drug costs. To learn more about these programs and for assistance with applying, you should contact your State Health Insurance Assistance Program (SHIP). If you do not know how to find your SHIP, you can call 877-839-2675 or visit www.shiptacenter.org.

-Marci