• Jamie Smith

Veterans, The VA, TRICARE, and Medicare Benefits.

Everything you need to know.


If you are a Veteran eligible for Medicare or turning 65, there are a lot of misconceptions about Medicare you should know. Now, you are not required to enroll in Medicare if you already have coverage through the US Department of Veterans Affairs. However, the VA strongly recommends that you should enroll as soon as you become eligible, and here’s why.


You can expand your coverage with both Medicare and VA benefits. While you can go to the VA for medical services and prescriptions at little to no cost, that may only sometimes be the case. If you need to go elsewhere or seek special treatment outside of the VA, you will likely have to pay the full cost yourself. Even for an emergency. While it is convenient, it is better to have additional coverage than not.


You could have to pay penalties in the future. For example, if you had not signed up for Medicare when you turned 65, at some point, you might not have VA benefits any longer.


Likewise, if you did not sign up for Medicare Part B coverage, you’ll likely have to wait a while, or you could be liable for late penalties permanently added to your Part B premiums.


VA health coverage is not one-size-fits-all. There are different priority levels that the VA assigns enrollees to according to various factors like income and any medical condition that came from their military service. Those Veterans in the lower priority groups could lose VA coverage completely. It is all dependent upon federal funding.


Medicare enrollment. Medicare works the same for Veterans as any other eligible enrollee. You will be automatically enrolled in Medicare Parts A and B if you receive Social Security benefits for at least four months before your 65th birthday. Remember that if you are not automatically enrolled or delay Part B coverage, you may have to pay higher monthly premiums.


Original Medicare offers Part A, Hospital Coverage, and Part B Medical Coverage, and it generally does not include dental, vision, or hearing benefits. In addition, Original Medicare covers only 80%, and you will need additional coverage for the 20% not covered.


Other options for the additional 20% are:

  • Medicare Supplement/Medigap

  • Medicare Advantage

  • Medicare Part D


Medicare Supplement/Medigap plans can be added to Original Medicare to help with a portion of the out-of-pocket choices not covered by Original Medicare with a monthly premium that increases annually. This option does not include Prescription Drug Coverage or additional benefits like dental, hearing, or vision.


Medicare Advantage plans, known as Part C, offer the same coverage as Original Medicare and generally include additional benefits such as Prescription Drug Coverage, dental, hearing, and vision. In addition, these plans often come with no monthly premium and other perks like over-the-counter allowances and more.


Medicare Part D is available as an add-on if you opt into a Medicare Supplement/Medigap plan. It will have a monthly premium in addition to the Medicare Part B and Medicare Supplement/Medigap monthly premiums.


It’s worth noting that if you sign up for Medicare, you can get either a Medicare Supplement/Medigap policy or a Medicare Advantage plan, but not both.


Your VA benefits and Medicare are separate plans and do not overlap in coverage. Therefore, enrolling in Medicare will not affect VA benefits and vice versa. You need to note that you cannot use your Medicare card when accessing care from the VA.


TRICARE for Life Plans (TFL) and Original Medicare. Veterans who are eligible for TRICARE and have Original Medicare can have both. TFL is a program that provides Medicare-wraparound coverage, which means they work together to coordinate your benefits to reduce your out-of-pocket medical costs.


TRICARE for Life (TFL) and Medicare Advantage. If you choose to enroll in a Medicare Advantage plan, you can do so and still keep TFL as long as you have both Medicare Parts A and B. In addition, many Medicare Advantage plan options provide cash-back benefits.


No matter what health coverage you decide to use, TRICARE pays last.


The Department of Veterans Affairs recommends you enroll in Medicare Parts A and B. Part B Medicare does involve paying a premium; however, depending on your situation and income level, you can receive help from various programs and plans. We can help you decide which option works for you and help get you the benefits you are eligible to receive.


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At Senior Solutions, our agents are here to ensure you are in the right plan according to your needs. As a result, we have become the go-to for Medicare and retirement for many individuals and their families.


Our mission is to ensure you are confident and happy, and we do this in person! We believe in-person communication provides a better understanding and builds a vital relationship for you and your family. We do this at no cost to you.


If you have any questions about your current plan and would like a complimentary Medicare Benefits Review, please call us at 833-905-1060.


If you live near Lincoln County in Kentucky, we have a Senior Resource Center open Monday - Friday. Monday and Fridays are by appointment, with walk-ins being welcome Tuesday, Wednesday, and Thursday from 9 am - 4 pm. Please call 606-669-6002 for an appointment.



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