I am a veteran with health care coverage from the VA system. Do I need Medicare as well?

En español | If you have coverage through the U.S. Department of Veterans Affairs (VA) and are eligible for Medicare, you’re not required to enroll. But you may have good reasons to do so. The VA itself strongly recommends that veterans with VA health care also enroll in Medicare Parts A and B as soon as they become eligible (unless they have group insurance from a current employer).

Here’s why:

·         VA health coverage isn’t set in stone and isn’t the same for everyone. The VA assigns enrollees to different priority levels according to various factors, such as income and whether they have any medical condition that derives from their military service. If federal funding for VA health care drops or doesn't keep pace with costs, some vets in the lower priority groups may lose VA coverage entirely.

·         Having both Medicare and VA benefits greatly widens your coverage. VA coverage pays for medical services if you go to a VA hospital or doctor. If you need to go elsehwere, you've very likely end up having to pay the full cost yourself, even in emergencies. With Medicare, you're covered if you need to go to a non-VA provider. This is an especially important point to consider if you live some distance from the nearest VA facility.

·         You may be subject to penalties in the future. At some point, when you’re well past 65, you mght lose VA coverage, or otherwise decide that you need Medicare. If you are not already signed up for Part B (and don't have insurance through an employer or other source), you'll likely have to wait a while for coverage, and you could be liable for late penalties that are permanently added to your Part B premiums.

When it comes to drug coverage, there is less downside to putting off Medicare. VA coverage for prescriptions is typically less expensive than Medicare Part D drug plans, and you won’t be hit with late penalties if you lose VA coverage in the future, provided that you sign up with a Part D plan within two months of that coverage ending.

However, If you have both VA and Part D drug coverage, you have the flexibility of using one or the other. This would allow you to get prescriptions from non-VA doctors and fill them at local retail pharmacies (rather than relying solely on the VA's mail-order service) and to obtain medications the VA doesn’t cover. You can apply for low-cost drug coverage under Part D’s Extra Help program if your income is under a certain level. 

The Medicare and VA systems are entirely separate, with no coordination of benefits between them. You would use your VA identity card at VA facilities and your Medicare card anywhere else. You'll find more information at the VA website on how VA care works with other insurance. 

https://www.aarp.org/health/medicare-qa-tool/does-medicare-work-with-veterans-coverage/