A Guide to Medicare and Veterans Benefits

Kara Lewis
By Kara LewisOctober 22, 2021
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Two-thirds of U.S. military veterans are over the age of 65, according to the Department of Veterans Affairs, making VA benefitsa popular option for senior health care coverage. Many older adults who are eligible for VA benefits also qualify for Medicare, a national health care insurance plan available to all seniors.

Read on to learn more about these two government programs, understand eligibility requirements, and find out how to combine the two to best meet your or your loved one’s care needs.

What is VA health care?

Honorably discharged veterans who served in the Army, Navy, or Air Force may qualify for VA benefits. However, requirements vary by branch, years served, and when your loved one’s service took place. Those who enlisted after September 7, 1980, or entered active duty after October 16, 1981, must have served for 24 months, although there may be exceptions for those disabled in the line of duty or those who faced other hardships. National Guard members who served in active duty during wartime can also receive benefits.

Based on these factors and others, veterans enrolled in VA benefits who wish to receive additional care are assigned to one of eight priority groups. The priority group number takes into account income, disability, and service history, and it helps to determine senior veterans’ copays. Veterans who sustained a disability or significant injury through service are placed in a higher priority group and receive a greater level of coverage than those who developed conditions later in life. 

Recent changes to VA health care eligibility

In September 2021, Veterans Affairs Secretary Denis McDonough implemented a policy to reassess dishonorably discharged veterans for VA benefit eligibility. Under this new policy, those who received other-than-honorable discharges due to sexual orientation, gender identity, or HIV status during “Don’t Ask, Don’t Tell” are eligible for all benefits available to honorably discharged veterans. LGBTQ+ veterans who haven’t applied for a discharge upgrade should do so to determine their eligibility for health and senior care services.

What does VA health care cover?

VA benefits help cover many — but not all — health care services. Services may include:

  • Preventive health testing
  • Routine eye exams
  • Nutrition and dietitian counseling
  • Flu shots and other immunizations
  • Surgeries
  • Dialysis
  • Organ transplants
  • X-rays
  • Blood work
  • Rehabilitation services
  • Therapy and other mental health counseling
  • Emergency care

Veterans must receive care at a preferred VA facility to be eligible for coverage. To find a convenient location for you or your loved one, you can use this comprehensive database of VA facilities.

What is Medicare?

Medicare is a U.S. federal insurance program that helps people 65 and older meet their medical needs. Just like with private insurance, anyone enrolled in Medicare will have copays and deductibles. Seniors can choose between multiple Medicare health plans. Medicare covers many health care services, such as:

  • Ambulance services
  • Anesthesia
  • Bariatric surgery
  • Cardiac rehabilitation
  • Chemotherapy
  • Diabetes prevention
  • Dialysis
  • Flu shots and other immunizations
  • Inpatient hospital care
  • Mammograms
  • Radiology

For a more extensive list of Medicare services, visit the government’s official Medicare coverage page.

Can you combine Medicare and veterans benefits?

Many seniors enhance their coverage and health care options by enrolling in both Medicare and VA benefits. In fact, retirees with VA benefits are encouraged to sign up for Medicare for more versatility and peace of mind.

When you or your loved one needs care, you can choose which benefits to use. Medicare allows seniors to visit non-VA facilities and doctors, which can be helpful for visits to specialists. Medicare Part D, which covers prescription drugs, also enables seniors to fill prescriptions through local pharmacies rather than through the VA’s mail-order service.

In addition to these wider options, seniors should keep long-term health needs in mind. If a veteran doesn’t sign up for Medicare when initially eligible but wants to sign up at a later date, they may encounter a penalty fee, according to the official Medicare website. Additionally, if the amount of government funding for the VA medical program changes, veterans in lower priority groups may be at risk for losing their coverage.

TRICARE for Life: A Medicare benefit for veterans

TRICARE for Life is a unique Medicare wraparound benefit designed specifically to meet the health care needs of veterans. It allows senior veterans access to both a network of civilian health care professionals and the resources of the Military Health System — like military hospitals and VA clinics.

TRICARE offers coverage for active as well as retired service members and their families. With TRICARE for Life, Medicare is still the primary payer. However, TRICARE pays second to Medicare, which can cover costs your normal Medicare benefits don’t. The costs of a TRICARE plan reflect the level of coverage offered. You can learn more about TRICARE health plans from their official military website

How to apply for Medicare and veterans benefits

Veterans interested in applying for VA medical coverage can complete the process online. To assist in this application process, veterans will need their discharge papers, most recent tax return, and Social Security numbers for themselves and any dependents. They should also have access to account numbers for currently held insurance (including Medicare and private insurance). 

Adults 65 and older can apply for Medicare through the U.S. Social Security website. Seniors should have tax documents and their Social Security number on hand.

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Other veterans benefits resources

Navigating the VA application process, as well as how Medicare and VA benefits intersect, can be a complicated and ongoing experience. Here are some other helpful resources for continuing to learn about VA benefits:

Sources:

Medicare Advantage. “Medical Advantage Fact Sheet.”

Triccare.Mil. “What is TRICARE?.”

U.S. Department of Veterans Affairs. “About VA health benefits.”

VAntagepoint. “Tenth Anniversary of the Repeal of Don’t Ask, Don’t Tell.”

Kara Lewis
Author
Kara Lewis

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