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A Guide to Medicare and VA Benefits

Kara Lewis
By Kara LewisSeptember 22, 2020
Two military veterans wearing their uniforms and smiling for a picture.

For seniors, Medicare and VA benefits are popular options for health care coverage. Medicare provides benefits for seniors age 65 and older. Meanwhile, two-thirds of all veterans fall into the senior age bracket. This makes many older adults eligible for both VA and Medicare.

Learn more about these two government programs, understand eligibility requirements, and find out how to use them to meet your health care needs.

What is VA health care?

Honorably discharged veterans who served in the active military, air service, or navy may qualify for VA benefits. In most cases, veterans must have served two continuous years, though there can be exceptions for those disabled in the line of duty or those who faced other hardships. National Guard members who served in active duty can also receive benefits.

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Based on these factors, veterans enrolled in VA benefits are assigned a priority group, one through eight. Your group number, or priority, takes into account income, disability, and service history, and is used to assist in determining your copays. Those who sustained a disability or significant injury through service will be placed in a higher priority group, which corresponds to a greater level of coverage.

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, you can use this comprehensive database of VA facilities.

What is Medicare?

Medicare is a U.S. federal program for people 65 and older to help them meet their medical needs. Just like with private insurance, those 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 Medicare coverage page.

If I have VA medical do I need Medicare?

Many seniors enhance their coverage and health care options through enrollment in both Medicare and VA benefits. When you need care, you choose which benefits to use. Those with VA benefits are encouraged to sign up for Medicare for more versatility and peace of mind.

Medicare allows seniors to visit non-VA facilities and doctors. 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 does not sign up for Medicare when initially eligible, but wants to sign up at a later date, they may encounter a penalty fee. Lastly, if the amount of government funding for the VA medical program changes, those in lower priority groups may be at risk for losing their coverage.

How to apply for VA medical and Medicare coverage

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

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

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.” 
http://files.kff.org/attachment/Fact-Sheet-Medicare-Advantage

U.S. Department of Veterans Affairs. “About VA health benefits.” 
https://www.va.gov/health-care/about-va-health-benefits/

Kara Lewis
Author
Kara Lewis

Kara Lewis is a content writer at A Place for Mom. She’s worked in writing, editing, and creative strategy for several years, most recently at Andrews McMeel Universal, Hallmark, and Gannett Media. Her writing has appeared in Bustle, Alma, and The Kansas City Star, among other outlets. She has won awards for digitally conscious journalism, investigative reporting, magazine writing, and poetry.

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