Can I use both VA health care and Medicare at the same time?

Yes. VA health care and Medicare are completely separate programs, and you can be enrolled in both simultaneously. However, you cannot use both to pay for the same service on the same visit. You choose which program to use each time you receive care. Many veterans use the VA for routine care and prescriptions while relying on Medicare for specialists, emergencies, or care away from a VA facility.

Does VA health care count as creditable coverage for Medicare Part B?

No. VA health care is not considered creditable coverage for Medicare Part B purposes. If you delay enrolling in Part B because you have VA coverage, you will face a permanent late-enrollment penalty of 10% added to your Part B premium for every full 12-month period you were eligible but did not enroll. Only employer-based group health insurance qualifies for a Special Enrollment Period.

Will Medicare pay for care I receive at a VA hospital?

No. Medicare does not pay for services received at VA facilities, and the VA does not bill Medicare. When you receive care at a VA hospital or clinic, the VA covers those services under its own system. Medicare only pays when you receive care from Medicare-participating providers outside the VA system. The two programs operate independently and cannot be combined for the same service.

Do I need Medicare Part D if I get prescriptions from the VA?

Not necessarily. VA prescription drug coverage is considered creditable coverage for Part D, so you will not face a late-enrollment penalty if you delay Part D while you have VA pharmacy benefits. The VA formulary is extensive and copays are often lower than Part D plans. If you later want Part D, you can enroll during the annual open enrollment period without penalty.

What is TRICARE for Life and how does it work with Medicare?

TRICARE for Life is a program for military retirees and their families who are entitled to Medicare Part A and enrolled in Part B. TFL acts as a secondary payer similar to a Medigap supplement, covering most costs that Medicare does not pay, including the 20% Part B coinsurance. TFL has no enrollment fee beyond the Part B premium and provides worldwide coverage. Enrolling in Part B is mandatory to maintain TFL benefits.

Can I have a Medicare Advantage plan and still use VA health care?

Yes, but your Medicare Advantage plan will not pay for or cover any services you receive at VA facilities. VA care does not count toward your MA plan's out-of-pocket maximum. If you primarily use the VA, you may not benefit from an MA plan. Some veterans prefer Original Medicare for its broader flexibility outside the VA system.

Medicare and VA Benefits: Can Veterans Use Both? (2026 Guide)

Can Veterans Have Both Medicare and VA Benefits?

Yes. If you are a veteran who is eligible for VA health care and also qualifies for Medicare, you can have both. There is no rule that forces you to choose one over the other. These are two entirely separate programs run by two different federal agencies, and enrolling in one does not affect your eligibility for the other.

Roughly nine million veterans are enrolled in VA health care, and millions of those veterans are also enrolled in Medicare. Having both gives you flexibility: use the VA for routine care, prescriptions, and specialized veteran services, then turn to Medicare when you need a private-sector provider, face an emergency far from a VA facility, or want faster access to a specialist.

But the two programs do not coordinate the way many people expect. They do not share billing, and you cannot combine them for a single visit. The biggest mistake veterans make is assuming VA coverage protects them from Medicare late-enrollment penalties. It does not.

How VA Health Care Works

VA health care is a government-run health system — not an insurance plan. The Department of Veterans Affairs operates roughly 1,300 facilities including hospitals, clinics, and community-based outpatient centers. To qualify, you generally must have served on active duty and received an honorable or general discharge.

The VA assigns enrolled veterans to one of eight priority groups based on service-connected disability rating, income, and other factors. Priority Group 1 includes veterans with disabilities rated at 50% or higher. Your priority group determines copay obligations: Groups 1 through 5 generally pay nothing for most care, while Groups 7 and 8 may owe $15 for primary care visits, $50 for specialty care, and several hundred dollars for inpatient stays.

VA coverage is broad — preventive care, primary care, specialty care, mental health, prescription drugs, vision, dental (for eligible veterans), and specialized programs for PTSD, traumatic brain injury, and Agent Orange exposure that are difficult to find elsewhere.

How Medicare Works for Veterans

Veterans are eligible for Medicare on the same terms as every other American. When you turn 65, you qualify based on age, work history, and citizenship. Military service and VA enrollment have no bearing on Medicare eligibility.

Part A (Hospital Insurance): Inpatient hospital stays, skilled nursing, hospice, and some home health. Premium-free for most people with 40+ quarters of Medicare taxes.
Part B (Medical Insurance): Doctor visits, outpatient care, preventive services, durable medical equipment. Standard premium: $185.00/month in 2025.
Part C (Medicare Advantage): Private plan alternative bundling Parts A, B, and usually D. Uses provider networks and often includes dental, vision, and hearing.
Part D (Prescription Drugs): Outpatient medications through private plans. Annual out-of-pocket cap of $2,000 starting in 2025.

Medicare gives you access to the entire civilian health care system. Over 97% of non-pediatric physicians accept Medicare, compared to the limited number of VA facilities available in many areas.

Key Differences Between VA and Medicare

Although both provide health coverage, the VA and Medicare differ in nearly every structural way.

Provider networks: VA care is delivered at VA facilities and VA-approved community care providers. Original Medicare lets you see any doctor or hospital that accepts Medicare nationwide.

Costs: Many veterans pay little to nothing for VA care. Medicare requires premiums ($185.00/month for Part B), deductibles ($1,676 for Part A, $257 for Part B), and 20% coinsurance with no annual cap under Original Medicare.

Coverage scope: The VA covers dental (for qualifying veterans), vision, hearing aids, and specialized veteran-specific programs. Original Medicare does not cover routine dental, vision, or hearing.

Prescription drugs: VA pharmacy copays are often $5 to $11 per 30-day supply with a broad formulary. Part D plans have varying premiums and cost-sharing, though the $2,000 annual cap provides a ceiling.

Geographic flexibility: Medicare works at any participating provider nationwide. VA care requires you to use VA facilities or authorized community care providers, which can be limited in rural areas.

Why Veterans Should Consider Enrolling in Medicare

Some veterans wonder why they should pay for Medicare when the VA already provides care. The answer comes down to flexibility, access, and risk management.

Access outside the VA: See any Medicare-accepting doctor, specialist, or hospital for second opinions, closer providers, or preferred physicians.
Emergency care anywhere: The nearest hospital in an emergency may not be a VA facility. Medicare covers emergency care at any participating hospital.
Travel coverage: Veterans who travel, split time between states, or winter elsewhere need coverage that follows them. Original Medicare works in all 50 states.
Shorter wait times: Some VA regions have significant wait times. Medicare provides an alternative path to care when you cannot wait.
Specialist access: Not every VA facility offers every specialty. Medicare opens the door to specialists, academic medical centers, and Centers of Excellence.

When to Enroll in Medicare as a Veteran

Unlike VA health care, which you can join anytime, Medicare has strict enrollment windows and permanent penalties for missing them.

Your Initial Enrollment Period (IEP) is a seven-month window starting three months before your 65th birthday month and ending three months after. This is the ideal time to sign up for both Part A and Part B.

Part A is straightforward. If you or your spouse paid Medicare taxes for at least 10 years, Part A is premium-free. There is no downside to enrolling. Every veteran should sign up for Part A at 65.

Part B is where it gets complicated. At $185.00 per month in 2025, some veterans question the expense when they already have VA coverage. But delaying Part B triggers a permanent late-enrollment penalty: 10% added to your monthly premium for each full 12-month period you were eligible but did not enroll. Wait five years and your premium permanently increases by 50% — an extra $92.50 every month for life.

Do You Need Medicare Part B if You Have VA Coverage?

This is the most consequential question for veterans approaching 65: VA health care does not protect you from the Medicare Part B late-enrollment penalty.

Medicare only waives the Part B penalty if you delayed because you had creditable employer-based group health coverage. VA health care, TRICARE (for non-retirees), and individual insurance do not count. The VA explicitly states that its coverage is not a substitute for Medicare and does not qualify for a Special Enrollment Period.

If you skip Part B at 65 and enroll at 70, you pay a 50% penalty surcharge permanently. You also must wait for the General Enrollment Period (January through March), with coverage not starting until July — creating months without Medicare.

The exception: veterans still actively working with employer group health coverage get a Special Enrollment Period when the employment or group coverage ends — eight months to enroll in Part B without penalty. But the employer coverage, not the VA coverage, triggers this right.

Most veterans should enroll in Part B during their IEP at 65, even if they plan to keep using VA care. The monthly premium preserves your flexibility and avoids a lifelong penalty.

Using VA and Medicare Together

Once you have both programs, you choose which to use on a visit-by-visit basis. But there are firm rules about how they interact.

Medicare does not pay for VA care. When you receive treatment at a VA facility, Medicare is not billed. VA visits do not count toward any Medicare deductible or out-of-pocket maximum.

The VA does not pay for non-VA care. If you see a private-sector doctor and bill Medicare, the VA is not involved. The VA only pays for care at VA facilities or through VA-authorized community care referrals.

You cannot bill both for the same service. Federal law prohibits billing both Medicare and the VA for the same service. A provider cannot submit a claim to one program and bill the other for the difference.

In practice, many veterans use the VA for primary care, mental health, prescriptions, and service-connected conditions, while turning to Medicare for outside specialists, travel care, and situations where the VA has long wait times.

Medicare Advantage and VA Benefits

Veterans can enroll in a Medicare Advantage plan and still use VA health care. However, your MA plan will not pay for any services received at VA facilities. That care does not count toward your deductible or out-of-pocket maximum. From your MA plan's perspective, VA visits do not exist.

If you rely heavily on the VA and rarely use outside providers, you are paying for an MA plan you barely use. And if you split care between systems, you manage two sets of providers, records, and formularies.

For veterans who want Medicare coverage beyond the VA, Original Medicare with a Medigap supplement often makes more sense than Medicare Advantage. Original Medicare has no network restrictions, works nationwide, and pairs seamlessly with VA care. You can see any doctor without referrals or network worries. The higher monthly cost buys genuine flexibility.

That said, some veterans in lower-priority groups who face VA copays may find value in a $0-premium MA plan for non-VA care. The right choice depends on how often you use the VA versus outside providers.

Prescription Drug Coverage: Part D vs. VA Pharmacy

The VA pharmacy benefit is one of the strongest in the country. Comparing it to Part D helps veterans decide whether they need both.

Cost: Priority Groups 1 through 6 pay $0 for service-connected medications and $5 for other generics. Groups 7 and 8 pay $5 for generics and $11 for brand-name drugs. Part D plans average roughly $46.50/month in premiums with varying copays, though the $2,000 annual cap provides cost certainty.

Formulary: The VA National Formulary is broad and regularly updated. Part D formularies vary by plan. A drug covered by the VA may not be on a specific Part D formulary, and vice versa.

Convenience: VA prescriptions are filled at VA pharmacies, through VA mail-order, or at some retail pharmacies. Part D plans offer broad retail and mail-order networks. If no VA pharmacy is nearby, Part D provides easier local access.

The good news: VA drug coverage is creditable for Part D, so you face no late-enrollment penalty by skipping Part D while enrolled in the VA pharmacy benefit. Many veterans skip Part D and save the monthly premium. If your VA eligibility changes, you can join a Part D plan during the next open enrollment without penalty.

TRICARE and Medicare

TRICARE covers active-duty service members, military retirees, and their families. It is separate from VA health care, and its interaction with Medicare has critical implications for retirees.

When a TRICARE-eligible beneficiary turns 65 and gains Medicare Part A entitlement, standard TRICARE coverage ends. It is replaced by TRICARE for Life (TFL) — but only if you enroll in Medicare Part B. This is mandatory. Without Part B, you lose all TRICARE coverage after 65.

TFL functions like a Medigap supplement at no additional premium beyond Part B. Medicare pays first, and TFL covers most remaining costs — deductibles, coinsurance, and copayments. For most Medicare-covered services, your out-of-pocket cost with TFL is zero or near-zero. TFL also provides overseas coverage and access to military treatment facilities, benefits that standard Medicare and Medigap do not offer.

TFL includes its own pharmacy benefit with access to military pharmacies, the TRICARE retail network, and mail-order. Military retirees with TFL generally do not need a separate Medigap policy — TFL provides comparable or better secondary coverage at no extra cost.

The critical takeaway: military retirees must enroll in Part B during their Initial Enrollment Period at 65. Failure to do so means losing TRICARE entirely and facing the permanent Part B late-enrollment penalty if you sign up later.

The Bottom Line

VA health care and Medicare serve different purposes and work best when used together. The VA provides specialized veteran services and low-cost prescriptions. Medicare provides nationwide civilian provider access and a safety net outside the VA system.

The most important action: enroll in Medicare Part A and Part B during your Initial Enrollment Period at 65. Part A is free for most veterans. Part B costs money, but skipping it creates a permanent penalty that only grows over time. VA coverage does not protect you from this penalty — only employer-based group health insurance does.

For prescriptions, the VA pharmacy benefit is excellent and counts as creditable Part D coverage, so most veterans can safely skip Part D without penalty. For military retirees, Part B enrollment is mandatory to maintain TRICARE for Life — one of the best supplemental arrangements available at no extra cost.

Every veteran's situation is different. Your priority group, disability rating, location, and health needs all factor into how you split care between the VA and Medicare. But the foundational advice is universal: do not leave the VA, and do not skip Medicare. Carry both, and you will have the broadest safety net the federal government offers.

Medicare and Veterans Benefits: Can You Use Both VA and Medicare?