Chapter 13 VA Health Care and Medicare

You may also be eligible to enroll in Medicare. Because each Veteran’s situation is unique, VA cannot provide a single answer to the question of whether you should enroll in Medicare, but we offer the following information to assist you in weighing your options.

Here are some key points about the two programs:

Remember, VA health care benefits are separate from Medicare. You may be enrolled in both programs, but the enrollment process (and the eligibility criteria) is different for each.

Medicare offers three types of coverage: inpatient (“Part A”), outpatient (“Part B”), and prescription drug (“Part D”). You can decide whether to participate in one “part” or all three.

VA does not recommend that you cancel or decline coverage in Medicare (or other health care or insurance programs) solely because you are enrolled in VA health care. There is no guarantee that in the years to come, Congress will appropriate sufficient funds for VA to provide care for all enrollment priority groups. If you are enrolled in one of the lower priority groups, this could leave you with no access to VA health care coverage. For this reason, signing up for Medicare as a secondary source of coverage may be in your best interest.

Enrolling in both VA and Medicare gives you greater flexibility. For example, if you are enrolled in both programs, you will have access to non-VA physicians (under Parts A and B); or you may obtain prescription drugs (under Medicare Part D) — prescribed by your non-VA physicians and filled at your local retail pharmacies — that are not on the VA formulary.

Medicare allows enrollment (typically at age 62) during a yearly enrollment period. You may be subject to a penalty if you don’t enroll when you first become eligible for some Medicare programs. You can delay enrollment in Part D (prescription drugs) without penalty if you are enrolled in a prescription drug plan (like VA’s) that is considered “creditable coverage” — that is, prescription drug coverage that provides a benefit at least as good as Medicare’s. However, “creditable coverage” for Part B (outpatient/doctor coverage) can only be received through an employer; so you cannot claim VA enrollment as “creditable coverage” for the outpatient Medicare program.

Take time to understand your options under the Medicare program, and read all information received from Medicare or the Social Security Administration carefully. Action on your part may be required.

For example, you are required to sign and return a card if you choose not to enroll in Medicare Part B. Failure to return the card could result in automatic enrollment and deduction of the Part B premium from your Social Security check.

For more information on the Medicare Program, visit or call 1-800-Medicare  (1-800-633-422-4227)