Medicare and VA Benefits: How They Work Together for Veterans

If you’re a veteran turning 65, you may be able to have both Medicare and VA benefits. They are separate programs, and generally they can’t pay for the same care. Each time you see a doctor or go to the hospital, you use one or the other.

Timing matters too: if you rely on VA health care and put off Part B, you may owe a late penalty. Here’s how the two fit together in 2026 and 2027, plus what TRICARE For Life adds for military retirees.

How Medicare and VA benefits work together

Medicare.gov says you can get care under either program. But Medicare doesn’t pay for any care you get at a VA facility, and VA says it won’t bill Medicare for that care.

Where you get care	Which benefit usually pays
A VA medical center or clinic	VA (a copay may apply for non-service-connected care, depending on your priority group)
A community provider, with a VA referral	VA (a VA copay may apply)
A non-VA doctor or hospital, without VA authorization	Medicare, if you have it
An emergency at a non-VA hospital	VA may pay if VA is told within 72 hours; otherwise Medicare may pay, if you have it
A non-VA hospital stay that VA authorized only in part	VA for what it authorized; Medicare may pay for Medicare-covered services VA didn’t authorize
A military hospital or clinic, if you have TRICARE	TRICARE

VA community care and Medicare

Community care is care from a non-VA provider that VA arranges. VA says it covers this care when VA care isn’t timely or accessible and your VA health care team gives you an authorized referral. A doctor who bills VA for authorized services must accept VA’s payment as payment in full and can’t bill you or Medicare for those services.

Without a referral, VA generally doesn’t pay for non-VA care. Medicare may pay for some or all of it, if you have Medicare.

Do veterans need Medicare Part A and Part B?

Most people don’t pay a premium for Part A, because they or a spouse paid Medicare taxes long enough while working. Part A helps pay for inpatient care at non-VA hospitals that accept Medicare. If you already get Social Security benefits, you’re enrolled in Part A and Part B automatically at 65.

Part B has a monthly premium. For 2026, the standard Part B premium is $202.90 a month. Keeping it is your choice. But Medicare’s 2027 handbook says VA coverage, like COBRA, doesn’t count as job-based coverage for a Special Enrollment Period.

Social Security’s Medicare booklet says that if you have VA coverage and don’t sign up for Part B when you’re first eligible:

• You may have to pay a late enrollment penalty for as long as you have Part B.
• You may have to wait to sign up, which delays your coverage.

Under Medicare’s rules, your premium may go up 10% for each full 12-month period you could have had Part B but didn’t. If you miss your window, you can generally sign up during the General Enrollment Period, January 1 – March 31, with coverage starting the next month.

VA encourages veterans to enroll in Medicare as soon as they’re eligible. It notes that your priority group, wait times and health needs can change, and so can VA funding. Still working? Job-based coverage follows different rules, so read our guide to Medicare and employer insurance.

VA drug coverage and Part D

Medicare.gov lists VA drug coverage among coverage that can be creditable, meaning it’s expected to pay, on average, at least as much as standard Medicare drug coverage. VA says there’s no Part D penalty if you join when first eligible, or within 63 days after your VA health care ends.

You can have both, but Medicare.gov notes you can’t use both for the same drug at the same time. VA adds that a Part D plan lets you fill prescriptions from non-VA doctors at a local pharmacy, instead of through VA’s mail-order service.

Keep records of the dates you had VA health care. If you join a Medicare drug plan later, the plan may ask whether you had creditable coverage. Our article on the Part D out-of-pocket cap explains 2026 and 2027 drug costs.

Medicare Advantage for veterans: can you have both?

Yes. Medicare Advantage plans come from private companies that contract with Medicare, and most use a network of doctors and hospitals. VA says you’d use the plan for non-VA care in its network, but the plan won’t pay for care at a VA facility. You keep paying your Part B premium, and any plan premium, even in months when you only use VA.

VA notes that Medicare Advantage plans may cover some dental, vision or hearing care that VA doesn’t cover for you, depending on your priority group, and a plan can be an option when VA care isn’t available. Benefits vary by plan, and our guide to Medicare Advantage HMO vs PPO explains how networks work.

With Original Medicare, a Medigap policy can help pay Medicare’s deductibles and coinsurance when you get care outside VA. VA says it doesn’t bill Medicare, but it may bill a Medicare supplemental policy for covered services.

How TRICARE For Life and Medicare work together

TRICARE For Life (TFL) covers Medicare-eligible uniformed services retirees 65 or older, their eligible family members and survivors, and certain former spouses. Medicare.gov is clear: you must have Part A and Part B to get TFL benefits.

• Signing up: With TRICARE, you generally must sign up for Part A and Part B when you’re first eligible to keep TRICARE. Active-duty service members and their family members don’t have to sign up for Part B to keep TRICARE while the sponsor is on active duty. Ask TRICARE what you’ll need when the sponsor retires.
• Starting TFL: VA says TFL starts once both parts are active. You don’t enroll in it separately.
• Who pays first: If you aren’t on active duty, Medicare pays first for Medicare-covered services, and TRICARE may pay second. At a military hospital or clinic, TRICARE pays.
• Drugs: You don’t need a Medicare drug plan if you have TRICARE. If you join one, it pays first and TRICARE pays second.
• VA care: VA says enrolling in TFL doesn’t cancel VA health care, and VA won’t bill TFL for care at a VA facility.

For questions, call TRICARE For Life at 1-866-773-0404 (TTY 1-866-773-0405).

Steps to take before you turn 65

A few steps now make it easier to use Medicare and VA benefits side by side.

1. Mark your Initial Enrollment Period. It’s 7 months: the 3 months before your 65th-birthday month, that month, and the 3 months after. Our Turning 65 checklist walks through it.
2. Confirm your VA priority group and copays. Call VA health care at 877-222-8387 (TTY 711), Monday – Friday, 8 AM – 8 PM Eastern.
3. Decide on Part A and Part B. Sign up through Social Security at ssa.gov/medicare/sign-up, or call 1-800-772-1213 (TTY 1-800-325-0778).
4. Retired from the military? Make sure Part A and Part B are both in place, and confirm TFL eligibility in DEERS through milConnect.
5. Missed a window? Our guide to Medicare Special Enrollment Periods explains when you can still make changes.

You can also call HICAP, California’s Health Insurance Counseling & Advocacy Program, at 1-800-434-0222, or Medicare at 1-800-MEDICARE (TTY 1-877-486-2048).

Frequently asked questions

Do veterans need Medicare Part B?

It’s your decision. VA coverage doesn’t give you a Special Enrollment Period for Part B. If you sign up later, you may pay a late penalty for as long as you have Part B. Military retirees with TRICARE generally must have Part A and Part B to keep TRICARE.

Will Medicare pay for care at a VA hospital?

No. Medicare doesn’t pay for care you get at a VA facility, and VA doesn’t bill Medicare for it. Generally, Medicare and VA benefits can’t pay for the same care. Medicare can help pay for covered care you get outside VA without a VA referral.

Does VA health care cover my spouse?

VA says it doesn’t normally provide care for veterans’ family members, so a spouse usually needs their own coverage. Some spouses, survivors and children may qualify for CHAMPVA, for example the spouse of a veteran rated permanently and totally disabled from a service-connected disability. Anyone eligible for TRICARE can’t get CHAMPVA. If they’re eligible for Medicare, they must have Part A and Part B to get or keep CHAMPVA.

Does VA or Medicare pay for long-term care?

Medicare doesn’t pay for long-term care, such as help with bathing and dressing. VA may provide long-term care for some veterans, so ask VA what you may be eligible for. See Does Medicare cover long-term care? for other options.

Talk with a licensed Boomers agent

A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions.

Find a licensed agent near you · See upcoming Medicare events

Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.

Sources

• Who pays first? (Medicare.gov)
• How Medicare works with other insurance (Medicare.gov)
• Medicare & You 2027 (Medicare.gov)
• Creditable prescription drug coverage (Medicare.gov)
• Avoid late enrollment penalties (Medicare.gov)
• Long-term care (Medicare.gov)
• Medicare, Publication 05-10043 (SSA.gov)
• Veterans turning 65 (VA.gov)
• VA health care and other insurance (VA.gov)
• CHAMPVA benefits (VA.gov)