TRICARE and VA Benefits with Medicare
PLEASE NOTE: A MESSAGE FROM VETERANS AFFAIRS AND MEDICARE REGARDING
Veteran Benefits (VA)
TRICARE is a regionally-managed health care program serving active duty and retired members of the uniformed services, as well as their families, and survivors. TRICARE brings together the health care resources of the uniformed services and civilian health care professionals to provide better access and high quality health care service.
For service members who are entitled to Medicare Part A and B, TRICARE provides Medicare “wrap-around” coverage. Medicare is the primary payer for these beneficiaries. TRICARE serves as a supplement, paying the Medicare deductible and patient cost share.
The law requires TRICARE beneficiaries who are entitled to Medicare Part A based upon age, disability, or End Stage Renal Disease (ESRD) to enroll in Medicare Part B to retain their TRICARE benefits. Beneficiaries lose TRICARE coverage for any period in which they could have been covered by Medicare Part B, but chose not to enroll.
VA MEDICAL BENEFITS EXPLAINED
If you served in the active military, naval or air service and are separated under any condition other than dishonorable, you may qualify for VA health care benefits. Current and former members of the Reserves or National Guard who were called to active duty (other than for training only) by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health care as well.
COORDINATION WITH MEDICARE
If you have other forms of health care coverage, such as a private insurance plan, Medicare, Medicaid or TRICARE, you can continue to use VA along with these plans. Remember: it is always a good idea to inform your doctors if you are receiving care outside of VA, so your health care can be coordinated.If you are eligible for Medicare Part D prescription drug coverage, you need to know that enrollment in the VA health care system is considered creditable coverage for Medicare Part D purposes. This means that VA prescription drug coverage is at least as good as the Medicare Part D coverage. Since only Veterans may enroll in the VA health care system, dependents and family members do not receive credible coverage under the Veteran’s enrollment.
However, there is one significant area in which VA health care is NOT creditable coverage: Medicare Part B (outpatient health care, including doctors’ fees). Creditable coverage for Medicare Part B can only be provided through an employer. As a result, VA health care benefits to Veterans are not creditable coverage for the Part B program. So although a Veteran may avoid the late enrollment penalty for Medicare Part D by citing VA health care enrollment, that enrollment would not help the Veteran avoid the late enrollment penalty for Part B.
VA does not recommend Veterans cancel or decline coverage in Medicare (or other health care or insurance programs) solely because they are enrolled in VA health care. Unlike Medicare, which offers the same benefits for all enrollees, VA assigns enrollees to enrollment priority groups, based on a variety of eligibility factors, such as service-connection and income.
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HERE ARE A FEW RESOURCES FOR TRICARE AND VA BENEFITS COORDINATING WITH MEDICARE