Having VA or TRICARE benefits does not automatically mean you can ignore Medicare. These programs work with Medicare differently, so understand the rules before delaying enrollment.

If You Have VA Health Care

VA health care and Medicare are separate systems.

  1. VA benefits generally cover care through VA facilities or VA-authorized providers.
  2. Medicare may cover eligible care from non-VA doctors and hospitals.
  3. Medicare can provide more flexibility outside the VA system.

Many veterans enroll in Medicare Parts A and B so they can receive care both inside and outside the VA.

Be Careful Before Delaying Part B

VA health care alone generally does not provide the same Medicare Special Enrollment Period available through active employer coverage.

Delaying Part B could lead to:

  1. A late-enrollment penalty
  2. A coverage gap
  3. Waiting for another enrollment period
  4. Limited access to non-VA providers

Consider whether you may want local or non-VA care later, even if you currently rely on the VA.

Do Veterans Need Medicare Part D?

VA prescription coverage is generally considered creditable drug coverage. You can usually delay Part D without a penalty while that coverage remains active.

Part D may still be worth comparing if:

  1. You want to use local retail pharmacies
  2. A medication is difficult to obtain through the VA
  3. You live in more than one location
  4. You qualify for Extra Help
  5. A Part D plan covers an important medication differently

Keep any notices showing that your VA drug coverage is creditable.

If You Have TRICARE

TRICARE works differently from VA health care.

Most Medicare-eligible military retirees and eligible family members must have:

  1. Medicare Part A
  2. Medicare Part B

Once both are active, TRICARE For Life generally begins automatically.

How TRICARE For Life Works

TRICARE For Life provides wraparound coverage with Medicare.

For services covered by both:

  1. Medicare generally processes the claim first.
  2. The remaining claim goes to TRICARE.
  3. TRICARE may pay some or all of the remaining eligible amount.

You must continue paying the Medicare Part B premium to keep TRICARE For Life.

Can You Delay Part B?

In most cases, delaying Part B can cause a Medicare-eligible military retiree to lose TRICARE coverage until Part B becomes active.

Different rules may apply when the military sponsor is still on active duty. Confirm your situation directly with TRICARE before delaying enrollment.

Do You Need Part D With TRICARE For Life?

TRICARE For Life includes prescription coverage through the TRICARE Pharmacy Program, so most beneficiaries do not need Part D.

Part D may still be considered when:

  1. You qualify for Extra Help
  2. It covers an important medication differently
  3. Local pharmacy access is more convenient
  4. The combined costs may benefit you

Compare your actual medications, pharmacies, premiums and copays before enrolling.

Medicare Advantage With VA Benefits

A veteran with Medicare Parts A and B may be eligible for Medicare Advantage.

Before enrolling, check:

  1. Are your non-VA doctors in-network?
  2. Are your prescriptions covered?
  3. Is your preferred pharmacy included?
  4. What are the hospital and specialist copays?
  5. Is prior authorization required?
  6. What is the annual out-of-pocket limit?
  7. Will you use the additional benefits?

Do not select a plan only because it has a low premium or attractive extras.

Medicare Advantage With TRICARE For Life

You may be able to combine Medicare Advantage with TRICARE For Life, but it can be more complicated.

Consider that:

  1. You must follow the plan’s network rules.
  2. Some services may require prior authorization.
  3. You may owe plan copays.
  4. Claims may not automatically transfer to TRICARE.
  5. You may need to submit some claims yourself.

Original Medicare and TRICARE For Life already coordinate closely, so Medicare Advantage is not automatically better.

Questions to Review

Before making a Medicare decision, ask:

  1. Do I have VA benefits, TRICARE or both?
  2. Do I need Part B to keep my military benefits?
  3. Do I want access to providers outside the VA?
  4. How are my prescriptions covered?
  5. Would Part D improve my access or costs?
  6. Are my doctors in the plan’s network?
  7. What premiums and copays would I pay?
  8. Would I need to submit claims myself?
  9. Does active employer coverage affect my timing?

Review Your Full Situation

The right decision depends on your military benefits, doctors, prescriptions, budget and preferred way of receiving care.

For veterans, Medicare can provide valuable access outside the VA system. For most Medicare-eligible military retirees, Parts A and B are necessary for TRICARE For Life.


I have helped many people with VA or TRICARE benefits review their Medicare options and understand how the different coverages may work together. If you are turning 65, do not delay Medicare or add another plan until you understand how it could affect your military benefits.

Call or text Shawn Ray Insurance at 435-244-2001.


This article provides general educational information. Medicare, VA and TRICARE rules may vary based on individual circumstances.