Top 5 Medicare Mistakes Veterans Make: 2026 Guide

Medicare decisions can be especially complicated for veterans. VA health care, TRICARE For Life, Original Medicare, Medicare Advantage, and prescription coverage follow different rules. This updated guide replaces the original article's unsupported savings examples and outdated 2025 figures with questions to check before you enroll, delay coverage, or change plans.

Mistake 1: Assuming TRICARE For Life and Medigap work the same way for everyone

Eligible beneficiaries need Medicare Part A and Part B to have TRICARE For Life. Part C and Part D are not required for TFL. When both Medicare and TRICARE cover a service, Medicare generally pays first and TRICARE pays last.^[1][2]

For many eligible beneficiaries, TFL coordinates with Medicare and may substantially reduce out-of-pocket costs for services covered by both programs. TFL does not require Medigap, but coverage and costs depend on the service, eligibility, and other insurance. Medicare does not cover every service TRICARE covers, so review your official benefits before dropping any policy.^[1][2]

Mistake 2: Treating IRMAA as a permanent bill you cannot question

The Income-Related Monthly Adjustment Amount can raise Part B and Part D premiums for higher-income beneficiaries. Social Security generally uses tax-return information from an earlier year, so a recent retirement, work stoppage or reduction, marriage, divorce, death of a spouse, or loss of income-producing property may give you a reason to ask Social Security to reconsider.^[8][9]

Use the official Social Security process and documentation rather than relying on a generic dollar example. Form SSA-44 is used to request a reduction after a qualifying life-changing event; Social Security decides the request based on your evidence and circumstances.^[9]

Your VA disability compensation and other veterans' benefits are generally treated under special tax rules, but IRMAA uses modified adjusted gross income. Ask Social Security or a qualified tax professional how your particular return is treated.^[8][10]

Mistake 3: Choosing a Medicare Advantage plan without checking coordination rules

Medicare Advantage is optional. A plan may have a network, referrals, prior authorization, deductibles, copayments, drug rules, and a yearly out-of-pocket limit. Those rules apply to the Medicare-covered care the plan manages; they do not replace VA authorization rules.^[4][7][11]

A Medicare Advantage plan may be used with TRICARE, but it can change provider-network rules, cost sharing, and claims procedures. For nonemergency care, a TFL beneficiary in Part C generally must use the plan's network; copayments may be due at the visit, and paper claims to TRICARE may be needed. Confirm the plan's Evidence of Coverage and TRICARE coordination before enrolling.^[1]

Some Medicare Advantage plans may help pay all or part of your Part B premium. This plan-specific Part B premium reduction varies by plan, county, year, and eligibility; you still generally owe Part B and other plan costs may apply. Compare the whole plan, not just this feature.^[5][6][4]

Mistake 4: Delaying Part B because you have VA health care

VA health care generally does not substitute for Medicare Part B for TRICARE For Life eligibility. The VA encourages eligible veterans to sign up for Medicare, in part because Medicare can help cover care from non-VA doctors and hospitals. Whether you have other insurance does not change VA health care eligibility, but each program has its own payment and authorization rules.^[11][1]

The Initial Enrollment Period lasts seven months. If you delay Part B without a qualifying Special Enrollment Period, the late-enrollment penalty is generally 10% for each full 12-month period you could have had Part B, usually for as long as you have Part B. Current-employment group coverage is a different rule; COBRA and retiree coverage do not create the usual job-based Special Enrollment Period.^[12][3]

Mistake 5: Never reviewing your plan after you enroll

Plan premiums, benefits, formularies, networks, and cost sharing can change. The Medicare Open Enrollment Period for Medicare Advantage and Part D is October 15 through December 7, with coverage generally beginning January 1. Reviewing options each year can help you compare changes, but it does not guarantee lower costs or a better fit.^[7][4]

• Check whether your doctors, hospitals, and pharmacies are in the plan's network.
• Review premiums, deductibles, copayments, drug costs, prior authorization, and the yearly out-of-pocket limit.
• If you have TFL, read the plan's network and claims rules and confirm coordination with TRICARE.^[1]
• If you use VA care, remember that non-VA community care generally must be authorized by VA first.^[13]
• Compare the new Annual Notice of Change with your current plan before deciding.

A safer next step

Gather your Medicare, VA, and TRICARE information; write down your doctors, prescriptions, and preferred pharmacies; then compare official plan materials. You can read the Veterans Medicare FAQ, learn more about VA health care and Medicare, or book a call with Veterans Advantage Financial®. We are an independent insurance agency, not part of or endorsed by Medicare, CMS, VA, TRICARE, Social Security, or any government agency.

There's no cost to you for our help. If you enroll, we're paid by the insurance company. We do not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE for information on all of your options.

This is general education, not personal advice, and it isn’t a recommendation of any specific plan. Veterans Advantage Financial® is a licensed insurance agency, not affiliated with or endorsed by Medicare, Social Security, VA, TRICARE or any government agency. Plan availability, costs and benefits vary by plan, county and year. Check your own situation with the agency or plan before making changes.

About the author

Christopher Duncan

Certified Medicare Insurance Planner™ · Retirement Income Certified Professional®

Christopher founded Veterans Advantage Financial® and has helped people with Medicare since 2006. He is a licensed insurance agent in all 50 states and DC (NPN 8613503). His dad, Wallace, is a Vietnam-era veteran.

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