Veterans Medicare questions, answered straight

We focus on veterans. Every day we work through how Medicare fits with VA health care, TRICARE For Life, CHAMPVA and service-connected disability, so those questions don’t surprise us.

Our founder, Christopher Duncan, has helped people with Medicare since 2006. He is a Certified Medicare Insurance Planner™ and a Retirement Income Certified Professional®. His dad, Wallace, is an 82-year-old Vietnam-era veteran who uses VA health care and Medicare.

We’re an independent agency, licensed in all 50 states and DC. We work with several insurance companies, so we can compare plans from more than one company in your county.

Nothing. There’s no charge for our help and no obligation. Licensed agents are paid by the insurance companies, not by you.

Plans themselves can have premiums and other costs. You pay the same plan premium whether you enroll through a licensed agent or directly with the plan.

No. We are not affiliated with or endorsed by Social Security, Medicare, the VA, TRICARE or any government agency. We don’t work for just one insurance company.

We do not offer every plan available in your area. To get information on all of your options, contact Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048) or your local State Health Insurance Assistance Program (SHIP).

No one is required to sign up for Medicare. But the VA answers this question itself. On VA.gov it asks, “If I already have VA health care benefits, should I still sign up for Medicare when I turn 65?” Its answer:

“Yes. We encourage you to sign up for Medicare as soon as you can.”VA.gov

The VA’s reasons: Medicare covers you at non-VA hospitals and doctors, “funding for VA health care could change in the future,” and if you delay Part B and need it later, you’ll pay a penalty.

VA health care doesn’t count as coverage that lets you put off Part B without a penalty. The penalty is 10% of the standard premium for each full year you could have had Part B but didn’t, and you pay it for as long as you have Part B.

Sources: VA.gov: VA health care and other insurance[1] · Medicare.gov: Avoid late enrollment penalties[2]

No. The VA says that whether or not you have other health coverage “doesn’t affect the VA health care benefits you can get.” You can keep using VA facilities the way you do now.

Each time you get care, you choose which benefit to use. Medicare and the VA generally can’t pay for the same service, and the VA doesn’t bill Medicare.

Sources: VA.gov: VA health care and other insurance[1] · Medicare.gov: Who pays first?[3]

Every year Medicare publishes a handbook called Medicare & You. On page 11 of the 2027 edition, Medicare says this about Medicare Advantage (Part C) plans:

“Some plans may have a $0 premium and may help pay all or part of your Part B premium.”Medicare & You 2027, page 11

That’s Medicare’s own wording. Availability varies by county, and not every plan offers it. A $0 premium doesn’t mean free care. Plans have copays and other costs.

One example: My dad, Wallace, has a plan with a $0 monthly premium that pays $185 of his $202.90 Part B premium, so he pays $17.90 a month for Part B. That’s what’s available in his county. Your county will have different plans and different options.

Sources: Medicare.gov: Medicare & You 2027, page 11[4] · Medicare.gov: Medicare costs[5]

Yes. The VA’s advice to sign up for Medicare doesn’t make an exception for a 100% rating, and the Part B late enrollment penalty works the same way at every rating.

If you ever need care outside the VA, or VA funding changes, a 100% rating won’t erase a penalty you’ve built up by waiting.

Read more: Why do veterans still need Medicare at 100% disabled?

Sources: VA.gov: VA health care and other insurance[1] · Medicare.gov: Avoid late enrollment penalties[2]

Here the rules work in your favor. Medicare counts VA drug coverage as creditable coverage, meaning it’s expected to pay at least as much as Medicare drug coverage. While you have it, you can wait on Part D without a penalty.

If you lose VA drug coverage, sign up for Medicare drug coverage within 63 days. The VA says there’s no Part D penalty “as long as you enroll when you’re first eligible or within 63 days of when you no longer have VA health care.”

Medicare Advantage plans usually include drug coverage, which can give you a pharmacy option outside the VA. You can’t use VA and Medicare drug coverage for the same prescription at the same time.

Sources: Medicare.gov: Creditable prescription drug coverage[6] · VA.gov: VA health care and other insurance[1] · Medicare.gov: Who pays first?[3]

VA dental care depends on your VA dental eligibility, not just your rating. Veterans rated 100% service-connected (or paid at the 100% rate for unemployability), veterans with a service-connected dental condition and former POWs are among those who qualify. Many veterans don’t. If you’re enrolled in VA health care and don’t qualify, you can buy dental insurance through the VA Dental Insurance Program (VADIP).

Original Medicare doesn’t cover most dental care, eye exams for prescription glasses, or hearing aids and the exams to fit them.

TRICARE For Life: TRICARE says beneficiaries who want dental or vision coverage may be able to buy it through FEDVIP, a separate program with its own premiums.

Medicare Advantage plans may cover extra benefits Original Medicare doesn’t, like certain dental, vision and hearing services. What’s covered, and how much, varies by plan and county. Check a plan’s details before you count on a benefit.

Sources: VA.gov: VA dental care[7] · Medicare.gov: What Original Medicare doesn’t cover[8] · TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9]

Yes. TRICARE says, “You need to have Medicare Part A and Part B to have TFL.” TRICARE For Life starts automatically once you have both, and you pay the Part B premium.

You don’t need Medicare Part C or Part D to have TRICARE For Life. TRICARE suggests making sure Part A and Part B are in place at least 2 months before you turn 65 so there’s no gap.

Sources: TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9] · TRICARE: TRICARE For Life[10]

Yes, but differently than it works with Original Medicare. TRICARE says that if you join a Medicare Advantage plan:

• You must get all nonemergency care from the plan’s network of providers.
• You may pay copays at the time of service.
• You may need to file paper claims for TRICARE to reimburse you for TRICARE-covered services.

If both Medicare and TRICARE cover a service, TRICARE pays last. You keep the TRICARE Pharmacy Program. Check the plan’s network and costs before you join.

Source: TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9]

Often it adds less than people expect. With Original Medicare, TRICARE For Life pays after Medicare for services both cover, and TRICARE says you generally won’t have out-of-pocket costs for those services.

A Medicare Supplement would pay before TRICARE, so you’d be paying a monthly premium for costs TRICARE For Life may already cover. Before you buy one, compare what it would actually add with what it costs each month.

Sources: TRICARE: TRICARE For Life[10] · TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9]

Your Initial Enrollment Period lasts 7 months: the 3 months before the month you turn 65, your birthday month and the 3 months after. If you sign up before your birthday month, coverage starts the month you turn 65.

If you start getting Social Security benefits at least 4 months before you turn 65, you get Part A and Part B automatically, and most people have the Part B premium taken out of their benefit. If not, you sign up through Social Security, and Medicare sends a bill for Part B every 3 months.

Sources: Medicare.gov: When does Medicare coverage start?[11] · Medicare.gov: How do I sign up for Medicare?[12] · Medicare.gov: How to pay Part A & Part B premiums[13]

You can, but VA health care won’t protect you from the late enrollment penalty. If you sign up later, the penalty is 10% of the standard premium for each full year you could have had Part B but didn’t. You pay it for as long as you have Part B, and because it’s a percentage, it rises when the premium rises.

You may also have to wait for the General Enrollment Period, January 1 to March 31, to sign up.

Sources: VA.gov: VA health care and other insurance[1] · Medicare.gov: Avoid late enrollment penalties[2] · Medicare.gov: When does Medicare coverage start?[11]

If you or your spouse have health coverage from a current job, you can usually delay Part B without a penalty. You’ll get a Special Enrollment Period that ends 8 months after the job or the coverage ends, whichever comes first.

Two things to watch:

• COBRA and retiree coverage don’t count as coverage from a current job.
• If the employer has fewer than 20 employees, Medicare usually pays first, so you may need Part B to be fully covered.

Check with the employer’s benefits office before you delay.

Sources: Medicare.gov: When does Medicare coverage start?[11] · Medicare.gov: Who pays first?[3]

1. Coverage for doctors and outpatient care. For most people, the government pays about 75% of the cost of Part B, and your premium covers the rest.
2. Protection from the penalty. Sign up late without a Special Enrollment Period and you pay 10% more for each full year you waited, for as long as you have Part B.
3. TRICARE For Life or CHAMPVA. TRICARE For Life requires Part A and Part B. CHAMPVA requires them too if you’re eligible for Medicare.

Sources: SSA.gov: Premiums: rules for higher-income beneficiaries[14] · Medicare.gov: Avoid late enrollment penalties[2] · TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9] · VA.gov: CHAMPVA benefits[15]

Medicare Advantage, also called Part C, is a Medicare-approved plan from a private company that you can choose instead of Original Medicare. It covers most Part A and Part B benefits and usually includes drug coverage.

You need both Part A and Part B to join one, and you must keep paying your Part B premium to stay in the plan.

Sources: Medicare.gov: Medicare costs[5] · Medicare.gov: Joining a plan[16]

It depends on the plan. HMO plans generally require you to use the plan’s network except for emergencies and urgent care. PPO plans let you see out-of-network providers, usually at a higher cost. Rules like prior authorization may apply.

Before you join, check that your doctors and hospitals are in the plan’s network. If you have TRICARE For Life, TRICARE says you must get nonemergency care from the plan’s network.

Source: TRICARE: Q&A: How does TRICARE For Life work with Medicare?[9]

Yes, at certain times:

• Open Enrollment, October 15 to December 7. Changes start January 1.
• Medicare Advantage Open Enrollment, January 1 to March 31. If you’re in a Medicare Advantage plan, you can switch to another one, or go back to Original Medicare and join a drug plan.
• Special Enrollment Periods for certain life events, like moving or losing other coverage.

Source: Medicare.gov: Joining a plan[16]

No. Your VA eligibility stays the same. The VA says other coverage “doesn’t affect the VA health care benefits you can get,” and you can keep using VA care.

When you get care through the plan, the plan’s own network, prior authorization and cost rules apply.

Source: VA.gov: VA health care and other insurance[1]

The standard Part B premium in 2026 is $202.90 a month. It can be higher if your income is higher, and it can change each year.

Most people pay no Part A premium because they or their spouse paid Medicare taxes long enough while working, generally at least 10 years. The rest of your cost depends on the coverage you choose and the care you use.

Source: Medicare.gov: Medicare costs[5]

Yes. Social Security puts it this way:

“For most beneficiaries, the government pays a substantial portion — about 75% — of the Part B premium, and the beneficiary pays the remaining 25%.”SSA.gov

The government’s share comes from federal general revenue. It isn’t an account in your name, and nothing is paid to you if you don’t sign up.

Source: SSA.gov: Premiums: rules for higher-income beneficiaries[14]

IRMAA (income-related monthly adjustment amount) is an extra amount added to your Part B and Part D premiums when your income is above certain limits. For 2026 it starts above $109,000 for individuals and $218,000 for joint filers.

Social Security usually uses your tax return from 2 years earlier, so 2026 amounts are generally based on 2024 income. If your income dropped because of a life-changing event, like stopping or cutting back work, marriage, divorce or the death of a spouse, you can ask for a new decision with Form SSA-44. If you think the decision is wrong, you can appeal.

Sources: SSA.gov: Premiums: rules for higher-income beneficiaries[14] · SSA.gov: Lower your IRMAA[17]

No. The IRS says not to include VA disability compensation in your income. Social Security bases IRMAA on your modified adjusted gross income from your tax return (your adjusted gross income plus tax-exempt interest), so VA disability compensation isn’t part of it.

Sources: IRS.gov: Publication 525, Taxable and Nontaxable Income[18] · SSA.gov: Premiums: rules for higher-income beneficiaries[14]

We’re licensed in all 50 states and DC and help veterans nationwide. Calls happen by phone, so where you live doesn’t matter.

Call 888-960-VETS (8387) or book a free call. We’ll spend about 20 minutes with you, learn your situation and explain the options in your county. No pressure.

If you want to talk about specific plans, Medicare rules require us to confirm the types of plans you want to discuss before the appointment. This is called a Scope of Appointment, and your agent will walk you through it.

Yes. We don’t disappear after you enroll. You get a yearly review before Open Enrollment, help with plan and billing questions, and a team that picks up the phone when your health needs change.

About 6 months before your 65th birthday. That leaves time to review your situation and sign up during your Initial Enrollment Period without a gap in coverage.

Already on Medicare and never had a review that looks at your VA benefits too? Call 888-960-VETS (8387) anytime.