Turning 65 With VA or TRICARE: Do You Still Need Medicare?

Turning 65 with VA or TRICARE benefits? Learn how Medicare Parts A and B, TRICARE For Life, VA health care, Part D, and Medicare Advantage may work together. This guide explains what to consider before delaying Medicare, how military prescription coverage affects Part D, and when another Medicare plan may or may not make sense. Shawn Ray has helped many veterans and military families review their Medicare options.

Shawn Ray

7/30/20263 min read

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

If You Have VA Health Care

VA health care and Medicare are separate systems.

  • VA benefits generally cover care through VA facilities or VA-authorized providers.

  • Medicare may cover eligible care from non-VA doctors and hospitals.

  • Medicare can give you more flexibility when receiving care outside the VA system.

Many veterans enroll in Medicare Parts A and B so they have access to both VA and non-VA care.

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 result in:

  • A late-enrollment penalty

  • A gap in coverage

  • Waiting for another enrollment period

  • Limited access to non-VA providers

Even if you currently receive most of your care through the VA, consider whether you may want access to local doctors, hospitals or specialists later.

Do Veterans Need Medicare Part D?

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

Part D may still be worth reviewing if:

  • You want to use local retail pharmacies

  • A medication is difficult to obtain through the VA

  • You live in more than one location

  • You qualify for Extra Help

  • A Part D plan covers an important medication differently

Keep any notices showing that your VA prescription 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:

  • Medicare Part A

  • 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 programs:

  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 costs.

You must continue paying the Medicare Part B premium to maintain 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 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 Medicare Part D.

Part D may still be considered when:

  • You qualify for Extra Help

  • It covers an important medication differently

  • Local pharmacy access is more convenient

  • The combined costs may work in your favor

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

Medicare Advantage With VA Benefits

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

Before enrolling, review:

  • Whether your non-VA doctors are in-network

  • Whether your prescriptions are covered

  • Whether your preferred pharmacy participates

  • Hospital and specialist copays

  • Prior-authorization requirements

  • The annual out-of-pocket limit

  • Whether you will use the additional benefits

Do not choose a plan only because it has a low premium or attractive extra benefits.

Medicare Advantage With TRICARE For Life

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

Consider that:

  • You must follow the plan’s provider-network rules.

  • Some services may require prior authorization.

  • You may owe plan copays.

  • Claims may not automatically transfer to TRICARE.

  • You may need to submit some claims yourself.

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

Questions to Review

Before making a Medicare decision, ask:

  • Do I have VA benefits, TRICARE or both?

  • Do I need Part B to maintain my military benefits?

  • Do I want access to care outside the VA?

  • How are my prescriptions currently covered?

  • Would Part D improve my access or costs?

  • Are my doctors included in the plan’s network?

  • What premiums and copays would I pay?

  • Would I need to submit claims myself?

  • Does active employer coverage affect my enrollment timing?

Review Your Full Situation

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

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

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

Have VA or TRICARE and Questions About Medicare?

I have helped many people with VA or TRICARE benefits understand their Medicare options. Let's review how your coverage may work together before you delay Medicare or add another plan.

Review My Medicare Options
Call or Text Shawn
Talk with Shawn