Veterans can have both Medicare and VA healthcare benefits—and the VA encourages it. Learn how these programs complement each other and how Medicare Advantage can expand your healthcare options beyond the VA system.
Yes—you can have both, and the VA encourages it. If you're a veteran eligible for VA healthcare, you may wonder if you also need Medicare. The short answer: having both gives you more options, more flexibility, and a safety net if your circumstances change.
Medicare and VA benefits are separate programs that don't coordinate coverage. This means:
If you receive care at a VA facility, your VA benefits provide coverage
If you receive care outside the VA system, your Medicare coverage applies
Medicare will not pay for care at VA facilities, and VA benefits will not pay for care at non-VA facilities
Having both types of coverage expands your healthcare options and provides flexibility to choose the care that works best for your situation.
The VA itself encourages eligible veterans to sign up for Medicare as soon as they can. Here's why:
More options for care: Medicare covers you at non-VA hospitals and doctors, giving you choices if you need care away from a VA facility or want a second opinion
VA funding could change: The VA's budget is approved by Congress each year. If funding changes, veterans in lower priority groups could lose some VA healthcare benefits. Medicare provides a stable backup.
VA priority groups aren't guaranteed: Your eligibility for VA healthcare depends on your assigned priority group (1-8), which is based on factors like service-connected disabilities and income. Your priority group—and the benefits you receive—could change.
Avoid late enrollment penalties: If you delay Medicare Part B and later need to enroll, you'll pay a 10% penalty for each 12-month period you could have had Part B but didn't—and this penalty lasts for life. Part D has a similar penalty.
Emergency coverage away from home: If you experience a medical emergency while traveling and aren't near a VA facility, Medicare covers you at any hospital
To enroll in any Medicare Advantage plan, you must first be enrolled in Original Medicare (Parts A and B). A Medicare Advantage plan provides the same coverage as Original Medicare, plus additional benefits—and it can complement your VA healthcare in valuable ways.
Why combining Medicare Advantage with VA benefits makes sense:
Access to non-VA providers: See doctors, specialists, and hospitals outside the VA system, which may be closer to home or more convenient
Out-of-pocket protection: Medicare Advantage plans have an annual out-of-pocket maximum (up to $9,350 in-network for 2025), unlike Original Medicare, which has no cap
Prescription drug coverage: Most Medicare Advantage plans include Part D, allowing you to fill prescriptions at local pharmacies instead of using VA mail-order services. Part D now has a $2,000 annual out-of-pocket cap (2025) thanks to the Inflation Reduction Act.
Reduced wait times: VA facilities can have long wait times for appointments. Medicare Advantage gives you options if you need care more quickly.
Coverage while traveling: Medicare Advantage PPO plans often cover care anywhere in the U.S., not just in your local area
Second opinions: Get a second opinion from a non-VA doctor if you're dealing with a complex health issue
Many veterans don't qualify for certain benefits through the VA (like routine dental care) or have their priority group limit on which services they can access. Medicare Advantage plans can fill these gaps with extra benefits that Original Medicare and VA healthcare may not provide:
Dental coverage: Routine exams, cleanings, X-rays, and in some plans, more extensive dental work (97% of 2026 MA plans offer dental)
Vision coverage: Routine eye exams, eyeglasses, and contact lens allowances (99% of 2026 MA plans offer vision)
Hearing coverage: Hearing exams and hearing aid allowances (97% of 2026 MA plans)
Over-the-counter (OTC) allowances: Monthly credits for items like pain relievers, vitamins, and first-aid supplies
Fitness programs: Gym memberships and wellness programs like SilverSneakers (95% of 2026 MA plans)
Transportation: Rides to and from medical appointments
Meal delivery: Some plans offer meals after hospital stays or for those with chronic conditions
Telehealth: Virtual visits with doctors and specialists
Part B Giveback: Some Medicare Advantage plans reduce your Part B premium, lowering your monthly costs
Important: Benefits vary by plan. Not every Medicare Advantage plan offers all of these benefits, and coverage levels differ. Check the specific plan details before enrolling.
Several insurers now offer Medicare Advantage plans specifically designed to complement VA benefits. These plans are available to anyone eligible for Medicare but are built with veterans' needs in mind.
Features of veteran-focused MA plans may include:
$0 monthly premiums (in addition to Part B)
Low or $0 copays for mental health visits
Broad provider networks for care outside the VA
Part B Giveback benefits to reduce your monthly premium
Partnerships with veteran service organizations (VSOs)
These plans are endorsed or recommended by organizations like USAA, AMVETS, VFW, and DAV. Ask your Medicare agent about veteran-focused plans available in North Carolina.
Veterans can enroll in Medicare plans during the same enrollment periods as all Medicare beneficiaries:
Initial Enrollment Period (IEP)
This 7-month window is your first opportunity to enroll in Medicare. It begins 3 months before your 65th birthday, includes your birthday month, and ends 3 months after your birthday month.
Example: If you turn 65 in June, your IEP runs from March 1 through September 30.
If you're under 65 and receiving Social Security disability benefits, you'll be eligible for Medicare in the 25th month after your first disability payment.
Annual Enrollment Period (AEP)
When: October 15 – December 7 each year
Coverage starts: January 1
During AEP, you can enroll in or switch Medicare Advantage plans, change from Original Medicare to Medicare Advantage (or vice versa), and join, switch, or drop Part D prescription drug plans.
Medicare Advantage Open Enrollment Period (MA OEP)
When: January 1 – March 31 each year
Coverage starts: The first of the month after you enroll
If you're already enrolled in a Medicare Advantage plan, you can switch to a different MA plan, drop your MA plan, and return to Original Medicare (and add a Part D plan). You cannot switch from Original Medicare to Medicare Advantage during this period.
Special Enrollment Periods (SEP)
Certain life events trigger a Special Enrollment Period, allowing you to change your coverage outside of regular enrollment windows. SEP-qualifying events include:
Moving to a new address outside your current plan's service area
Losing employer or other creditable coverage
Your current plan terminates or leaves your area
Qualifying for or losing Medicaid
Entering or leaving a skilled nursing facility
SEPs typically last 60 days from the qualifying event. Contact a Medicare agent to understand your options during a Special Enrollment Period.
Medicare Part A: $0 for most veterans (if you or your spouse worked and paid Medicare taxes for 40+ quarters)
Medicare Part B premium: $185/month in 2025, $202.90/month in 2026 (most beneficiaries)
Medicare Advantage: Many plans have $0 monthly premiums (in addition to Part B)
Part D prescription drugs: $2,000 annual out-of-pocket cap in 2025, $2,100 in 2026
Note: If you're worried about the Part B premium, some Medicare Advantage plans offer a Part B Giveback benefit that reduces or eliminates this cost.
Carry both cards: If you have both VA and Medicare coverage, carry both cards and tell providers which coverage you want to use before receiving care.
Choose before receiving care: Decide which benefits program you'll use before your appointment—the two programs don't coordinate afterward.
HMO vs. PPO: HMO plans require you to use in-network providers and usually need referrals. PPO plans allow out-of-network care at a higher cost. Consider which structure works best alongside your VA care.
Review plans annually: Medicare Advantage benefits can change each year. Review your Annual Notice of Change (ANOC) and compare plans during the Annual Enrollment Period.
TRICARE considerations: If you have TRICARE, you must enroll in both Medicare Parts A and B to keep TRICARE For Life coverage. TFL then acts as supplemental coverage to Medicare
Navigating both VA benefits and Medicare can feel complicated, but you don't have to figure it out alone. Our dedicated NC Medicare agents understand veteran-specific healthcare needs and can help you:
Compare Medicare Advantage plans that complement your VA benefits
Find veteran-focused plans with $0 premiums and extra benefits
Check if your doctors are in-network
Understand your enrollment periods and options
Enroll in the plan that's right for your healthcare needs