Can you explain how Medicare works with other types of insurance like Veterans Affairs benefits or employer plans?

Question

Linda Bolan · Accepted Answer

Veteran Affairs benefits and separate from Medicare.  If a Senior is using the VA, Medicare is not responsible for any coverage.  If the Senior also has a Medicare plan and sees a doctor outside of the VA they Medicare may pay.

In the case where a Senior has an employer plan and Medicare.  Typically, the  employer plan pays first and then it goes to Medicare as a secondary.  But employee plans vary and coverage could work differently.

Larry Dalton · Answer

This process is known as the coordination of benefits in medical billing. Your primary insurance pays first, and then your secondary insurance, such as Medicare, covers the remaining eligible costs. I have found that Veterans Affairs (VA) benefits often do not work well with outside their contractors and frequently do not cooperate with the outside billing process. 

The VA has its own private contractors and billing procedures that they prefer to use.  As a result, you will often find that each provider handles its own coverage separately.

Steve Brauer · Answer

With employer plans, if you are still working and want to stay on the Employer Health Insurance plan, and you have more than 20 employees at the job, you can delay your Part B enrollment until you leave the employer. With VA-type benefits, it's a little trickier. The VA covers some people, and others have Tri-Care for life. With both you have to enroll into Part A and B of Medicare, but its a longer conversation with the coverage beyond that.

Answered by Steve Brauer on April 8, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Fred Manas · Answer

Medicare can work with both Veterans Affairs (VA) benefits and employer-sponsored health plans, but the order in which they pay for medical care can vary. 
Generally, if a veteran is eligible for VA benefits, they can choose whether to use those benefits or Medicare, but they generally can't use both for the same service. 
Employer-sponsored plans may also be considered primary or secondary depending on factors like the size of the company and the specific coverage offered.

Bob Nunn · Answer

It works fantastic with Tri-Care for life and would recommend doing a Ma only with giveback to subsidize part B . That will allow you really to have robust coverage and should really never have a bill . Employers plans need to be analyzed on the individual merits of each plan . You should provide Agent with a EOB to look over , if unwilling do not stay with that agent call me. .

Answered by Bob Nunn on April 8, 2025

Agent Licensed in FL, AL, AR & 36 other states

Answered by Bob Nunn Medicare Insurance Agent

Rachael Metcalf · Answer

1. Employer-so if you have group coverage and are planning on working at your job past 65, you do not need to take out your Part B and pay the premium. Medicare will be a secondary to your group.
2. Veterans- medicare advantage plans work well with VA coverage. There are specific plans just for the beneficiaries who use the VA. You can get all or some of your Part B premium from medicare reimbursed. You can have a second opinion with a doctor outside of the VA on advantage plans. Just take note: if you do not get your prescriptions through the VA then the VA medicare advantage plan will not work for you.

Scott Klag · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/can-you-explain-how-medicare-works-with-other-types-of-insurance-like-veterans-affairs-benefits-or-employer-plans#scott-klag

Can you explain how Medicare works with other types of insurance like Veterans Affairs benefits or employer plans?

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Can you explain how Medicare works with other types of insurance like Veterans Affairs benefits or employer plans?

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