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 are 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.

Steve and Sue 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 and Sue Brauer on April 8, 2025

Broker Licensed in AZ & CA

Answered by Steve and Sue Brauer Medicare Insurance Agent

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.

Bill Wheeler · Answer

Thank you for your question.
1. Medicare and VA benefits don't work directly together. You cannot use Medicare at a VA 
facility. 
Medicare is used when you are not going to a Va Facility.
2. Medicare works in conjunction with your employer insurance. It pays first (80%) then your employer plan kicks in.

Michael Andrews · 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#michael-andrews

Michael Wehner · Answer

With Employer group plans, Medicare coordinates benefits. But it depends on what size of employer group you are a part of. If your group is larger than 20 employees, your group plan will be primary and Medicare will be secondary. Many Medicare beneficiaries delay their Part B coverage and only opt for Part A when they are part of a group plan that has more than 20 employees. If your are part of an Employer group that is less than 20 employees, Medicare will be primary and the group plan will be secondary. It will be important for you to enroll in both Part A and B is you are on a small employer group plan. Also, if you are on a small employer group plan (under 20 employees) that plan may choose to not allow you to continue that coverage once you are enrolled in Medicare. 
Veterans Affairs benefits typically work separately from your Medicare Coverage. But having additional Medicare coverage such as a Medicare Advantage plan allows you to receive care outside of the VA system if you so choose.

Leslie Kaz · Answer

Medicare can work alongside other insurance, but who pays first (primary) and who pays second (secondary) depends on which type of coverage you have and why you have it.

1. Employer or Union Group Health Plans
If you’re 65+ and still working (or covered by a working spouse’s plan):

Employer has 20+ employees: Employer plan pays first, Medicare pays second.

Employer has fewer than 20 employees: Medicare pays first, employer plan pays second.

Tip: Always confirm with HR whether your coverage is considered creditable for delaying Part B or Part D without penalty.

2. Retiree Coverage
Usually pays after Medicare.

You must enroll in Medicare Parts A & B for retiree coverage to work fully.

Retiree coverage may help pay Medicare’s deductibles and coinsurance, but benefits can change — especially if your former employer changes the plan.

3. Veterans Affairs (VA) Benefits
VA benefits cover care only in VA facilities.

Medicare covers care in non-VA facilities.

You can have both:

Use VA for prescriptions or specialty care.

Use Medicare for civilian doctors/hospitals.

Tip: Many vets keep Part B to avoid penalties and to have access to non-VA care.

4. TRICARE for Life (Military Retirees & Spouses)
You must have Medicare Parts A & B.

Medicare pays first for Medicare-covered services.

TRICARE pays second, often covering what Medicare doesn’t (including some drugs).

For VA or military facilities, TRICARE pays first.

5. Medicaid
Medicaid is always the payer of last resort — it pays after Medicare and any other insurance.

If you have both Medicare and Medicaid (“dual eligible”), you may qualify for a Special Needs Plan (D-SNP) that coordinates both.

6. Workers’ Compensation
Workers’ comp pays first for job-related injuries or illness.

Medicare may pay for unrelated services.

Eduardo Camacho · Answer

There are certain carriers that has designed Medicare Plans specifically for Veterans, those plans may coordinate services along with the VA or in the case employers there are Group Medicare Plans offered exclusively by employers

Answered by Eduardo Camacho on May 2, 2025

Agent Licensed in CA, FL, NC, NV, SC & TX

Answered by Eduardo Camacho 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.

Vachik Chakhbazian · Answer

Medicare can work alongside other insurance types like VA benefits and employer-sponsored plans, but coordination rules vary. VA benefits are separate, and you choose which to use for each service. Medicare and VA benefits generally don't pay for the same services, with the VA covering care at VA facilities and Medicare covering care elsewhere. Medicare pays second to employer plans if you're working past 65

Answered by Vachik Chakhbazian on July 4, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Marcie Barnes · Answer

If you have VA coverage you have many great options.

You can have Part A only and VA benefits.  That is something to consider when the VA covers all your medical expenses.

You can have Part A Hospital and Part B Medical and VA coverage.  If you chose this option, you are eligible for a Medicare Advantage plan that provides extra benefits that Medicare or the VA doesn't offer.

If you would like to further discuss your options I am here to help

Deborah Webster · Answer

Medicare can be primary or secondary insurance depending on your situation. You can work with an agent to determine how this would work. The ship office is another place you can schedule an appointment to speak with a licensed agent.

Answered by Deborah Webster on July 11, 2025

Broker Licensed in Ia & SC

Answered by Deborah Webster Medicare Insurance Agent

Jack Mayer · Answer

Medicare does not work with VA Benefits, it is totally independent of the VA Health Plan. Most active employees with group coverage enroll in Part A because it is premium-free if you have worked for at least ten years. Part A can coordinate to lower your costs if you have a hospital stay. For example, let’s say your employer health plan has a $3,000 deductible. The Medicare Part A hospital deductible is $1,676 in 2025. So if you have both your employer insurance and Part A, and you incur a bill for a hospital stay, you will only be out $1,676 for your inpatient hospital services. Medicare pays the rest of any Part A services.

Answered by Jack Mayer on June 2, 2025

Agent Licensed in CA & NV

Answered by Jack Mayer Medicare Insurance Agent

Ronnie Robinson · Answer

For these questions, we pull in the respected personnel to help our clients on an individual basis, depending on the situation. We have seen that most families' options are different.

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

Dennis Sullivan · Answer

Typically, Veterans take the route of a ZERO PREMIUM Medicare Advantage Plan to co-exist with the services offered at the VA. These don't carry part D (prescription drugs) because they receive those from the VA, thus carry Great beefits such as a part B buyback, dental, vision, hearin, or just a 2nd opinion...
Employer plans need to be evaluated on a cost basis compared to a MEDicare Plan..

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

Johnnie Jeter · Answer

Typically when you are a veteran for Instance you have a chronic condition you are allowed to get on a chronic condition plan such as a C snip. plan that many carriers cover and not lose any of your veteran benefits, and still benefit from that plan with has additional Benefits to what you already have with the veterans plan, typically many veterans have TRICARE… you will not lose that coverage in addition to a chronic condition plan designed to help a beneficiary.

Answered by Johnnie Jeter on August 13, 2025

Broker Licensed in GA & OH

Answered by Johnnie Jeter Medicare Insurance Agent

Debra Hartman · Answer

Medicare can be primary or secondary payer depending on the other insurance coverage and individual circumstances. 
Best to check with your employers plan and the VA plans. 
If the employer has more than 20 employees, your employers plan would be primary.

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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