Know a military vet turning 65? Here's how Medicare can work with VA health care
If you get health care through the Veterans Health Administration and are nearing your 65th birthday, don't overlook whether Medicare would make sense for you. While not all military veterans rely on VA health care, those who do might not realize they can use Medicare alongside their existing benefits. "Many are in the dark about using both," said certified financial planner Hans "John" Scheil, CEO and owner of Cardinal Advisors in Durham, North Carolina. "But there are a lot of options for veterans when it comes to Medicare."

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The VA health system provides care for 9 million veterans each year at its 1,250 facilities, including 172 medical centers and more than 1,000 outpatient sites across the country. However, it generally doesn't cover care outside of those locations. "With Medicare, you have much broader options," said Elizabeth Gavino, founder of Lewin & Gavino in New York and an independent broker and general agent for Medicare plans. "You can have access to doctors and hospitals not near a VA facility, or you might want a second opinion from a doctor outside the system." The program encourages those using VA health care to sign up for Medicare when first eligible. Doing so has no impact on your VA coverage. You get seven months to sign up; the enrollment period starts three months before the month in which you turn 65 and ends three months after your birthday month. For example, if the big day is June 15, your signup window begins March 1 and ends Sept. 30. And remember, signing up for Medicare does not affect your VA health-care benefits. Medicare Part A, which provides hospital coverage, costs nothing. The standard premium for Part B, which is for outpatient care and medical equipment, is $135.50 for 2019. (Those with higher incomes pay more. See chart.)

What your Medicare Part B premium will be in 2019 based on your 2017 yearly income File individual tax return File joint tax return File married & separate tax return You pay each month (in 2019) $85,000 or less $170,000 or less $85,000 or less $135.50 Above $85,000 up to $107,000 Above $170,000 up to $214,000 Not applicable $189.60 Above $107,000 up to $133,500 Above $214,000 up to $267,000 Not applicable $270.90 Above $133,500 up to $160,000 Above $267,000 up to $320,000 Not applicable $352.20 $160,000 and less than $500,000 Above $320,000 and less than $750,000 Above $85,000 and less than $415,000 $433.40 $500,000 or above $750,000 and above $415,000 and above $460.50

Source: Source: Medicare.gov

Like the rest of the population, if you don't sign up for Part B when you're first eligible, you could face a life-lasting penalty if you change your mind later. And the longer you delay, the higher the amount that gets tacked on to your premium. It's worth noting that for veterans who plan to use TriCare for Life — an insurance program administered by the Department of Defense — you must enroll in Medicare Parts A and B. Part D, which is for prescription drug coverage, is optional. Some people using VA health care sign up for it so they can get their medicine from non-VA doctors and have their prescriptions filled at their local pharmacy instead of through the VA mail-order service. However, VA prescription drug coverage generally comes with lower costs than a Part D plan. And, there's no harm in not signing up: If you don't do it when you're first eligible for Medicare and then change your mind later, you won't pay a penalty because it is considered "creditable" by the Centers for Medicare and Medicaid Services.

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