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Medicare Information for Veterans

If you have Medicare and veterans benefits, you may choose to get treatment under either program. But you have to choose one program or the other each time you need care. Medicare cannot pay for the same service paid for by the Department of Veterans Affairs (VA). Nor can the VA pay for the same service paid for by Medicare.

If You Choose to Use Your Veterans Benefits

If you choose to use your veterans benefits, there are cases where Medicare can pay for emergency inpatient and outpatient hospital services. Medicare will not pay if you receive VA-authorized services in a hospital that is not part of the VA system or from a doctor who is not affiliated with the VA.

If You Choose to Use Your Medicare Benefits

If you choose to use your Medicare benefits, Medicare will pay for Medicare-covered services you get from hospitals and doctors not affiliated with the VA, as long as the VA will not be paying for the same services.

When Covered Services are Different, Medicare and VA Each Help Pay

If the VA authorizes hospital services in other than a VA hospital, but does not cover all the services , Medicare will pay for Medicare-covered services for which the VA does not pay.

Co-payments: Sometimes Medicare Can Pay or Help Pay

The VA charges co-payments to some veterans with non-service connected conditions whose income is at or above certain income levels. Medicare may pay part or all of this co-payment. Medicare cannot pay for VA co-payments for services furnished by VA hospitals and facilities, unless the services are emergency inpatient, outpatient hospital services.or VA-authorized care by a doctor.

Fee Basis Cards: Sometimes Medicare Can Help Pay

The VA issues "fee basis ID cards" to certain veterans. You may be issued a fee basis card because:

  • You have a service connected disability.
  • You will need medical services for an extended period of time; or there are no VA facilities in your area that can furnish the care you need.

If you have a fee basis card, you may choose any doctor you wish to treat you for the condition specified on the card. If the doctor accepts you as a patient and bills the VA for services, the doctor must accept VA's payment as payment in full. The doctor may not bill you or Medicare for any charges not paid by the VA. If your doctor does not accept the fee basis card, you may file a claim with the VA yourself. The VA then pays the VA-approved amount. If the VA payment is less than the Medicare-approved amount, Medicare will pay benefits. Your doctor's office should be aware of the procedures for obtaining the supplemental benefits.

Where to Get Help

Call 1-800-Medicare (1-800-633-4273).