Medicare for Veterans

There were over 8.8 million Veterans who are aged 65+ in the US in 2019. Even though these Veterans have access to free or almost free healthcare through the VA, they may still benefit from Medicare. This gives you an opportunity to sell to this target market. Having Medicare opens the doors to a wider doctor network and may provide supplemental coverage opportunities.

VA Benefit Distribution

Individuals who served on active duty in the military and were discharged or released, other than dishonorable discharge or were only active during training, can apply for VA health benefits. The VA encourages all servicemen and women to apply because there are so many exceptions, and your client may be eligible for benefits they didn’t know they were eligible for. The VA states that some veterans may even receive “enhanced eligibility” if they:

  • Were a POW (prisoner of war)
  • Received the Purple Heart Medal or the Medal of Honor
  • Have a service-connected disability of 10% or more
  • Hold a VA pension
  • Discharged from service for a disability
  • Served in a Theater of Operations for 5 years after discharge
  • Served in Vietnam (1962-1975)
  • Service in the Persian Gulf (1990-1998)
  • Spent 30+ days at Camp Lejeune (1953-1987)
  • Have a catastrophic disability
  • Have a household income below the VA’s National Income

VA Benefits

Veterans are often assigned a priority level that determines their access to facilities and benefits, as well as copay amounts for things like inpatient hospital stays and medications. Some veterans may have to pay a copay for doctor visits and prescription drugs, but others may receive free appointments. Others may also be able to enroll in a family plan.  The VA hosts a descriptive list of covered services including but not limited to STD treatment, women’s health, mental health, military exposures, polytrauma, rehabilitation, spinal cord injuries, and telehealth. The VA provides plenty of health coverage, but it’s limited to VA care only.  For seniors who may have a low priority level, they might not be getting their options for care through the VA. Beneficiaries can’t just see any doctor. That’s why offering them Medicare will help them tremendously.

Similar to VA, Tricare is available to retired service members and those who were discharged for disease or disability. Some Veterans are eligible for both VA benefits and Tricare. Generally, the VA provides more coverage but Tricare provides more flexibility. Tricare coverage can include care received in a VA facility. This comparison sheet from Tricare shows the differences. To enroll in Tricare, you must already have Medicare Part A and B.

Medicare for Veterans
Determining what is best for your VA client, whether it’s Tricare, VA coverage, or another private health care plan, you’ll be able to show them that Medicare will benefit them. If you need help enrolling them in the right plan for their unique situation, please reach out to our Brokerage Sales Specialists at (800) 878-1058, ext. 1380, or by emailing us at [email protected]