A 100% service-connected disabled veteran receiving benefits from the Department of Veterans Affairs said he pays nothing for his medical care, dental, vision or prescriptions. So when he got his Medicare Part B card in the mail, he had questions: Could he keep his VA benefits? Would Medicare cover prescriptions the VA doesn't? What about dental?
The roughly 300,000 veterans who turn 65 each year may share his confusion. With Medicare Part B premiums jumping to $202.90 per month in 2026, understanding what you actually need matters.
Medicare and VA Don't Work Together
Here's the most important thing to understand: Medicare and VA benefits operate as separate systems that don't coordinate. Before every doctor's appointment, you choose which benefit to use.
VA coverage works only at VA facilities except under certain circumstances. Medicare works at any Medicare-certified facility, which includes nearly every civilian hospital and doctor's office in America.
Read more: See Your 2026 VA Disability Pay Rates
Should You Enroll?
Yes, even if you have VA coverage. The VA itself encourages veterans to sign up for Medicare when they turn 65.
Here's what each part costs in 2026:
- Part A (hospital): Free for most veterans who worked 10-plus years. The deductible is $1,736 for hospital stays.
- Part B (doctor visits): $202.90 per month with a $283 annual deductible. The catch? If you skip Part B at 65 and enroll later, you pay a 10% penalty for every 12 months you delayed. That penalty is permanent.
- Part D (Prescriptions): Optional for veterans with VA coverage. VA prescription coverage counts as “creditable” under Medicare, so you won't face penalties for skipping Part D. Maximum out-of-pocket for 2026 is $2,100.
- Part C (Medicare Advantage): Private plans that replace original Medicare. Most include prescription coverage plus dental, vision and hearing benefits.
Read more: Here’s How to Maximize VA Benefits Over Your Lifetime
The Prescription Drug Decision
You cannot use both VA and Medicare Part D for the same prescription but must pick one each time you fill.
If you're 100% service-connected disabled and the VA covers everything, skip Part D. If you see civilian doctors who prescribe medications that the VA doesn't stock, Part D makes sense.
"The VA mail-order pharmacy works great for me," said a 100% disabled Marine Corps veteran. "Why would I pay $50 a month for Part D when the VA gives me everything free?"
Mental Health Coverage
Medicare Part B covers outpatient mental health services. You can see any psychiatrist or therapist who accepts Medicare without VA referral or approval.
"The wait for a psychiatrist at my VA was four months," said a 50% disabled Marine Corps veteran. "I called a civilian psychiatrist who took Medicare. Got an appointment in two weeks."
Read more: Tricare for Life is Medicare Wraparound Coverage
The Dental Problem
Original Medicare doesn't cover routine dental care. No cleanings, no fillings, no crowns.
Your options:
- Medicare Advantage plans: Most include some dental benefits, though coverage varies
- Standalone dental insurance: Plans range from $25 to $100 per month, according to an estimate in U.S. News & World Report.
- VA dental program: 100% service-connected veterans often qualify for comprehensive VA dental benefits.
Check your eligibility at va.gov/dental.
What to Do Now
Three months before turning 65:
- Enroll in Medicare Part A and Part B at ssa.gov or call 1-800-772-1213.
- Keep your VA benefits (Medicare doesn't cancel them).
- Decide if you need Part D based on your prescriptions.
Key contacts:
- Medicare: 1-800-633-4227 or medicare.gov
- VA benefits: 1-800-827-1000 or va.gov
- Free Medicare counseling: shiphelp.org
The Bottom Line
You can and should have both Medicare and VA benefits. Keep VA for service-connected care, and use Medicare for civilian providers, especially if you live far from a VA facility.
The worst mistake is doing nothing. Missing your enrollment window means penalties that last the rest of your life.
If you're confused, call your local veterans service officer. Their help is free.
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