How the two benefits work
Medicare and the VA are separate federal programs, and generally they can't pay for the same item or service. Medicare doesn't pay for any care at a VA hospital or clinic. The VA pays for care at VA facilities and for community care it authorizes in advance. If you go to a non-VA doctor or hospital on your own, Medicare (or your Medicare plan) is the coverage that pays, with the usual Medicare cost sharing.
That gives you flexibility. You might get your primary care and prescriptions through the VA and use Medicare for a specialist or hospital closer to home, or for emergencies when you're far from a VA facility.
VA care in Washington
Washington veterans are served by several VA health care systems: VA Puget Sound (with medical centers in Seattle and at American Lake near Tacoma), the Mann-Grandstaff VA Medical Center in Spokane, the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, and VA Portland, which has a campus in Vancouver for Southwest Washington. Each system also runs community clinics in other towns. For many veterans in rural counties, the Olympic Peninsula or the islands, the drive to a VA medical center can be long, which is one reason to keep Medicare as a second option.
Part B and Part D decisions
- Part A usually has no premium, and the VA encourages veterans to sign up for Medicare as soon as they can.
- Part B has a monthly premium ($202.90 in 2026 for most people). VA coverage doesn't protect you from the Part B late penalty, which is 10% of the standard premium for each full 12 months you could have had Part B. The VA says it encourages veterans to sign up, because VA funding could change and veterans in lower priority groups could lose VA health care in the future.
- Medigap: the VA doesn't bill Medicare, but it may bill a Medicare supplement policy for care of conditions that aren't service-connected. You won't owe any balance the policy doesn't pay, beyond any VA copay for your priority group.
- Part D: VA drug coverage is creditable, so you can delay Part D without a penalty. You might still want a Part D plan for prescriptions from non-VA doctors.
- Medicare Advantage: you can join a plan and keep VA benefits. Check whether the plan's network includes doctors near you, since the VA isn't part of any Medicare plan network.
If you are also a military retiree, TRICARE For Life has its own rules; see does TRICARE For Life require Part B?
Get help
For VA eligibility and enrollment, call the VA health benefits line at 877-222-8387 or contact your VA medical center. For Medicare enrollment, call Social Security at 1-800-772-1213. A licensed insurance agent with Benefits Life can explain how Medicare plans fit with VA care, at no cost to you: (206) SENIORS (206-736-4677), TTY 711. See also veterans and Medicare in Washington and the late penalty calculator.
Related questions
Does TRICARE For Life require Part B?
Rules for military retirees and families.
Do I need Part B if I'm still working?
Which coverage lets you wait.
What is Washington's Medicare phone number?
Official numbers, including the VA.
Sources
- Medicare.gov — Who pays first? (VA benefits)
- Medicare.gov — How Medicare Works with Other Insurance (PDF)
- VA — VA health care and other insurance
- VA Puget Sound Health Care System
- VA Spokane Health Care (Mann-Grandstaff VA Medical Center)
- VA Walla Walla Health Care (Jonathan M. Wainwright Memorial VA Medical Center)
- VA Portland Health Care System (Vancouver campus)
- Medicare.gov — Avoid late enrollment penalties
Frequently asked questions
Does Medicare pay for care at the VA medical center in Seattle or Spokane?
No. Medicare doesn't pay for care at any VA facility. The VA covers care it provides under your VA benefits, with any VA copays that apply to you.
Do I need Part B if I have VA health care?
It's your choice, but think it through. VA health care doesn't count as coverage that lets you delay Part B without a penalty, so if you sign up later you may pay a Part B late penalty for as long as you have Part B. Part B lets you use non-VA doctors and outpatient care if your VA eligibility, priority group or access ever changes.
Does my VA drug coverage count for Part D?
Yes. VA prescription drug coverage is creditable coverage, so you won't pay a Part D late penalty if you join a Medicare drug plan later. You can't use VA drug coverage and a Medicare drug plan for the same prescription at the same time.
What about VA community care?
If the VA authorizes care from a community provider, the VA pays and the provider must accept the VA's payment as payment in full. If the VA authorizes only part of a non-VA hospital stay, Medicare may pay for the Medicare-covered services the VA didn't authorize.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
