Yes. If you have Veterans Administration (VA) drug coverage, you can also join a Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan that includes drug coverage (MAPD) - and together, these two types of coverage (VA and Part D) may provide you with the broadest and most economical prescription drug coverage.
Question: Can I combine my Medicare Part D drug coverage with my VA drug coverage?
No. Although you can have both VA and Part D drug coverage - and you can use either your VA drug benefit or your Medicare Part D plan (depending which coverage is most economical), you cannot use both your VA benefits together with your Medicare Part D benefits to pay for a single prescription purchases.
Question: Will my VA drug coverage count toward entering Catastrophic Coverage?
No. Your VA drug benefits remain separate from your Medicare Part D benefits and coverage. As noted by Medicare: "Since VA and Part D benefits are separate and distinct, a veteran’s payment of a VA medication copayment does not count toward his or her gross covered drug costs or TrOOP expenditures under his or her Part D benefit."
Important: VA coverage is "creditable drug coverage" - which means - No Part D late-enrollment penalty.
Important: You can add Medicare Part D drug coverage to your VA drug coverage during an enrollment period.
You can join a Medicare Part D plan or a Medicare Advantage plan during your Initial Enrollment Period (IEP) when you first become eligible for Medicare. After the close of your Initial Enrollment Period - and you decide to join a Medicare drug plan - you must wait for a valid enrollment period (such as the annual Medicare Open Enrollment Period (AEP) that starts October 15 and continues through December 7) - or you may be able to join a Medicare Part D drug plan outside of the AEP if you use a Special Enrollment Period.
Again, if you have VA drug coverage and delay enrolling in a Medicare Part D plan, you will not pay a late enrollment penalty since VA drug coverage is considered creditable drug coverage.
Question: Can I combine my Medicare Part D drug coverage with my VA drug coverage?
No. Although you can have both VA and Part D drug coverage - and you can use either your VA drug benefit or your Medicare Part D plan (depending which coverage is most economical), you cannot use both your VA benefits together with your Medicare Part D benefits to pay for a single prescription purchases.
Question: Will my VA drug coverage count toward entering Catastrophic Coverage?
No. Your VA drug benefits remain separate from your Medicare Part D benefits and coverage. As noted by Medicare: "Since VA and Part D benefits are separate and distinct, a veteran’s payment of a VA medication copayment does not count toward his or her gross covered drug costs or TrOOP expenditures under his or her Part D benefit."
Important: VA coverage is "creditable drug coverage" - which means - No Part D late-enrollment penalty.
VA prescription drug coverage is considered creditable drug coverage, meaning that VA drug coverage it is at least as good as the standard Medicare drug coverage.
- You do not need to join a Part D drug plan:
If you decide that your VA drug coverage meets your prescription needs,
you can choose not to join a Medicare drug plan.
- You can add Medicare drug coverage later without a penalty. If you later decide you want to join a Medicare drug plan, you will not pay a late enrollment penalty when you decide to join a Medicare Part D plan.
- You can drop your Medicare drug coverage without risk of a future penalty.
If you have joined a Medicare Part D plan and then find that your VA
drug coverage provides for all of your prescription needs, you can use
the annual Open Enrollment Period (AEP) or a Special Enrollment Period (SEP) to disenroll from your Medicare Part D drug plan (and save the cost of monthly premiums).
Related Question: I receive all of my medications through the VA, so can I disenroll from my Medicare Part D plan?
Tip: Keep your $0 premium Medicare Advantage plan that includes drug coverage. If you have access to a Medicare Advantage plan in your area that includes drug coverage (MAPD) and has a $0 premium or a Part B premium "give-back" or rebate - you may wish to keep your MAPD along with your VA coverage - even when you do not need or use the MAPD drug coverage since you are not paying a monthly premium for the Medicare Advantage plan (or may actually be getting back a portion of your Medicare Part B premium).
You can join a Medicare Part D plan or a Medicare Advantage plan during your Initial Enrollment Period (IEP) when you first become eligible for Medicare. After the close of your Initial Enrollment Period - and you decide to join a Medicare drug plan - you must wait for a valid enrollment period (such as the annual Medicare Open Enrollment Period (AEP) that starts October 15 and continues through December 7) - or you may be able to join a Medicare Part D drug plan outside of the AEP if you use a Special Enrollment Period.
Again, if you have VA drug coverage and delay enrolling in a Medicare Part D plan, you will not pay a late enrollment penalty since VA drug coverage is considered creditable drug coverage.
Additional considerations:
If you are entitled to VA health benefits, your coverage will not change when you become eligible for Medicare, but
based on your prescription drug needs, you may choose to have both VA and Medicare drug coverage.
If you are thinking about joining a Medicare drug plan and you have VA benefits, you should consider:
-
Where you live may affect your decision to add Medicare drug coverage to your benefits.
You may benefit from Medicare drug coverage if you are in a nursing home that does not let you use your current VA drug benefits. You may also want to add Medicare drug coverage if you live far from a VA facility.
-
Where you want to fill your prescriptions may affect your decision to add Medicare drug coverage to your benefits.
As noted by Medicare, in most cases, "VA prescriptions generally must be written by a VA physician" and you must get your drugs from a VA pharmacy in person or through the VA’s "Consolidated Mail Outpatient Pharmacy (CMOP)" operations. And since a VA pharmacy does not fill prescriptions for Part D plans, you will need to use local retail pharmacies or your plan's mail order pharmacy if you join a Medicare drug plan.
For additional information, please contact the VA Health Benefits
Service Center at 1-877-222-8387.
TTY users should call 1-800-829-4833
or telephone a Medicare representative at 1-800-633-4227.
Sources include:
U.S. Department of Health & Human Services
Medicare Prescription Drug Benefit Manual, Chapter 14 -
Coordination of Benefits
- Browse Medicare Part D prescription drug plans
- Browse Medicare Advantage plans (MAPD)
- Sign-up for our Medicare Part D Newsletter.
- Still have a question? Click here to let us know.