Medicare Alongside Coverage You Already Earned
You paid into Medicare out of every cheque you ever earned, and it does not stop being yours because you also have VA care, TRICARE, CHAMPVA or a federal health plan. The question was never whether to take it. The question is how it fits with what you already have — and where the wrong move costs you something you cannot get back.
No plan described here is a veterans plan, a VA plan, a military plan or a federal employee plan. Medicare Advantage and Part D plans are private insurance. None is issued by, sponsored by, endorsed by or affiliated with the Department of Veterans Affairs, the Department of Defense, any branch of the armed services, or the Office of Personnel Management. Your VA, TRICARE, CHAMPVA, FEHB or PSHB coverage is administered by those agencies and nothing on this page changes it.
Two benefits, earned separately
You have two things, not one
Medicare is an earned benefit you paid for through payroll taxes across a working lifetime. VA health care, TRICARE For Life, CHAMPVA, FEHB and PSHB are separate benefits, earned separately. Holding one has never required giving up the other, and for several of these programmes Medicare is not optional at all — it is the thing that keeps the other benefit running.
What Medicare adds that the other system may not
Care outside the VA, on your schedule and near your home. A second opinion from a doctor who does not work for the same system. Emergency care wherever you happen to be. Routine dental, which most veterans have no VA benefit for at all. Hearing aids. Vision. None of that is a criticism of VA care. It is simply coverage the other card does not carry.
And the part nobody warns you about
Three moves go wrong often enough to be worth naming. Cancelling a federal or postal health plan instead of suspending it, which in most cases cannot be undone for the rest of your life. Dropping Part B because another system covers you, which can end TRICARE For Life or CHAMPVA outright. And adding a Medicare drug plan on top of drug coverage you already have — which for CHAMPVA and PSHB does not add anything, it removes something. Each page below names the trap for that programme and tells you who to call to check.
Find the one you hold
VA Health Care & Medicare
Your VA pharmacy is creditable drug coverage. Your VA care is not a substitute for Part B, and treating it as one carries a lifetime penalty.
TRICARE For Life & Medicare
Part B is not optional — drop it and TRICARE For Life ends. What a Medicare Advantage plan does and does not change if you enrol in one.
CHAMPVA & Medicare
VA says plainly you do not need Part D to keep CHAMPVA — and a drug plan ends Meds by Mail, which is free.
FEHB & Medicare
Keep it, suspend it, or cancel it. One of those three is permanent, and it is the one people pick by accident.
PSHB & Medicare
You cannot hold two Part D plans. Joining a second one takes you out of the PSHB drug benefit and leaves you paying the same premium for no drug coverage.
Before you change anything
Never cancel a federal or postal health plan in order to take a Medicare plan
OPM allows an annuitant to suspend FEHB or PSHB in order to enrol in a Medicare Advantage plan, and to come back during a later Open Season — or immediately if the Medicare Advantage plan is involuntarily lost. Cancellation is generally permanent. An annuitant who cancels rather than suspends usually cannot get the coverage back, and loses the government's share of the premium for life. These are different forms and different boxes. Before you sign either one, call OPM Retirement Services at 1-888-767-6738 and get the answer for your own enrolment in writing.
Do not drop Part B because another system covers you
TRICARE For Life and CHAMPVA both require Part B. Dropping it can end that coverage. VA health care does not replace Part B either, and it creates no special enrolment period — so somebody who declines Part B on the strength of VA care can face a lifetime late-enrolment penalty and a wait until the next General Enrollment Period. Check with the programme that administers your coverage before you touch Part B.
Do not add a drug plan to drug coverage you already have
For CHAMPVA and PSHB this is the expensive one. CHAMPVA's Meds by Mail programme is only available to people with no other prescription coverage, so a Medicare drug plan ends it. A PSHB enrollee cannot be in two Part D plans at once, so joining another one removes the PSHB drug benefit while the premium stays the same. Both pages below spell this out.
The one idea that runs through all of it
Every kind of coverage on this page already includes prescription drug coverage that Medicare counts as creditable — meaning it is at least as good as a Part D plan, so you are not building a late-enrollment penalty while you hold it. That one fact decides the shape of any Medicare Advantage plan that would make sense next to it.
A Medicare Advantage plan that carries no Part D drug coverage is usually written as “MA-Only” or a medical-only plan. It covers what Part A and Part B cover, plus whatever extras the plan includes, and it leaves your existing drug coverage alone. For two of the programmes below, that is not a preference — adding Part D takes a benefit away.
Every number you might need
Nothing here is a decision about your benefit. These are the people who administer it and can tell you how it applies to you.
- VA Health Benefits — 1-800-827-1000 · www.va.gov
- TRICARE For Life — 1-866-773-0404 · tricare.mil
- CHAMPVA — 1-800-733-8387 · www.va.gov
- OPM Retirement Services — 1-888-767-6738 · www.opm.gov
- OPM — Postal Service Health Benefits — 1-888-767-6738 · www.opm.gov
- Medicare — 1-800-MEDICARE · www.medicare.gov
Talk it through with somebody who knows how these fit together
No medical questions, no pressure, and no application on the first call. If the honest answer is that your existing coverage already does the job, that is the answer you will get.
The ones that come up every week
Does enrolling in a Medicare Advantage plan affect my VA health care?
No. Your VA enrolment, your Priority Group and your disability compensation are administered by VA and are not changed by a private insurance enrolment. What a Medicare Advantage plan does is give you a way to get care outside the VA system. It pays nothing toward care you receive at a VA facility.
I use the VA for all my prescriptions. Do I need a Medicare drug plan?
Generally no. VA pharmacy benefits are creditable prescription drug coverage, which means you are not building a Part D late-enrolment penalty while you use them. The same is true of TRICARE, CHAMPVA and federal plan drug benefits. Confirm your own situation with the programme that administers your coverage.
Can I keep my FEHB plan and take a Medicare Advantage plan at the same time?
OPM states that an individual may enrol in a Medicare Advantage plan and also remain enrolled in an FEHB plan. If you do, OPM requires you to tell your FEHB plan, because it needs to know whether you have Original Medicare or a Medicare Advantage plan in order to coordinate benefits correctly. Confirm the specifics with your own carrier and with OPM at 1-888-767-6738.
What is the difference between suspending and cancelling FEHB or PSHB?
Suspension is reversible — an annuitant can return during a later Open Season, or immediately if a Medicare Advantage plan is involuntarily lost. Cancellation is generally permanent, and takes the government's share of the premium with it. They are different administrative actions. Before filing either, call OPM Retirement Services at 1-888-767-6738 and get the answer for your own enrolment.
I get my CHAMPVA medications in the mail. Should I take a Medicare drug plan?
VA states that Meds by Mail is available only to CHAMPVA beneficiaries with no other prescription coverage, and that you do not need Part D to get CHAMPVA. A Medicare drug plan would end Meds by Mail rather than add to it. Confirm with CHAMPVA at 1-800-733-8387 before changing anything.
Will a Medicare Advantage plan lower my Part B premium?
Some plans include a Part B premium reduction, often called a giveback. It is a feature of particular plans in particular counties rather than something Medicare Advantage does generally, and the amount varies. It is worth asking about for your own county, and worth checking on Medicare.gov rather than taking anyone's word for it — including ours.
Does TRICARE For Life end if I join a Medicare Advantage plan?
No. You still have Medicare, the Medicare Advantage plan becomes the primary payer, and TRICARE For Life remains the second payer for TRICARE-covered services. Note that TRICARE's guidance says Medicare Advantage claims do not cross over automatically, so a claim may occasionally need following up. Dropping Part B, on the other hand, does end TRICARE For Life.