ECOS Medicare Solutions
Plain-English Medicare help in Washington State

Your situation · Veterans & military retirees

Medicare for Washington State veterans and military retirees

From Joint Base Lewis-McChord and Naval Base Kitsap to Fairchild and Whidbey Island, Washington retires a lot of service members. How TRICARE For Life and VA health care each work with Medicare — explained by a retired Air Force officer who has been through the paperwork himself.

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Washington is a military state on Medicare. Joint Base Lewis-McChord supports more than 40,000 service members and more than 90,000 family members, veterans and retirees in Pierce and Thurston counties; Naval Base Kitsap is the third-largest naval installation in the country; Fairchild Air Force Base outside Spokane, Naval Air Station Whidbey Island at Oak Harbor and Naval Station Everett each have a retiree community around them. How your military benefits coordinate with Medicare depends a lot on which benefit you have.

TRICARE For Life (TFL)

  • Requires you to have Medicare Part A and Part B.
  • Pays secondary to Medicare — it wraps around Medicare like a supplement.
  • TFL pharmacy is creditable, so a separate Part D plan is usually unnecessary.
  • TFL can pair with a Medicare Advantage plan; because drug coverage already exists, an MA-only plan (Advantage without Part D) can add dental or vision without duplicating your Rx.
  • Because TFL already fills Medicare’s gaps, a Medigap policy is usually unnecessary too.

VA health care

  • Separate from Medicare — the two do not coordinate and don’t disrupt each other.
  • Medicare doesn’t pay at VA facilities; the VA doesn’t cover Medicare cost-sharing.
  • VA medical is not creditable for Part B — enroll in Part B on time to avoid a lifelong penalty.
  • VA pharmacy is creditable for Part D, so you can rely on it for drug coverage.
  • Having both Medicare and VA gives you more places to get care — UW Medicine, Providence or MultiCare with Medicare, the VA for service-connected care and prescriptions.

The mistake we most want you to avoid: skipping Part B because you have VA care. Because VA medical coverage isn’t creditable for Part B, delaying it can trigger a penalty that lasts as long as you have Medicare, and it leaves you with no coverage at a non-VA hospital. If you are approaching 65 with VA benefits, talk to us about timing first.

Where Washington veterans get VA care

VA Puget Sound Health Care System runs the Seattle medical center on Beacon Hill and the American Lake campus in Tacoma, with community clinics around the Sound. Mann-Grandstaff VA Medical Center in Spokane serves the Inland Northwest. The Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla serves the southeast and the Tri-Cities. Clark County veterans use the Vancouver campus of the VA Portland Health Care System. The two military hospitals — Madigan Army Medical Center at JBLM and Naval Hospital Bremerton — see retirees on a space-available basis under TRICARE rules; Medicare does not pay there. We have pages for the three big retiree communities: Joint Base Lewis-McChord, Naval Base Kitsap and Fairchild Air Force Base.

Which Washington plan fits a veteran

  • VA care plus Original Medicare and a Medigap policy gives the widest choice: any hospital in the state, no network question, VA pharmacy for drugs, and in Washington the freedom to change Medigap plans later. Many veterans skip Part D entirely because the VA pharmacy is creditable — keep the VA’s letter as proof.
  • VA care plus a $0-premium Advantage plan is common and can work, as long as you understand the network limits and that the VA and the plan will not coordinate a single bill.
  • TFL plus an MA-only plan for dental, vision and hearing, if the extras are worth it and the network reaches your doctors.

How we help

We look at exactly which benefits you carry, confirm your Part B timing, decide whether a separate drug plan adds anything, and — if it makes sense — compare an MA-only or Medigap option for the gaps. Darin served 22 years in the Air Force and retired as an officer; he has filled out the same forms you are looking at.

ECOS Medicare Solutions is a private insurance agency and is not affiliated with or endorsed by the U.S. Department of Veterans Affairs, the Department of Defense, the TRICARE program, the Washington State Department of Veterans Affairs, or the federal Medicare program.

Good to know

Frequently asked questions

I have VA health care. Do I need Medicare Part B?

In most cases, yes — enroll on time. VA medical coverage is not considered creditable for Part B, so delaying Part B can cause a permanent late penalty. Having both VA and Medicare gives you more options for where to get care.

With TRICARE For Life, do I need a Part D drug plan or a Medigap policy?

Usually neither. TRICARE For Life pharmacy is creditable drug coverage, and TFL already pays secondary to Medicare, filling the gaps a supplement would. That is also why an MA-only plan can make sense if you want dental or vision.

Does Medicare pay at Madigan, Naval Hospital Bremerton or the Seattle VA?

No. Medicare does not pay at military or VA facilities, and they do not cover Medicare cost-sharing. They operate separately, which is why many veterans keep both.

Is VA pharmacy coverage enough to avoid the Part D penalty?

Yes. VA prescription coverage is creditable for Part D, so you can skip a Part D plan without a penalty as long as you keep it. Keep the VA’s notice of creditable coverage in case you enroll in Part D later.

Ready when you are

Let’s sort out your benefits together, veteran to veteran.

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Sources we used on this page

Figures are checked against the source at the review date in the byline below. If a source has changed since, the source wins.

Darin Weidauer

Written and reviewed by Darin Weidauer — licensed insurance agent (NPN 18580338, WA License #1010707), Gerontologist (USC Leonard Davis School of Gerontology), MBA, Registered Social Security Analyst, and 22-year U.S. Air Force veteran.Last reviewed September 13, 2026. Plan availability, benefits and costs change every plan year — verify current details at Medicare.gov, 1-800-MEDICARE, or Washington SHIBA at 800-562-6900.