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VA & Medicare benefits for spouses, dependents and family caregivers
If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits along with these plans.
Why is it that the VA demands details about your individual health insurance policy (including coverage under a spouse's plan)?The VA requires this information because they have to bill your private health insurance provider for any care, supplies, or medicine we provide to treat your non-service-connected conditions (illnesses or injuries that are not related to your military service). They do not bill Medicare or Medicaid but may bill Medicare supplemental health insurance for covered services. Does it help in any way to give VA my health insurance information?
Yes, of course. Giving the VA your health insurance information helps you because:
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No. It doesn't matter whether or not you have health insurance coverage. This fact does not affect the VA health care benefits you can get. Should I still sign up for Medicare when I turn 65 or am medically disabled?
Yes, you should sign up for Medicare as soon as you can for the following reasons:
- Having Medicare means you're covered if you need to go to a non-VA hospital or doctor, so you'll have more options to choose from.
- Funding for VA health care could change in the future. You should sign up for every health care benefit that you're eligible to receive in case you need them due to an unexpected situation.
- IMPORTANT! Don't delay signing up for Medicare Part B (coverage for doctors and outpatient services), because if you need to sign up later because you lost your VA health care benefits or need more choice in care options, you'll pay a penalty.
- This Medicare Part B late penalty gets bigger each year you delay signing up. You'll be required to pay it every year for the rest of your life.
- When you sign up for Medicare Part D (coverage for prescription drugs), Medicare PART D Prescription Drug Coverage you'll be able to use it to get medicine from non-VA doctors and fill your prescription drug needs immediately at your local pharmacy instead of through the VA mail-order service.
- Again, there is a penalty (1% per month) that you don't have "creditable prescription drug coverage" by delaying Medicare Part D if you don't enroll when you are first eligible to or within 63 days of when you no longer have VA health care or other creditable prescription drug coverage. Just do it!
No. Due to the VA MISSION Act of 2018, the VA no longer requires permission to bill health insurance providers or Medicare for care related to a sensitive diagnosis (like alcohol or drug abuse, alcoholism, HIV or HIV testing, sickle cell anemia, or other diagnoses included in Public Law 38 U.S.C. 7332-protected information).
Before submitting any claims for care related to a sensitive diagnosis, we notified veterans of this change by sending a one-time notice to all veterans who had signed a release of information refusing to allow us to bill for care related to a sensitive diagnosis in the past. The Federal Register also published this change.
The VA VA Locations. is now submitting claims to health insurance carriers for all non-service-connected care, even if we dont have a signature or written authorization permitting us to disclose protected information on these claims or in veterans medical records.
The VA is required by law to bill the veterans health insurance, or Medicare and Medicaid (including your spouses insurance if youre covered under the policy). The money collected goes back to VA medical centers to support health care costs provided to all veterans.
You may submit a restriction request asking the VA not to disclose your health information for billing purposes, but the VA is not required to grant your request. To submit a restriction request, please contact your nearest VA health facility and ask to speak with the Privacy Officer. You can also ask to talk with the billing office for more information.
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