Is VA Healthcare Enough?

If you qualify for health care at the Veteran’s Administration, you will have access to he lowest prescription drug prices in the nation. How much you pay for your care is based on many factors (service related disability, Agent Orange exposure and income). Wait? Income? Yes, many people are shocked to find out that the VA uses means testing. Meaning, if you make a lot of money, they expect you to purchase your own insurance and not rely on the VA.

I’ve had many clients over the years that assume they’ll get their care from the VA, since they served and were honorably discharge. Most have never even applied. It’s easy to find out if you qualify here. You will need a copy of your DD214 to apply.

Next Steps

If you have been accepted, your next question is “Do I need Medicare too?” That answer is very personal to your situation. Technically, no, you don’t need Medicare if you plan to get all your care at the VA. Medicare doesn’t work inside the VA. But Medicare gives you options outside the VA that may be very attractive.

Medicare Part B cost the average American $170.10 a month in 2022. It went up nearly 15% a month from 2021 and we expect that again for 2023. If you can afford Part B, my recommendation is to get it and enroll in some type of Medicare Advantage plan with a $0 monthly cost. If you prefer to get your care at the VA, fine. But if the waits are too long and you prefer to access a specialist in your HMO network now, your private plan gives you that flexibility. Many veterans don’t live close to a VA facility. Having to drive on the highway can be a challenge once the vet is ill. Many HMO plans offer free taxi or Lyft rides. Or you may choose to see a doctor nearby using your private insurance, rather than trekking down to the VA.

Want Extra Benefits?

Many companies built a special Medicare Advantage plan for Vets. These plans don’t have drug coverage since VA Rx is better, but they offer many extra benefits. Some plans may offer money for items in a pharmacy that don’t require a prescription or an allotment of money for groceries, rent or utilities. These types of extra benefits vary by company and can change each year. Vets see Joe Namath ads on TV and figure out that they can have the best of both worlds, VA health care and Private Medicare Advantage—but only if they sign up and pay for Medicare Part B monthly.

Don’t Overlook the Late Penalties

A snag in this system is that vets who didn’t sign up for Medicare Part B at age 65 and later want it at age 66+ will have to pay a monthly late Part B penalty. The penalty makes no sense for Vets, so don’t try to understand it. Just know that they will pay 10% more for every year that they waited past age 65 to sign up for Part B. This penalty lasts a lifetime and can be what keeps some older Vets from trying out the option described above. 

If VA healthcare isn’t enough, and you choose to give yourself this additional option for care outside the VA, you can cancel it later if you choose. You can cancel Medicare Part B by contacting 1-800-Medicare and you are allowed to drop private Medicare plans during the fall’s Annual Election Period. 


Sylvia Gordon and her sister, Rebecca, run Gordon Marketing, one of the nation’s largest Medicare FMO/NMA offices. They have a team of over 100 that train and support independent insurance agents in all 50 states. You can find Sylvia’s weekly posts on LinkedIn and the sisters' Youtube channel posts 2 training videos each week. Contact Sylvia at or 800-388-8342.


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