I have Medicare and Veterans’ benefits.Who pays first? If you have or can get both Medicare and Veterans’ benefits, you can get treatment under either program. When you get health care, you must choose which benefits to use each time you see a doctor or get health care. Medicare can’t pay for the same service that was covered by Veterans’ benefits, and your Veterans’ benefits can’t pay for the same service that was covered by Medicare. Also, Medicare is never the secondary payer after the Department of Veterans Affairs (VA).

 

Note: to get the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility.

 

Are there any situations when both Medicare and the VA may pay? Yes. If the VA authorizes services in a non-VA hospital, but didn’t authorize all of the services you get during your hospital stay, then Medicare may pay for the Medicare-covered services the VA didn’t authorize.

 

Example: Bob, a Veteran, goes to a non-VA hospital for a service authorized by the VA. While at the non-VA hospital, Bob gets other non-VA authorized services that the VA won’t pay for. Some of these services are Medicare-covered services. Medicare may pay for some of the non-VA authorized services that Bob got. Bob will have to pay for services that Medicare or the VA doesn’t cover.

 

I have a VA fee-basis identification (ID) card.Who pays first? The VA may give "fee-basis ID cards" to certain Veterans if these conditions apply:

• You have a service-connected disability.

• You’ll need medical services for an extended time period.

• There are no VA hospitals in your area.

•  

If you have a fee-basis ID card, you may choose any doctor listed on your card to treat you.

 

If the doctor accepts you as a patient and bills the VA for services, the doctor must accept the VA’s payment as payment in full. The doctor can’t bill you or Medicare for these services.

 

If your doctor doesn’t accept the fee-basis ID card, you’ll need to file a claim with the VA yourself. The VA will pay the approved amount either to you or to your doctor.

 

Where can I get more information on Veterans’ benefits? Visit VA.gov, call your local VA office, or call the national VA information number at 1-800-827-1000. TTY users should call 1-800-829-4833.

 

Source of information: www.Medicare.gov