In short
- The VA doesn't bill Medicare, and Medicare doesn't pay for VA care. You can use both, but not for the same service.
- VA coverage doesn't count as current employer coverage, so delaying Part B can mean a lifelong 10% per year penalty.
- VA drug coverage is creditable, so you can delay Part D without a penalty as long as you keep VA coverage.
- TRICARE For Life requires Part A and Part B. In the U.S., Medicare pays first and TRICARE For Life pays second.
- Nebraska VA sites include the Lincoln VA Clinic, Omaha and Grand Island VA Medical Centers, and the Sarpy County VA Clinic in Papillion.
If you served, you may have up to three health programs to fit together at 65: VA health care, TRICARE (for military retirees and their families), and Medicare. They follow different rules, and the most expensive mistake is assuming one replaces another.
Do VA health care and Medicare work together?
Not directly. They are separate programs that don't coordinate benefits. According to VA.gov, the VA doesn't bill Medicare. Medicare doesn't pay for care you get at a VA facility. You can use both, but you choose which one to use for each visit or service.
Here is how that plays out:
- At a VA medical center or clinic, the VA covers your care under your VA benefits.
- At a civilian doctor or hospital that the VA hasn't authorized, Medicare is what pays. VA benefits don't apply.
- In an emergency far from a VA facility, having Medicare means the nearest hospital is covered under normal Medicare rules.
The VA may bill a Medicare Supplement policy for some covered services, so a Medigap plan isn't useless for VA care, but it's not the main reason veterans buy one.
Should veterans sign up for Medicare Part B?
For most veterans, yes. VA.gov says, "We encourage you to sign up for Medicare as soon as you can." The reason is the penalty.
VA coverage doesn't count as health coverage from current employment. Medicare & You 2027 lists it alongside COBRA and retiree plans: none of them give you a Special Enrollment Period to sign up for Part B later without a penalty. If you skip Part B at 65 and sign up later, the late enrollment penalty is 10% for each full 12-month period you could have had Part B, added to your premium for as long as you have it. On the 2026 standard premium of $202.90, three years late adds about $60.87 a month for life.
There are other reasons veterans keep Part B:
- VA benefits only pay at VA facilities or for civilian care the VA authorizes.
- You may live an hour or more from a VA medical center, as plenty of Nebraskans do.
- Medicare lets you use civilian hospitals and specialists without VA authorization.
- You need Part B to buy a Medigap policy or join a Medicare Advantage plan.
Our guide to late enrollment penalties has worked examples, and the Part B penalty calculator does the math for your dates.
How does VA drug coverage work with Part D?
VA prescription coverage counts as creditable drug coverage. That means you can skip Part D while you have VA coverage and join later without a penalty, as long as you don't go 63 days or more in a row without creditable coverage.
You can also join a Part D plan alongside VA coverage. Medicare & You 2027 notes that if you do, you can't use both for the same drug at the same time. Some veterans use the VA pharmacy for maintenance drugs and keep Part D for prescriptions from civilian doctors, especially if they live far from a VA clinic.
How does TRICARE For Life work with Medicare?
TRICARE For Life (TFL) is Medicare wraparound coverage for TRICARE-eligible military retirees and family members who have Medicare. The rules come from TRICARE:
| Question | TRICARE For Life answer |
|---|---|
| Do I need Medicare? | Yes. You must have Part A and Part B. Coverage is automatic once you do. |
| Who pays first in the U.S.? | Medicare pays first. TFL pays second for services both cover. |
| Who pays first overseas? | TRICARE pays first, and you pay TRICARE's cost sharing. |
| Enrollment fee? | None for TFL. You still pay your Part B premium. |
| Do I need Part D? | No. TRICARE pharmacy covers drugs. If you join Part D, it pays first. |
| What if neither covers it? | You pay the full charge. |
Because Medicare and TFL together cover most costs, few TFL members need a Medicare Supplement. If you're a military retiree in the Bellevue or Papillion area, the 55th Medical Group's Ehrling Bergquist Clinic at Offutt Air Force Base accepts e-prescriptions from civilian providers at its pharmacy, according to TRICARE.
CHAMPVA, the VA's program for certain family members, also requires Part A and Part B. Call CHAMPVA at 1-800-733-8387 with questions.
Can veterans use Medicare Advantage?
Yes. With Part A and Part B, you can join a Medicare Advantage plan that serves your county and still use VA care whenever you want. Some Medicare Advantage plans in Nebraska for 2027 don't include Part D drug coverage. Some veterans pair one of those with VA pharmacy benefits, and because VA drug coverage is creditable, there's no Part D penalty for doing so.
Check two things before you join. First, your civilian doctors and hospitals need to be in the plan's network. Second, if you have TRICARE For Life, ask TRICARE how it would work with the plan. Medicare & You 2027 notes that for prescriptions, a Medicare Advantage plan and TRICARE coordinate only when the plan's network pharmacy is also a TRICARE network pharmacy. Otherwise you file your own claim to get paid back. Plans, premiums, networks and benefits vary by county and change every year. Our Medicare Advantage page explains networks, and our Medicare Supplement page covers the alternative.
Where are the VA facilities in eastern and central Nebraska?
The VA Nebraska-Western Iowa Health Care System runs these sites close to Lincoln, Omaha and Grand Island:
| Facility | Address | Notes |
|---|---|---|
| Lincoln VA Clinic | 420 Victory Park Drive, Lincoln | Outpatient clinic, open weekdays: primary care, mental health, lab, Express Care, whole health |
| Omaha VA Medical Center | 4101 Woolworth Avenue, Omaha | Includes the Ambulatory Care Center that opened in August 2020 |
| Grand Island VA Medical Center | 2201 North Broadwell Avenue, Grand Island | Community Living Center for long-term care, rehab and hospice; opened in 1950 |
| Sarpy County VA Clinic | 1330 Jersey Street, Papillion | Opened September 6, 2024, replacing the Bellevue VA clinic |
| Bellevue Whole Health Clinic | 2206 Longo Drive, Suite 102, Bellevue | Whole health services |
The VA also has clinics in Holdrege, Norfolk and North Platte. There is no VA clinic in Kearney, Hastings, Columbus, Fremont or Nebraska City, though Kearney is home to the state-run Central Nebraska Veterans' Home.
The Lincoln VA Clinic sits on the Victory Park campus, which also houses Aging Partners. Our office on S 68th Street Place is about half a mile away. Veterans in Sarpy County will find more local detail on our Papillion and Bellevue pages.
Where can veterans get unbiased help?
- VA benefits: VA.gov or 1-800-827-1000 (TTY 711)
- TRICARE For Life: 1-866-773-0404, or tricare.mil/tfl
- Medicare: 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week (TTY 1-877-486-2048)
- Nebraska SHIP: 1-800-234-7119 for unbiased Medicare counseling
If you're turning 65 and want to sort out how VA, TRICARE and Medicare fit for you, talk to me. It costs you nothing.
Frequently asked questions
Most do. The VA encourages veterans to sign up for Medicare as soon as they can. VA care only covers care at VA facilities or care the VA authorizes. Medicare lets you see civilian doctors and hospitals, which matters in an emergency, when you travel, or if VA funding or your priority group changes. VA coverage also doesn't protect you from the Part B late enrollment penalty.
No. Medicare & You 2027 lists VA coverage among the types that don't count as current employer coverage for the Part B Special Enrollment Period. If you skip Part B at 65 and sign up later, you can owe a penalty of 10% for each full 12-month period you went without it, for as long as you have Part B. VA drug coverage does count as creditable for Part D.
You can, but many people with TRICARE For Life don't need one. In the U.S., Medicare pays first and TRICARE For Life pays most of what's left for services both programs cover. That is similar to what a Medigap policy does. Before buying a supplement, look at what TRICARE For Life already pays and whether the extra premium buys anything you would actually use.
No. Medicare & You 2027 says that if you have TRICARE, you don't need to join a separate Medicare drug plan. TRICARE's pharmacy program covers prescriptions. If you do join a Part D plan, it pays first and TRICARE pays second. Most people entitled to Part A must also keep Part B to keep their TRICARE pharmacy benefits.
Yes. Veterans with Part A and Part B can join a Medicare Advantage plan that serves their county, and still use VA care. Some Nebraska plans for 2027 have no Part D drug coverage, which some veterans pair with VA pharmacy benefits. Because VA drug coverage is creditable, that pairing doesn't trigger a Part D penalty. Plans, networks and costs vary by county and change every year.
The Lincoln VA Clinic is at 420 Victory Park Drive in Lincoln, offering primary care, mental health, lab work, Express Care and whole health services on weekdays. The nearest VA medical centers are in Omaha, at 4101 Woolworth Avenue, and Grand Island, at 2201 North Broadwell Avenue. The Sarpy County VA Clinic opened in Papillion in September 2024.
Sources
- VA.gov: VA health care and other health insurance (opens in a new tab)
- TRICARE: TRICARE For Life (opens in a new tab)
- Medicare & You 2027 handbook (CMS Product No. 10050) (opens in a new tab)
- VA Nebraska-Western Iowa Health Care System: Locations (opens in a new tab)
- Medicare.gov: Avoid late enrollment penalties (opens in a new tab)
- TRICARE: 55th Medical Group Ehrling Bergquist Clinic, Offutt AFB (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
