How VA and a Medicare Advantage plan fit together
Medicare.gov says that if you have Medicare and VA benefits, you can get treatment under either program, but Medicare and VA can't pay for the same items or services. A Medicare Advantage plan is a Medicare-approved plan from a private company that covers your Part A and Part B services, and usually Part D. So:
- At a VA medical center or clinic, VA pays under its rules, including any VA copay for your priority group.
- With the plan's doctors and hospitals, the plan pays under its rules and you pay its copays or coinsurance. VA doesn't pay them.
- Emergencies: Medicare Advantage plans cover emergency care, including outside the plan's network.
VA says giving it your health insurance information can help: payments VA collects for care not related to your service may offset part or all of your VA copay. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
Things North Carolina veterans should check
- Map your care. List the VA sites you use (North Carolina's VA medical centers are in Asheville, Durham, Fayetteville and Salisbury, with clinics across the state) and the non-VA doctors and hospitals you'd want for everything else.
- Check networks. Make sure a plan's network includes those non-VA providers. Plans vary by county: for 2027, CMS lists 40 Medicare Advantage plans open to everyone in Cumberland County and 44 in Buncombe County. See your county page.
- Check drug coverage. If you'll keep getting most prescriptions from VA, a plan's drug coverage may matter less to you. Medicare's guide says you can't use both for the same prescription.
- If you also have TRICARE For Life, you must keep Part B. TRICARE says TFL can reimburse plan copayments for TRICARE-covered services when you file a paper claim.
- State Health Plan retirees: joining an outside Medicare Advantage plan moves you off the Plan's group Medicare Advantage plan and onto its 70/30 Plan. See State Health Plan retirees.
Compare plans at Medicare.gov or see plans for your ZIP code. You can change plans during Open Enrollment, October 15 to December 7 each year (under way now for 2027 coverage), or switch once from January 1 to March 31 if you're already in a Medicare Advantage plan. Some 2027 plans in North Carolina are ending; see plans ending in 2027. More in Medicare Advantage in North Carolina and our guide to military retirees, veterans and TRICARE in North Carolina. To compare plans from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Do I need Medicare if I have VA care?
Why VA says to sign up at 65.
Does TRICARE For Life work with Medicare?
For military retirees.
Does Medicare cover Camp Lejeune illnesses?
VA, Medicare and the family program.
Sources
- Medicare.gov — Who pays first? (Veterans' benefits)
- U.S. Department of Veterans Affairs — VA health care and other insurance
- CMS — Your Guide to Medicare Drug Coverage (June 2026)
- TRICARE — TRICARE For Life Handbook (updated August 2026)
- Medicare.gov — Compare Original Medicare and Medicare Advantage
More questions in this guide
- Can military retirees on Medicare use the Fort Bragg pharmacy?
- Do I need Medicare if I have VA health care in North Carolina?
- Do I need Medicare Part B with TRICARE For Life?
- Does Medicare cover illnesses from Camp Lejeune water contamination?
- Does TRICARE For Life work with Medicare in North Carolina?
- What happens to TRICARE Prime at 65 in North Carolina?
Part of the guide: Military retirees, veterans and TRICARE in North Carolina: how Medicare fits · All questions
Frequently asked questions
If I have VA care, should I pick Original Medicare or Medicare Advantage?
It depends on where you'd get non-VA care. Original Medicare works with any provider in the U.S. who accepts Medicare; Medicare Advantage plans generally use a network and service area and may require prior authorization. Compare both against the doctors and hospitals you'd use outside VA.
Can I use VA drug coverage and a plan's Part D at the same time?
You can have both, but Medicare's drug coverage guide says you can't use both for the same prescription.
Does a Medicare Advantage plan affect my VA eligibility?
No. VA says having other health coverage doesn't affect the VA health care benefits you can get. Tell VA about your other coverage so it can bill it for care not related to your service.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
