Navigating Medicare Advantage with VA, TRICARE For Life, and CHAMPVA Benefits
Good news for TRICARE For Life beneficiaries: enrolling in Medicare Advantage does not affect your TRICARE coverage.
April 3, 2025
If you are a Veteran or a family member covered under CHAMPVA, TRICARE For Life (TFL), or VA Health Benefits and you're considering enrolling in a Medicare Advantage (Part C) plan, understanding how these programs work together is key. Here’s a breakdown of what you need to know to make informed decisions about your health coverage.
CHAMPVA & Medicare Advantage
CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) can serve as a secondary payer when you’re enrolled in another health plan, such as a Medicare Advantage plan. This means CHAMPVA helps cover out-of-pocket costs like deductibles, co-pays, and coinsurance after your primary plan pays.
Most healthcare providers will bill your Medicare Advantage plan first, and CHAMPVA will pick up the remaining balance. However, there are exceptions. If you're also covered by Medicaid, Indian Health Services, or certain crime victim benefits, CHAMPVA may act as your primary payer.
Keep in mind: CHAMPVA does not cover Medicare Part B premiums. To stay eligible, you must be enrolled in both Medicare Part A & Part B.
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TRICARE For Life & Medicare Advantage
Good news for TRICARE For Life beneficiaries: enrolling in Medicare Advantage does not affect your TRICARE coverage. Medicare Advantage becomes your primary insurer, while TFL acts as a secondary payer for TRICARE-covered services.
However, unlike Original Medicare, Medicare Advantage claims do not automatically crossover to TRICARE. This means you may have to manually file claims with TRICARE For Life for reimbursement, unless your provider or Medicare Advantage Health Plan carrier is willing to submit those claims for you on your behalf.
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VA Health Benefits & Medicare Advantage
If you receive care through the VA, you can also use Medicare Advantage, Medicaid, or private insurance. While the VA doesn’t bill Medicare, they may bill your private insurance for care provided for non-service-connected conditions.
Providing your health insurance details to the VA can help reduce copayments and improve care coordination. Importantly, your insurance status doesn’t impact your eligibility for VA health care benefits.
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At Stellar Benefits, we are committed to helping veterans receive health care benefits they are eligible for. If you have questions or would like a free review, please contact us today.