Medicare Advantage For Veterans & Spouses

How To Get The Most Out of Medicare With VA, Tricare, or CHAMPVA Benefits

Introduction
Veterans & spouses have choices with Medicare
Benefits of Medicare Advantage
How Medicare Advantage works with VA, TRICARE, & CHAMPVA
More about how Medicare Advantage works
Medicare Advantage pros & cons
Top Medicare Advantage insurance providers
Medicare Advantage frequently asked questions

Introduction

If you’re a veteran, military retiree, or spouse with VA health benefits, TRICARE, or CHAMPVA, you may be wondering whether Medicare Advantage is a smart choice. Whether you’re starting Medicare or already on it, the answer depends on your personal situation and what you want out of Medicare. In recent years, more and more Veterans, Spouses, & their family members have been choosing Medicare Advantage due to the real value it provides. This value is derived from potentially lowering your monthly cost of Medicare plus the many extra benefits that you get with Medicare Advantage. In this guide, we’ll dive into these extra benefits, explain how Medicare Advantage works with VA, TRICARE, & CHAMPVA, and explain how Medicare Advantage compares to Original Medicare. We’ll also discuss valuable features such as the Part B Giveback, dental, vision, hearing, fitness memberships, and other extras that may help reduce your overall healthcare costs while complementing the military benefits you’ve already earned.

Veterans & Spouses Have a Choice Between Original Medicare & Medicare Advantage

There are several “parts” associated with Medicare, but Medicare Parts A and Part B are the foundation of your coverage. Part A generally covers inpatient care, including hospital stays and skilled nursing facility care, while Part B covers doctors’ visits, outpatient care, lab services, preventive services, and many other medical services. When you become eligible for Medicare, you generally have two ways to receive your Medicare Part A and Part B benefits: Original Medicare or Medicare Advantage.

Original Medicare is when you receive Medicare A & B directly through the federal government and Medicare Advantage is when you receive your Medicare A & B benefits through a private insurer. With Medicare Advantage you continue to have Medicare, however, your benefits are provided by an insurer who is contracted and approved by the federal government. Presently, Original Medicare only provides the standard medical coverage and is the same for everyone. Medicare Advantage provides that same medical coverage and usually includes many extra benefits. It is those benefits that can give an “advantage” to Veterans & Spouses and help them make the most out of Medicare. In fact, there are specific Medicare Advantage plans designed for Veterans & spouses who have VA, TRICARE, or CHAMPVA. Let’s explore the details of of Medicare Advantage benefits in the next section.

Benefits of Medicare Advantage Vs. Original Medicare

As mentioned earlier, compared to Original Medicare, Medicare Advantage plans can provide significantly more coverage and valuable cost-saving benefits. This is especially true for Veterans and spouses with VA, TRICARE, or CHAMPVA benefits. The great thing is that, in most cases, you don’t pay any extra for these additional benefits. In fact, Veterans & spouses will probably end up paying less than Original Medicare when enrolled in Medicare Advantage, as you’ll find in the first benefit; “Part B Giveback.”

Part B Giveback – This is the number 1 sought after benefit that is often included with Medicare Advantage plans designed for Veterans & Spouses. Part B Giveback is a reduction for all or part of your monthly Medicare Part B premium. It is essentially a credit or rebate that you get back by being enrolled in certain Medicare Advantage plans. For example, if the monthly Medicare Part B premium is $202.50 / mo. (like it is in 2026), and your plan has a giveback of $135 / mo., you only end up paying $67.50 / mo for your Medicare. As you can see, this benefit alone can save you thousands of dollars per year.
Comprehensive Medical Coverage – Medicare Advantage Includes all Medicare Part A (hospital) and Part B (medical) services while combining your coverage into one convenient plan. If you have TRICARE or CHAMPVA, they are secondary to your Medicare Advantage plan and will help cover any copays or other medical costs. If you have VA medical benefits, Medicare Advantage works alongside and separately, allowing you to have medical options outside of the VA.
Fitness & Wellness Programs – Almost all plans for Veterans & spouses include SilverSneakers® or something like it. This benefit gives you a zero cost gym membership, fitness classes, wellness coaching, and other programs that help you stay healthy and save money. You can learn more at www.silversneakers.com.
Dental Benefits – The level of coverage varies with each plan, however, many plans cover preventive care, cleanings, X-rays, fillings, crowns, dentures, and other services. Original Medicare does not provide coverage for these services.
Vision Coverage – Benefits often include annual eye exams, allowances for glasses or contact lenses, and discounts on additional eyewear. This is in addition to medical coverage for conditions of the eyes.
Hearing Benefits – Coverage frequently includes hearing exams and allowances toward hearing aids.
Over-the-Counter (OTC) Allowances – Many plans provide a quarterly or monthly allowance for eligible health products, including pain relievers, vitamins, first aid supplies, and other everyday healthcare items.
Transportation & Telehealth – Depending on the plan, members may receive transportation to medical appointments, virtual doctor visits, nurse hotlines, and additional convenience benefits.
Prescription Drug Coverage – You can choose between a Medicare Advantage plan without or with prescription drug coverage. Many Veterans & spouses choose plans without drug coverage because VA, Tricare, and CHAMPVA benefits provide adequate coverage. However, you will often have options to choose from.

Save Hundreds Or Thousands of Dollars Per Year

Part B Giveback is a benefit included with some Medicare Advantage plans that credits you back all or part of your monthly Medicare premium. This could potentially save you thousands of dollars per year without losing any coverage.

How Medicare Advantage Works with VA, TRICARE, & CHAMPVA Benefits

The good news is that choosing Medicare Advantage doesn’t mean giving up your military healthcare benefits. Just like Original Medicare, Medicare Advantage works with or alongside VA, TRICARE, and CHAMPVA. So, you can take “advantage” of the extra benefits included with Medicare Advantage, while not worrying about losing anything.

Medicare Advantage & VA

When enrolled in Medicare Advantage, Veterans can continue using VA doctors and facilities while also gaining access to care outside the VA. Veterans can also continue to use their VA prescription benefits or they can use prescription coverage through a Medicare Advantage plan. There are also Medicare Advantage plans for Veterans with VA coverage that do not include prescription coverage. For Veterans with VA benefits, having Medicare Advantage can be especially helpful. The possibility of lowering their monthly Medicare costs and having extra benefits like dental, vision, and hearing; Really can help them get the best value out of Medicare.

Medicare Advantage and TRICARE

As a military retiree or spouse with Tricare, when you turn 65, your benefits convert to “Tricare for Life. When you have Medicare Advantage, your Tricare for Life is secondary coverage and will help cover any copays or other medical costs under your Medicare Advantage plan. This often leads you to have zero out of pocket responsibility for medical costs. Also with your Tricare for Life, you will continue to have prescription drug coverage, so it often makes sense to get a Medicare Advantage plan without drug coverage. This way you can maximize the benefits in other areas of the plan and not interfere with the quality prescription coverage you already have.

Medicare Advantage & CHAMPVA

As a spouse or family member of a disabled or deceased Veteran, you may rely on CHAMPVA for your medical and prescription coverage. When you become eligible for Medicare and enroll in Medicare Advantage, your CHAMPVA becomes secondary coverage. CHAMPVA will help cover all or most of your copays under your Medicare Advantage plan, often leading you to have zero out of pocket costs for medical care. In addition, many spouses of disabled or deceased Veterans truly benefit from the Part B giveback that’s often included with Medicare Advantage plans for Veterans & spouses. As mentioned earlier, the Part B Giveback can save you thousands of dollars per year on your Medicare premium by crediting all or some of it back to you. This really comes in handy Veteran’s spouses who may be looking for ways to save money. Finally, when you have CHAMPVA and start Medicare, you will continue to have prescription drug coverage under your CHAMPVA, which includes your “Meds by Mail” program. Because of this, it often makes sense to enroll in a Medicare Advantage plan that doesn’t include drug coverage. This way there’s no interference with the quality and low cost drug benefits you’re used to, while allowing you to maximize benefits in other areas of your plan.

Choosing the right Medicare Advantage plan depends on how you use your VA, TRICARE, or CHAMPVA benefits, where you receive medical care, and which additional benefits are most important to you. Understanding how these programs work together can help you maximize your healthcare coverage while minimizing your out-of-pocket costs

More About How Medicare Advantage Works

Now that you have a better understanding of the benefits of Medicare Advantage and how it works with military health benefits, let’s discuss some other topics to help you develop a deeper understanding for how it operates.

Doctor Networks – There are several different types of Medicare Advantage plans, but the two most common are PPOs and HMOs. Medicare Advantage plans operate with provider networks, which means there are lists of doctors who have agreed to accept the plan. If you have TRICARE, CHAMPVA, or VA benefits, you’re probably used to using doctor networks. The good news is that because Medicare Advantage is such a well-established healthcare program, many people find that their doctors are already in the network and that there are many other quality providers to choose from.
PPO & HMO – As mentioned, PPOs and HMOs are the two most common types of Medicare Advantage plans. PPOs are more flexible and tend to be the most popular option. PPOs typically have large doctor networks that cover entire states or even the whole country. PPOs also allow you to use doctors who are outside the network and generally don’t require referrals. With HMO plans, you’ll need to receive care from providers within the plan’s network, except in emergency or urgent care situations. You will choose a primary care doctor and generally need referrals before seeing specialist doctors. Think of an HMO as the “stay within the team” option. If your doctors are already in the network and you’re comfortable using that network, an HMO can be an attractive choice.
Availability Based on County – Your selection of Medicare Advantage plans is based on the county you live in. So, depending on where you live, your choices can vary. If you live in more densely populated suburban or urban areas, you’ll usually have more options. If you live in rural, less-populated areas, you may have fewer options. Even so, there are usually several good choices, no matter where you live. We find that plans designed for Veterans & spouses with VA, TRICARE, or CHAMPVA are often available throughout most or all of the state where you live.

Medicare Advantage – Pros & Cons

In this article, you’ve learned about Medicare Advantage, the benefits, and how it works. And, although it’s appealing for many Veterans & spouses, Medicare Advantage may not be for everyone. Just like anything else, there are pros and cons. Whether Medicare Advantage is right for you depends on your unique situation, what’s most important to you, and the system you’re willing to work within. As mentioned earlier in this article, when you have Medicare, your two choices are Medicare Advantage and Original Medicare. To sum it all up, here are the pros and cons of Medicare Advantage vs. Original Medicare.

Pros

Many Extra Benefits – Medicare Advantage includes the same standard medical benefits as Original Medicare under Medicare A & B. However, where Original Medicare only provides medical coverage, Medicare Advantage can provide extra benefits like dental, vision, hearing, gym memberships, over the counter supplies, and others; All for no additional monthly cost to you. Having these extra benefits can help you get more of the things you need without spending extra money, therefore getting your best value out of Medicare.
Money Back For Premiums – Part B Giveback is a benefit that is often included in Medicare Advantage plans designed for Veterans & Spouses. This benefit can save you hundreds or thousands of dollars per year on your Medicare Part B premium by returning all or a part of it back to you. This can help make Medicare much more affordable, especially considering you’re not losing any coverage, and in fact, you’re gaining coverage in many areas.
When you have VA, Tricare, or CHAMPVA benefits, you can use them with or alongside Medicare Advantage. Tricare and CHAMPVA become secondary insurance to Medicare Advantage, just like they do with Original Medicare. In this case, they will help you cover all or most of any copays for approved medical care under your Medicare Advantage plan. This often leads you to have zero or very little out of pocket costs. For Veterans with only VA benefits, Medicare Advantage can help you gain access to doctors and other care outside of the VA. And, whether you have VA, Tricare, or CHAMPVA benefits, you’ll have the option to include or leave out prescription coverage with your Medicare Advantage plan. This allows you to get more benefits in other areas of your plan while not interfering with your military prescription benefits.

Cons

Doctor Networks – Medicare Advantage plans include doctor and provider networks within PPO and HMO options, whereas, Original Medicare allows you to use any doctor. This means that with Medicare Advantage, in most cases, you’ll need to use doctors that are in in the network, with the exception of emergency or urgent care. Medicare Advantage plan networks can be large, so oftentimes there will be plans that include the doctors you’re already already seeing. PPO plans can offer flexibility, as their networks often cover the entire country and they allow you to use out of network doctors, subject to terms and costs.
Prior authorization – Both Original Medicare and Medicare Advantage have prior authorization requirements for certain medical services. Prior authorization is when a doctor or medical provider needs prior approval from the insurer before certain types of medical care can be completed. For the most part we find that Medicare Advantage follows the same guidelines and is similar to Original Medicare in terms of approving healthcare. However, in some cases, Medicare Advantage plans may have more prior authorization requirements and be more restrictive in terms of what’s approved.
Non coordination of benefits – If you have Original Medicare with TRICARE or CHAMPVA, when you see a doctor and a claim is filed, that claim automatically goes to TRICARE or CHAMPVA. When you have Medicare Advantage with TRICARE or CHAMPVA, the doctor will need to file 2 claims; First, they file with your Medicare Advantage plan, then they will need to file a separate claim with TRICARE or CHAMPVA. This often isn’t an inconvenience for the insured Veteran or spouse, it’s just an extra step that the doctor needs to take in fling claims. In rare instances, when the doctor won’t file the secondary claim with TRICARE or CHAMPVA, it can lead to the inconvenience or the insured needing to file it themselves.
Plan changes – Whether you have Original Medicare or Medicare Advantage, they will always include the standard medical coverage under Medicare parts A & B. Also, benefits and coverage are locked for both Original Medicare and Medicare Advantage once the calendar year begins. With Original Medicare, there are usually slight changes in premiums, copays, and deductibles from year to year. The same is true for Medicare Advantage plans, which can change each year in terms of copays and specific benefits. Medicare Advantage plans are usually stable from year to year, especially plans for Veterans & spouses. If you’re enrolled in a Medicare Advantage plan, your insurance provider will mail you an “Annual Notice” at the end of each year, which contains details on upcoming plan changes. Because open enrollment is at the end of the year, understanding the changes allows you to decide whether to keep your plan, change to a different one, or move to Original Medicare. Doctor networks under Medicare Advantage plans are usually stable, however, doctors and medical providers can choose to leave a plan anytime during the year. This could cause the need to see a different doctor or if you have a Medicare Advantage PPO, see your doctor as out of network (with a PPO), and change your plan at the end of the year.

Tips For Choosing Your Best Plan

Weigh the pros & cons of Medicare Advantage and decide if it might be a good option for you.
Work with a reputable and qualified Licensed Agent to help you explore Medicare Advantage plans that may be a good fit. Check your doctors and healthcare providers to see which plans they accept and how your medications are covered if you’ll need drug coverage.
Understand how it works, the benefits & coverage, and how it fits with your VA, TRICARE, or CHAMPVA benefits.
Decide on a plan that best meets your wants & needs, enroll, and give it a try. Keep in mind, your decisions aren’t final. You can change your plan each year during open enrollment or go back to Original Medicare.

We Can Help Make It Easy To Find Your Best Plan

We are experts in Medicare Advantage and offer a variety of plans and insurance providers, including the ones listed below. In addition, we understand VA, TRICARE, and CHAMPVA, and have helped many Veterans & spouses. There are no fees, costs, or obligation for our services. To get started, CLICK HERE to email us your questions or call us toll free at 1-855-625-7633.

Top Medicare Advantage Insurance Companies for Veterans & Spouses

We offer these and more

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Humana is a top national health insurer and administrator of TRICARE benefits. Through their Humana “Honor” Medicare Advantage plans, which are endorsed by USAA, Humana has become a leader in Medicare Advantage plans for Veterans & spouses. They offer PPO and HMO options and their plans are known for their large doctor networks, quality medical coverage, the largest Part B givebacks, and extra’s like dental, vision, hearing, and fitness memberships.

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United Healthcare is a top national health insurer and Medicare Advantage provider. Offering plans throughout the country, in particular their “Patriot” Medicare Advantage plan, which is designed for Veterans & spouses. They have PPO and HMO options and their plans are known for their very robust doctor networks, quality medical coverage, Part B giveback, dental, vision, hearing, and fitness benefits.

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Aetna is another top health insurer and Medicare Advantage provider. For Veterans & spouses, they are known for their “Eagle” plans, which often include large Part B givebacks, dental, vision, hearing, over the counter, and fitness benefits. Many also find Aetna plans to have large doctor networks and good medical coverage.

We Can Help Make It Easy To Find Your Best Plan

We are experts in Medicare Advantage and offer a variety of plans and insurance providers, including the ones listed below. In addition, we understand VA, TRICARE, and CHAMPVA, and have helped many Veterans & spouses. There are no fees, costs, or obligation for our services. To get started, CLICK HERE to fill out the Veterans & spouses assessment form or call us toll free at 1-855-625-7633.

Medicare Advantage Frequently Asked Questions for Veterans & Spouses

Will Medicare Advantage and it’s extra benefits cost me more monthly? In most cases no. The nice thing about Medicare Advantage is that you can get the standard medical coverage plus extra benefits, for no extra monthly cost. In fact, in many cases you can get the extra benefits and a lower monthly cost (see Part B giveback below.)

What is Part B Giveback and How Is It Provided? Part B Giveback is a benefit of certain Medicare Advantage plans, in particular, plans designed for those with Military health benefits. Part B Giveback is a monthly amount you get back that lowers your monthly cost of Medicare. The credit is applied automatically to your Medicare premium and / or Social Security and can save you hundreds, even thousands of dollars per year. Many plans for Veterans & spouses are able to provide this credit because Many Veterans use the VA, which lowers overall healthcare costs for the plan.

How does Medicare Advantage provide extra benefits for no extra monthly cost? When you sign up for a Medicare Advantage plan it is provided by a private insurance company and it becomes your Medicare benefits. Medicare then pays your insurance provider a monthly amount, which includes a little extra in order to provide you with your benefits. This extra amount enables Medicare Advantage insurers to provide the benefits for no extra cost.

Will having Medicare Advantage lower the quality of my coverage or care? No, not necessarily. Medicare Advantage plans are contracted and regulated by the federal government. They must follow certain rules and and are tracked by Medicare. Medicare Advantage plans provide coverage for all medically needed care and treatment under Medicare Part A & B. Medicare Advantage plans generally follow Medicare’s rules for approving medical care and claims, however, in some cases they have their own approval guidelines. There are different types of plans available and the quality can vary among insurance providers. This is why it’s important to choose a quality plan and insurer.

If I sign up for Medicare Advantage, can I keep my doctors? If you have VA benefits, you can continue with your current doctors at VA facilities & network providers. VA benefits are separate from Medicare, so there is no interference with them. For military hospitals & clinics, you can continue to use them. Care at military bases and facilities continues to be covered fully by Tricare with no Medicare involvement. For private civilian / Medicare doctors, in most cases, you will be able to keep seeing them. Medicare Advantage plans have networks, meaning a list of doctors and hospitals that are accept the plan. Some Medicare Advantage plans (PPO) allow you to go out of network and see any doctor. When evaluating a Medicare Advantage plan, it’s important to check if your doctors and medical providers accept the plan. If you’re working with us, this is something that we will do for you.

How does Medicare Advantage coordinate with my VA, Tricare, or CHAMPVA benefits? When you have Tricare or CHAMPVA benefits they become secondary to Medicare Advantage or Original Medicare. As secondary coverage, Tricare and CHAMPVA will cover any copays or other out of pocket costs under your plan. This does not happen automatically with Medicare Advantage like it does with Original Medicare. When you visit a doctor or medical provider they will file a claim with your Medicare Advantage plan, and once approved, then they can file a claim separately with Tricare or CHAMPVA to cover the copay. In most cases, doctors offices will handle everything. However, in rare instances you may need to file with Tricare or CHAMPVA to be reimbursed for a copay under your Medicare Advantage plan. For VA healthcare, neither Medicare Advantage nor Original Medicare have any involvement in claims. VA coverage remains separate from and works alongside Medicare Advantage.

When can I enroll in a Medicare Advantage plan? There are two primary periods when you can enroll in a Medicare Advantage plan. 1. When you first start Medicare A & B, usually 3 months before you start and up to 3 months after. 2. During the Annual Open Enrollment period which begins October 15th and lasts through December 7th. Other than that, you may qualify for a Special Enrollment Period, which is based on life events such as moving or leaving employer coverage. You ca contact us to check your eligibility.

If I decide to enroll in Medicare Advantage instead of Original Medicare, can I ever change back? Yes you can. Each year from January 1st through March 31st you can dis-enroll from a Medicare Advantage plan and go back to Original Medicare. This is called the Medicare Advantage Open Enrollment Period.

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We are an independent agency that offers a variety of plans & insurers. 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 your options.