Tricare VS VA Benefits
- Megan Hutton (Unlicensed)
Our military veterans normally have either Tricare or VA Benefits. Some family members of Veterans can have Tricare for Life or ChampVA. Tricare and ChampVA work the same.
There are several differences between the two. The biggest difference is that Tricare works like a supplement after Medicare/MA/MAPD plan pays whatever it is supposed to, but VA Benefits does not. VA Benefits can only be used at the VA, unless the beneficiary has previously filed for exceptions.
Why would anyone with Tricare (or ChampVA) get a MA/MAPD plan? They have “everything taken care of.”
People with Tricare get a MA/MAPD plan for the additional benefits that MA/MAPD plans offer.
Why would anyone with VA Benefits get a MA/MAPD plan? They have “everything taken care of.”
Some people hate the VA and wish they did not have to go to the VA for everything.
Some Veterans do not get dental, vision, and hearing from the VA and want those additional benefits.
Some people want reassurance that they will not get an outrageous medical bill after going to a civilian hospital for an emergency. VA Benefits do not typically cover ER visits nor inpatient stays at civilian hospitals, even if it was a car accident or a heart attack.
Some people must travel far to get to the VA hospital for their visits and would like to find a doctor that is closer.
MA/MAPD plans offer a LOT of additional benefits that VA Benefits does not offer.
The following table is a basic break down of the differences between Tricare and VA Benefits.
Tricare and ChampVA | VA Benefits |
Works with Medicare. Tricare acts like a supplement after Medicare pays 80% of the medical bill. For Medicare Approved medical visits, Medicare pays 80% of the bill and then Tricare takes care of the rest (up to 20% of the full bill). | Completely separate from Medicare. Medicare does not affect VA Benefits and VA Benefits do not affect Medicare. VA Benefits can usually only be used at VA Hospitals, VA facilities, and VA Pharmacies. Medicare pays NOTHING at the VA facilities, and VA pharmacy. |
Can be used at any civilian doctor, hospital, pharmacy that accepts Medicare and Tricare. | Beneficiaries must get approval from the VA to use civilian doctors, which requires extenuating circumstances and lots of paperwork. |
Most beneficiaries have dental, vision, and hearing benefits through Tricare, but NOT EVERYONE. Always ask. | Most beneficiaries have dental, vision, and hearing benefits through VA Benefits, but NOT EVERYONE. Always ask. |
Prescriptions are covered by Tricare at civilian pharmacies, but there may be copays. | Prescriptions are covered by VA Benefits ONLY IF they are prescribed by a VA Doctor and filled at the VA Pharmacy. |
May cover transportation to and from doctor’s visits. The Beneficiary must fill out paperwork and get approved for transportation. | May cover transportation to and from VA doctor’s visits. The Beneficiary must fill out paperwork and get approved for transportation. |
If enrolled into a Medicare Advantage plan, then the Medicare Advantage plan pays whatever it is supposed to, and then Tricare pays the rest (up to 20% of the medical bill). | Enrolling into a Medicare Advantage plan has NO EFFECT on VA Benefits. They can still go to the VA for everything if they desire. |
Additional benefits that can come from a Medicare Advantage plan include, but are not limited to:
| Additional benefits that can come from a Medicare Advantage plan include, but are not limited to:
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