For veterans approaching 65(202) 552-1418

VA Healthcare

What VA healthcare covers — and where Medicare picks up the rest

VA healthcare is one of the most comprehensive systems in the country for what it's designed to cover. Knowing where it ends is the key to deciding what else you need at 65.

What VA generally covers

  • Primary and specialty care at VA medical centers and clinics
  • Inpatient hospital and surgical care at VA facilities
  • Mental health, substance use, and PTSD care
  • Prescriptions filled through VA pharmacies (creditable for Part D)
  • Preventive care, immunizations, and screenings
  • Some dental, vision, and hearing services for eligible veterans
  • VA Community Care when VA can't provide a service in time or distance

What VA generally won't cover

  • Care from a non‑VA provider that wasn't pre‑authorized
  • Most emergency care at non‑VA hospitals (limited exceptions apply)
  • Routine care for family members (with narrow exceptions)
  • Services outside the U.S. (with narrow exceptions for service‑connected care)
  • Dental for most veterans without specific eligibility

Priority groups, copays, and what you'll pay

The VA assigns each enrolled veteran to one of eight priority groups. Higher‑priority groups (1–4) typically pay no copays for VA care and prescriptions. Lower groups may have copays for care unrelated to a service‑connected condition. Your priority group is set when you enroll and is reviewed if your circumstances change.

VA Community Care — the bridge to civilian providers

Through the MISSION Act, eligible veterans may receive care from community (non‑VA) providers when VA can't provide the service, when wait times exceed standards, or when driving distance is too far. Community Care must generally be authorized in advance by VA — without that authorization, the visit may not be covered. This is one of the clearest reasons many veterans add Original Medicare: it gives you another path to civilian care without needing prior VA authorization.

VA + Medicare: complementary, not duplicative

VA and Medicare don't share claims. When you receive care at a VA facility, VA pays. When you receive care from a Medicare‑accepting civilian provider, Medicare pays. You get to choose which door to walk through for any given visit, which is exactly the flexibility most veterans want at 65.

Free, no-obligation help

Talk through your options with a licensed specialist for veterans

You'll never pay a fee. Specialists are paid by the carriers and can walk you through enrollment timing, plan availability in your ZIP, and how a plan would fit alongside your VA care.