Dear Rusty: I’m not yet old enough, but must I enroll in Medicare at age 65? I am a disabled military veteran with VA benefits, so must I still take Medicare when I turn 65? Signed: Disabled Veteran

Dear Disabled Veteran: First, please accept my gratitude for your military service to our country. And please also know that if you now rely 100% on the VA for all your healthcare needs, and you expect that to continue for the rest of your life, then you have the option to decline enrolling in Medicare Part B when you turn 65. However, if you believe that using healthcare providers from outside the VA may someday be in your future, you should enroll in Medicare when you are first eligible.

Although you are required to enroll in Medicare Part A (coverage for inpatient hospitalization services) if you collect Social Security after age 65, enrolling in Medicare Part B (coverage for outpatient medical services) is always optional because there is a monthly premium for Part B ($202.90 for 2026 - changes yearly). So, as a military veteran using VA healthcare, you have a choice to either enroll in Medicare Part B at age 65, or not if you get all your healthcare services from the Veterans Administration. Just be aware that VA healthcare is not considered “creditable” for Medicare purposes, so if you do not enroll in Medicare Part B during your Medicare Initial Enrollment Period (IEP), and later choose to enroll in Medicare Part B, there will be a permanent Late Enrollment Penalty for enrolling in Medicare Part B outside your initial enrollment period (your Medicare IEP is three months on either side of the month you turn 65).

So, the decision you will need to make as you approach 65 years of age is this: will all of your healthcare needs always be provided through the VA? Or do you want the convenience (and flexibility) to know you can use any healthcare provider anywhere in the U.S. or its territories, whenever and wherever you wish. If the latter is true, then you should likely enroll in Medicare Part B when you turn 65. You can still use the VA for some services if you are enrolled in both, but there is no coordination of benefits (e.g., the VA will not make copayments if you use Medicare services, and vice versa). Which means that you may also wish to consider a Medicare Advantage plan or a Medicare Supplement plan to go with Medicare Part B if/when you enroll.

I hope this answers your question, but please don’t hesitate to contact us again if needed. And, importantly, thank you for your service to our country.

“Ask Rusty” is a layman’s guide to the intricacies of Social Security, provided by the Association of Mature American Citizens. To submit a question, visit amacfoundation.org/programs/social-security-advisory or email ssadvisor@amacfoundation.org.