Question:

Hello Jim, You have directed me in the past and would like your opinion. I'm 100% PT, over 10 yrs, age over 60. My doctor accepts my VA and I have Tricare as a back-up. Do I need to have Medicare Part B with both VA and Tricare for life when I reach 65? If so why would you recommend all 3 vs just VA and Tricare? 

Jim's Reply:

I hear you...Interestingly, only a veteran will be questioning whether we have too many health care choices. Our options are plentiful as a result of our honorable military service and that's a good thing. I was a military brat and never understood why my young civlian peers didn't enjoy the Navy hospitals and doctors and medics I got to see.
 

I've advised for a long while now that the amount of health insurance one carries has to be tailored to the individual. If you are eligible for VA care and you live within reasonable distance of a reliable VA facility, and you're happy with your care, you're done. If you aren't sure that your VA facility will meet your personal needs over time, then you look at your options. 
 

Emergency care is a big concern. Yeah, sure...VA is supposed to take care of any civilian emergency bills but a lot of vets are being sued by bill collectors right now so I wouldn't count on that. Part B covers a ton of the costs associated with emergency care so if a VA medical center isn't nearby, Part B may be wise.
 

Tricare always introduces a few curves by not being accepted by all providers. OK, right...that's true of any insurance but there have been a lot of changes to Tricare over the years so before you rely on it be sure it'll work for you where you are. If it works for you, you're done.
 

VA health care offers a pharmacy service (Meds By Mail) that is outstanding. Part B offers zilch for pharmacy and I'm unsure of how your particular Tricare coverage responds to prescriptions.
 

In a nutshell, your tolerance to risks (availability, financial, emergency care) and your own assessment of your current and future needs will be what will guide your choices. I get along really well with Medicare Part A & B and I use my VA care mostly for medicines. 
 

Making all the choices is a pain...of a good kind. Good luck.