Why do I have to pay for Medicare if I never use it?

If you're receiving medical benefits through the VA, you don't necessarily need coverage from Medicare Part B (the part of Medicare that covers doctors bills and other outpatient care, which costs around $100 per month (the exact amount varies a bit depending on when you first enrolled). And if you don't want Medicare Part B, you don't need to be enrolled in it. If you are enrolled in Medicare Part B and you want to disenroll, contact your local Social Security office. they can take care of the paperwork to get you disenrolled and stop the Medicare deduction from your Social Security benefits. (By the way, there is no reason to disenroll from Medicare Part A, which covers inpatient care, for which you pay no monthly premium.)

The question of whether you SHOULD disenroll in Medicare Part B depends on whether you are completely satisfied with the medical care and coverage you get from the VA. Many people who are eligible for coverage from both systems find that at some point they would prefer to get certain care from outside the VA system, or that the care they want is simply not available from the VA where and when they want or need it. In those situations, being enrolled in Medicare would give you a wider choice of health care providers. On the other hand, if you live in an area that has extensive VA medical facilities and the care you are offered locally by the VA seems very broad, then you might do perfectly well remaining exclusively within the VA medical system and not having Medicare as a back-up.

One other thing to bear in mind is that if at some later point you find that the VA system is not providing you with full or satisfactory care, you could then enroll in Medicare part B. There are two downsides to this strategy. The first is that you can only do this delayed enrollment in Medicare Part B during an "open enrollment" period in the first three months of each year, with coverage to begin July 1 of that year. The other downside is that your monthly premium will be higher than the normal premium by 10% for each year than you were not enrolled.

To learn more details about how Medicare and VA medical benefits work together, take a look at the Medicare online booklet Medicare and Other Health Benefits: Your Guide to Who Pays First.