This is taken directly from the Medicare and You 2009 book:
Medicare generally doesn't cover health care while you are traveling outside the U.S. (the "U.S." includes the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa). There are some exceptions including some cases where Medicare may pay for services that you get while on board a ship within the territorial waters adjoining the land areas of the U.S. In rare cases, Medicare may pay for inpatient hospital, doctor, or ambulance services you get in a foreign country in the following situations:
1) If an emergency arose within the U.S. and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition
2) If you are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency
3) If you live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists
You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
You can see the book by going to the link in the Related Links.
This is one of the many limitations with medicare, supplement policies often have coverage for travel.
part a is hospital coverage, part b is dr coverage
VA coverage would not bar you from getting Medicare Part D.
You can get prescription drug coverage (or Medicare Part D) through Medicare ... If, at any point, you drop Medicare Part D and have a break in coverage, restrictions will apply.
Medicare
Part A
Medicare Prescription Drug Coverage (Part D): Medicare offers prescription drug coverage (Part D) for everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. If you want Medicare drug coverage, you need to choose a plan that works with your health coverage. For more information: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf page 63
Part B
Part D
Medicare Prescription Drug Coverage (Part D): Medicare offers prescription drug coverage (Part D) for everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. If you want Medicare drug coverage, you need to choose a plan that works with your health coverage. For more information: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf page 63
Medicare part D is a prescription drug coverage insurance that is a part of your medicare insurance if you qualify. It can be applied for at the medicare.gov website.
Please explain your question more thoroughly if my answer does not suffice. I am unsure of what you mean by Medicare Carve Out Coverage. You can buy a Medicare Supplement at any time once you have received your Medicare Part A and Part B. If you do not enroll within 6 months of your Part B effective date you would be subject to underwriting. You can not join a Medicare Supplement if you already have a Medicare Advantage Plan as this is not allowed by Centers for Medicare. You would be required to drop your Medicare Advantage Plan prior to the Medicare Supplement effective date. If you had coverage through an employer, you would not need Medicare Supplement coverage as your employer coverage would be primary and then Medicare would be secondary for your out-of-pocket costs covered by Medicare.