Veterans to Save Money on VA Prescriptions

January 29, 2016

Under new rules proposed earlier this month by the Department of Veterans Affairs (VA), most veterans can expect to see $1 - $4 in savings per prescription for outpatient medications, starting next year.

The new regulations will change the VA's drug payment schedule for veterans with non-service connected conditions in priority groups 2 through 8, to a three-tiered system, similar to the TRICARE pharmacy program.

Under the current system, these veterans pay a flat fee of $8 - $9 per medication for a 30-day supply, with copayments capped at $960 per year.

Starting in 2017, the VA will implement a three-tier copayment system, capping the annual maximum for copayments at $700:

TierPrescription Drug TypeCopay (30 Day Supply)
1Preferred Generic Drugs$5
2Non-Preferred Generics And Over-The-Counter$8
3Brand Name$11

Because many medications are generics, most veterans should see the new system reduce their out-of-pocket costs.

Those with service-connected conditions in priority group one - veterans with disability ratings of 50 percent or more or unemployable - will still be exempt from paying copays under the new rule.

VA wants to encourage veterans to use one pharmacy instead of shopping around at multiple pharmacies to fill medications. By using one pharmacy at lower drug costs, VA anticipates veterans will be more likely to take the medications they're prescribed. VA, in turn, will be able to collect better patient data and better manage patient health.

 

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