Va Copays For Medications



Welcome to the Department of Veterans Affairs Pharmacy Benefits Management (PBM) Services

Federal Pharmacists are essential to health care access and delivery in the United States; recognized as health care providers of patient-centered primary and specialty care, and as trusted public health leaders. As experts in medication use and comprehensive pharmacy services, we promote wellness, prevent and manage diseases, ensure patient safety and optimize health outcomes in collaboration with the health care team.

The VA Pharmacy Benefits Management Services offer a broad range of services and are committed to provide and deliver Veterans personalized, proactive, patient-driven health care.

Our Mission: To improve the health status of Veterans by encouraging the appropriate use of medications in a comprehensive medical care setting.

  1. The tiered structure established copayments for 30-day prescriptions at $5 for Tier 1 (top 75 generics), $8 for Tier 2 (all other generics) and $11 for Tier 3 (sole source/brand name). Veterans in Priority Groups 2 through 8 are limited to a $700 annual copayment cap.
  2. Over-the-counter medications (like aspirin, cough syrup, or vitamins) that you get from a VA pharmacy. You may want to consider buying your over-the-counter medications on your own. Note: The cost for any medications you receive while staying in a VA or other approved hospital or health facility are covered by your inpatient care copay.
  3. Qualify for full Extra Help, which has lower copays than VA coverage; If you are considering enrolling in VA drug coverage and Part D, remember that the two do not work together. Your VA benefits will only pay at VA pharmacies and facilities, and Part D will only pay at pharmacies in your plan’s network.
  4. VA Medications List. Print - Click this link to display a Printer Friendly page. Refill a Prescription - Click this link to display the My HealtheVet Rx Refill page titled: Refill Prescriptions. NOTE - The columns for Medication, Category, Status, Start Date, Stop Date, and Pharmacy, can be sorted in ascending or descending order. To sort a column, click on a triangle (or ).

Under the current regulations, medication copay amounts are based on priority groups and established using a formula based on the medication components of the Medical Consumer Price Index formula. VA estimates that copayment amounts would increase three times over the next six years if the current regulations are left unchanged.

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Our Goal: To provide Veterans with reliable, evidence-based medication information in an efficient manner so you along with your health care team can make informed decisions about your medications and improve your overall health.

Ordering Prescriptions Online!

Prescription

To order your prescriptions only, please visit My HealtheVet where you can register to manage your VA prescription refills.

Tiered Copay

Click here to view the current Tiered Copay list
Click here to learn more about Tiered Copay

What's New at PBM?

6/11Dolutegravir (Juluca, Tivicay, Triumeq) and Potential Risk for Neural Tube Defects- National PBM Bulletin
6/11AMENDMENT - Accu-Chek Aviva Plus Health Network Strips Urgent Medical Device Correction - Heparin and Saline Syringe Recall Due to Contamination - National PBM Patient Level Recall Communication
6/11Accu-Chek Aviva Plus Health Network Strips Urgent Medical Device Correction - National PBM Patient Level Recall Communication
6/11Heparin and Saline Syringe Recall Due to Contamination - National PBM Patient Level Recal Communication
6/11Synthetic Marijuana and Potential Risk for Bleedinf UPDATE - National PBM Bulletin
6/11Medication Safety in Seconds Newsletter - Issue 5; Volume 8; May 2018
6/11Medication Safety in Seconds Newsletter - Issue 4; Volume 8; April 2018
6/11Medication Safety in Seconds Newsletter - Issue 3; Volume 8; March 2018
3/21Sofosbuvir/Velpatasvir (Epclusa) and Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) Look-Alike/Sound-Alike Potential - National PBM Bulletin
12/11Medication Safety in Seconds Newsletter - Issue 9; Volume 7; October 2017
12/11Medication Safety in Seconds Newsletter - Issue 8; Volume 7; September 2017

VA Medication Safety

VA National Formulary

Pharmacy Residencies

VA Medication Safety

VA Center for Medication Safety is a comprehensive pharmacovigilance program that evaluates preventable Adverse Drug Events (ADEs) via conducting and promoting medication safety projects at the regional and national levels, providing interventions to decrease preventable ADEs, and educating the field on safe and best practices to minimize ADEs. The VA Center for Medication Safety provides feedback and guidance regarding ADE data unique to each Veterans Integrated Service Network (VISN), while translating research and published evidence into national policy through its oversight of, and cooperative arrangements with, VISN Formulary Committees and Pharmacy leaders, the Medical Advisory Panel as well as other departments within VA. Learn more >>

VA National Formulary

Copays

Pay Gov Va Copayments

The purpose of the VA National Formulary is to provide high quality, best value pharmaceutical products while assuring the portability and standardization of the pharmacy benefit to eligible Veterans accepted by the Department of Veteran Affairs for care. The Pharmacy Benefits Management Formulary Management Program Office is responsible for coordinating the VA formulary management process with the Medical Advisory Panel and VISN Pharmacist Executives Committee. It has the following responsibilities:

  • Developing and maintaining an Evidence-based formulary
  • Standardizing the drug benefit across the VA system to reduce geographic variation in cost and utilization
  • Promoting appropriate drug therapy
  • Improving drug safety
  • Improving the distribution of pharmaceuticals
  • Reducing drug inventory and acquisition costs
Learn more >>

Pharmacy Residencies

The VA Pharmacy Residency Programs are residencies of choice. The Pharmacy Residency Program Office (PRPO) oversees the strategic planning of pharmacy residency programs and supports the growth and expansion of residency programs nationwide. VA has over 236 residency programs and over 600 residents and fellows in a variety of specialty training such as Geriatrics, Oncology, Pharmacy Administration, Pharmacotherapy, Infectious Disease, Pharmacoeconomics, Managed Care, Ambulatory Care, Cardiology, Mental Health and many more. The PRPO is dedicated to VA's mission to care for the needs of Veterans and to do so, has expanded the Mental Health Pharmacy Residency programs. VA is the largest trainer of Mental Health Pharmacy residents with the highest percentage of Board Certified Psychiatric Pharmacists in the country. Moreover, VA is transforming the way residents are trained and interact in a professional program. Inter-professional training programs are growing in VA and offers the trainees of all health care professions the ability to learn from each other and develop close professional relationships and working teams. VA also offers direct patient care opportunities for residents to learn how to work as a clinical pharmacist in today's health care environment. VA is a health care system that will meet all of your learning needs and support you professionally throughout your VA career. Join the VA team and become a member of our pharmacy experts and award winning teams! Learn more >>

In the Spotlight

Copayment Debts to be Canceled, Refunded

American Recovery Plan will cancel many VA copayments for medical care and prescriptions

If you're a Veteran who receives care through VA, here's what this means for you:

What Is The Copay For Va Prescriptions

  • If you received a patient statement in January 2021 that included copayments for services received on or after April 6, 2020, those charges will be canceled. You should not pay them.

  • If you already paid your copayments for services received on or after April 6, 2020, you will receive a refund.

  • If you have unpaid copayments for services received prior to April 6, 2020, your payment is not required or expected to be paid until October 2021. VA will not pursue collection action on charges during this time. Any Veterans who prefers to continue making payments on their balances for services prior to April 6, 2020 may do so. Find out how to pay your VA copay bill.

Pay My Va Prescription Bill

Veterans receiving a refund do not need to do anything at this time. We ask for your patience as we work to cancel copayments and process refunds.