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Tue Feb 5, 2013, 06:00 PM

Anybody here know why my CHAMPVA co-pay went up?

Or where I could look online to find out? What I paid for my prescriptions was double in January and February from what it has been. The pharmacy checked my records and said that my co-pay went up. WTH? I'm a spouse of a disabled vet, BTW, not a vet myself. If there are changes this year, I haven't gotten anything in the mail about it. (Of course, that's nothing unusual.)

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Reply Anybody here know why my CHAMPVA co-pay went up? (Original post)
Silver Gaia Feb 2013 OP
nadinbrzezinski Feb 2013 #1
Silver Gaia Feb 2013 #2
Silver Gaia Feb 2013 #3
pinboy3niner Feb 2013 #4
Silver Gaia Feb 2013 #5

Response to Silver Gaia (Original post)

Tue Feb 5, 2013, 08:45 PM

1. Tricare announced the change and increase in copays.

Champus was replaced by tricare.

Here, one source.

https://tricare.martinspoint.org/about-martins-point/news/2012/tricare-rx-copay-increases-feb-1-2013

Per usual, no copays if you go to military pharmacy. I am considering that.

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Response to nadinbrzezinski (Reply #1)

Wed Feb 6, 2013, 05:59 AM

2. That's good info, but what I have is called CHAMPVA. It is not the same as CHAMPUS.

I am the spouse of a 100% disabled veteran, and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) is the program for spouses and children of these veterans. So I am not a Tricare patient. So far as I am aware, I don't have the option of going to the military pharmacy at the VA Hospital where my husband gets his treatment and his meds. Mine works like insurance. I go to my regular doctor and the VA pays for part of it, like insurance does. Same with the pharmacy.

ETA: I may be eligible to participate in the Meds by Mail program, according the the CHAMPVA info at the VA website, but I have never tried that before. My husband uses it, but I have not tried--partly because I guess I just figured that as long as they are cheap enough for me to afford at the pharmacy, I am not using funds from the VA that, in my mind, should go to someone more deserving, meaning a disabled vet.

I'm just trying to figure out why my co-pay went up this year, and am wondering if my other co-pays went up as well (like for a doctor visit), and I can't seem to find any info about it.

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Response to Silver Gaia (Original post)

Wed Feb 6, 2013, 06:30 AM

3. I can find NOTHING about co-pays going up on CHAMPVA anywhere on the net.

Not at the VA website, not at forums where vets post... nothing at all. I'm beginning to wonder if the clerk at the pharmacy just didn't know what she was talking about. Maybe the cost of the medication itself went up, which would make my cost higher. Or maybe they just screwed something up. I think I'm gonna go back and talk to the pharmacist himself about this. It isn't making any sense!

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Response to Silver Gaia (Original post)

Thu Feb 7, 2013, 09:02 AM

4. Could your cost be affected by unmet deductible?

Pharmacy Deductible and CAT Cap

When you buy your medicine at a participating pharmacy (that is, one that accepts CHAMPVA assignment) and you have no other health insurance with pharmacy benefits, you pay at a reduced rate as allowed by the VA. But you must also meet any unsatisfied deductible. The annual outpatient deductible is $50 per person and $100 per family under CHAMPVA.

Once you have met the deductible, the VA will share in your costs at the reduced rate. It will pay 75% of the allowable and you pay 25%.

...


http://champvabenefits.com/pharmacy-deductible-catastrophic-cap/



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Response to pinboy3niner (Reply #4)

Fri Feb 8, 2013, 07:34 AM

5. That's what I thought at first.

I usually pay more in January, which takes care of the $50 deductible, so I didn't question it when I had to pay more last month. But it was exactly the same again this month. Maybe the cost of the meds actually went down, though, so the full deductible was not met in January? I have not had time to go in and speak with the pharmacist, but will ask him about this. It's possible. This makes more sense to me than what the clerk said about my co-pay going up. I think she didn't know and was just guessing.

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