View a list of the top 200 medications available from Meds by Mail If you have been diagnosed with Hepatitis C, cancer, or another costly health condition, please contact Meds by Mail to see if your medication is available.Īdditional information can be found at Meds by Mail The medication is provided with no out-of-pocket cost to you! Meds by Mail also offers certain specialty medications that could save you hundreds or even thousands of dollars. The best part of MbM is that there is NO cost share or copay, and no annual deductible. Meds by Mail offers nonurgent, maintenance prescription medications delivered directly to your home. Each prescription must first be paid by the beneficiary and then reviewed in order to be considered for CWVV pharmacy benefits. If related, the beneficiary will be reimbursed and then will be able to use OptumRX for future refills of that medication. The beneficiary must then submit a claim with medical documentation to show it is related to their disability. The first time a prescription is received, the beneficiary must pay 100% out-of-pocket. Pharmacies that are a part of the OptumRx network will send the claim electronically to VHA Office of Community Care for payment.ĬWVV beneficiaries can only use OputmRx to obtain prescriptions for their rated disability or conditions related to their disability. Spina Bifida and CWVV beneficiaries can use a local pharmacy in the OptumRx network and the Meds by Mail program to obtain their medications without a cost share/copay. Information on filing CHAMPVA claims can be found on CHAMPVA Claims–Information for Beneficiariesįact Sheet 01-05: CHAMPVA Pharmacy Benefits Information for Spina Bifida and CWVV Beneficiaries In this case, you may not have a cost share if the medication is covered by your primary insurance as well as by CHAMPVA. Be sure to tell your pharmacy that you have both primary prescription coverage and CHAMPVA. If you have other health insurance with pharmacy coverage, including Medicare Part D, even though it is primary to CHAMPVA, you are still able to use an OptumRx pharmacy. Pharmacies that are a part of the OptumRx network will collect your 25% cost share/copay along with the annual deductible and send the claim to CHAMPVA for the remaining amount. You can use your local pharmacy in the OptumRx network for other prescription medications. *Refrigerated medications cannot be delivered to a post office box or outside of the continental United States. Prescribed, maintenance medication will be mailed to your home.*
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VA Software Documentation Library (VDL)Įligible CHAMPVA beneficiaries who do not have other health insurance (OHI) with pharmacy coverage are able to use MbM for nonurgent, maintenance medications.Clinical Trainees (Academic Affiliations).War Related Illness & Injury Study Center.Average Administrative Cost for Prescriptions.Durable Medical Equipment/ Pharmacy Requirements.Spina Bifida Health Care Benefits Program.Indian Health Services/Tribal Health Program.Training Courses and Educational Resources.CHAMPVA In-house Treatment Initiative (CITI).