If you have Veterans Administration (VA) drug coverage, you can also join a Medicare Part D prescription drug plan (PDP
) or Medicare Advantage plan that includes drug coverage (MAPD
) - and together, these two types of coverage (VA and Part D) might provide you with the broadest and most economical prescription drug coverage.
Question: Can I combine my Medicare Part D drug coverage with my VA drug coverage?
Although you can have both VA and Part D drug coverage - and use either your VA drug benefit or your Medicare Part D plan (depending which coverage is most economical), you cannot
use both your VA benefits together with
your Medicare Part D benefits to pay for the same prescription.
Question: Will my VA drug coverage count toward entering or exiting the Part D Donut Hole?
Your VA drug benefits remain separate from your Medicare Part D benefits and coverage. As noted by Medicare: "Since VA and Part D benefits are separate and distinct, a veteran’s payment of a VA medication copayment does not
count toward his or her gross covered drug costs or TrOOP
expenditures under his or her Part D benefit."
VA coverage is "creditable drug coverage" = No late-enrollment penalty.
If you decide that VA drug coverage meets your prescription needs, you can choose not to join a Medicare drug plan.
VA prescription drug coverage is considered creditable drug coverage
, which means it is at least as good as Medicare drug coverage. If you decide you want to join a Medicare drug plan after you are first eligible, you will not pay
a late enrollment penalty
if you later decide to join a Medicare Part D plan.
You can add Medicare Part D drug coverage to your VA coverage during an enrollment period.
Please remember, after the close of your Initial Enrollment Period
- if you want to join a Medicare drug plan, you must wait for a valid enrollment period (such as the annual Medicare Open Enrollment Period (AEP) that starts October 15 and continues through December 7) - or you may be able to join a Medicare Part D drug plan outside of the AEP if you use a Special Enrollment Period
Again, if you have VA drug coverage and delay enrolling in a Medicare Part D plan, you will not pay a late enrollment penalty since VA drug coverage is considered creditable drug coverage.
If you are entitled to VA health benefits, your coverage will not change when you become eligible for Medicare, but
based on your prescription drug needs, you may choose to have both VA and Medicare drug coverage.
If you are thinking about joining a Medicare drug plan and you have VA benefits, you should consider:
Where you want to fill your prescriptions
As noted by Medicare, in most cases, "VA prescriptions generally must be written by a VA physician" and you must get your drugs from a VA pharmacy in person or through the VA’s "Consolidated Mail Outpatient Pharmacy (CMOP)" operations. And since a VA pharmacy does not fill prescriptions for Part D plans, you will need to use local retail pharmacies or your plan's mail order pharmacy if you join a Medicare drug plan.
For additional information, please contact the VA Health Benefits Service Center at 1-877-222-8387. TTY users should call 1-800-829-4833 or telephone a Medicare representative at 1-800-633-4227.
U.S. Department of Health & Human Services
Medicare Prescription Drug Benefit Manual, Chapter 14 -
Coordination of Benefits, (Rev. 18, 09-17-18)