Yes. 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?
No. 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?
No. 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."
Important: You can add Medicare Part D drug coverage to your VA drug coverage during an enrollment period.
You can join a Medicare Part D plan or a Medicare Advantage plan during your
Initial Enrollment Period (IEP) when you first become eligible for Medicare. After the close of your
Initial Enrollment Period
- and you decide 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.
Additional considerations:
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 may affect your decision to add Medicare drug coverage to your benefits.
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.
Sources include:
U.S. Department of Health & Human Services
Medicare Prescription Drug Benefit Manual, Chapter 14 -
Coordination of Benefits