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If I have VA drug benefits can I also add Medicare Part D prescription drug coverage?


Yes.  If you have Veterans Administration (VA) drug coverage, you can also join a Medicare Part D prescription drug plan or Medicare Advantage plan that includes drug coverage (MAPD) - and together, these two types of coverage might provide you with the broadest and most economical prescription drug coverage.

However, if you join a Medicare Part D plan and have VA drug coverage, the two benefits remain separate.

Although you can have both VA and Part D drug coverage, you will not be able to use your VA benefits together with your Medicare Part D benefits to pay for the same prescription.  In addition, 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 that 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 that starts October 15 and continues through December 7).  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 Information:

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 live
    You may benefit from Medicare drug coverage if you are in a nursing home that does not let you use your current VA drug benefits. You may also want Medicare drug coverage if you live far from a VA facility.
  • Where you want to fill your prescriptions
    As noted by Medicaer, 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:
U.S. Department of Health & Human Services
Medicare Prescription Drug Benefit Manual, Chapter 14 - Coordination of Benefits, (Rev. 18, 09-17-18)







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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.