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Question: How will my VA health benefits work with my Medicare prescription drug coverage?

Answer:

If you get VA health benefits, your coverage will not change. If you decide that VA drug coverage meets your needs, you can choose not to join a Medicare drug plan. You can keep your current coverage.

It will almost always be to your advantage to keep your current coverage without making any changes. An exception is if you qualify for Medicare's extra help. You may benefit by applying for the extra help.

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 won't have to pay a late enrollment penalty if you join within 63 days of involuntarily losing your VA coverage. If you don't lose your coverage and you want to join a Medicare drug plan, you must wait for a valid enrollment period. You will not have to pay a late enrollment penalty.

If you have VA coverage and you choose to disenroll from your Medicare drug plan, you get a special enrollment period to do so.

You should contact your local VA facility before making any changes to your drug coverage.

ADDITIONAL INFORMATION
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:
    In most cases, with VA drug coverage, you must get your drugs from a VA pharmacy in person or by mail. If you'd rather get your prescriptions from local retail pharmacies, you may want to consider 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.

(Source: U.S. Department of Health & Human Services)



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