Jump to content

Ads

  • Searches Community Forums, Blog and more

Recommended Posts

http://www.pbm.va.gov/NationalFormulary.aspx

VA Prescription Benefits

Many veterans prefer to have their prescriptions filled at the St. Louis VA Medical Center to take advantage of the pharmacy benefit available to veterans.

The VA Medical Center Pharmacy cannot fill prescriptions written by non-VA physicians.

Patients are eligible for medications only for those conditions for which they are receiving active treatment at the VA Medical Center.

The VA Medical Center will not provide medications that are not listed on the VA Medication Formulary

Share this post


Link to post
Share on other sites

Ad


Bull - it depends on your PCP. Caveat: you would probably need to be at least 70% svc connected in order for this to work. All you need to do is go to your VA doc to see him/her about the same condition you were seen for out here in the real world. Then....produce the prescription that your civilian doc gave you at the END of the appointment - ask, "do you think that this would be a good med to treat [your condition]??". Secret here is to make sure you let your PCP know that you're double checking (getting a 2nd opinion). Make sure that they think you value their opinion. There are exceptions to the VA formulary - they CAN and do order non-formulary meds. Ya' can't get it immediately, but if u come up with a script that there's no suitable formulary substitute (and it's a safe med) you should be able to get somewhere with it in the VA system. Do your research before u go to the VA and print out the RX sheet from a site like medscape dot com. If u suck up and make it appear that your PCP came up with the idea, your chances of getting this accomplished are maximized. A couple of times, my PCP came up with even a better choice for a better drug than the civilian doc wrote for, not on the VA formulary.

Ya' gotta nurture your relationship with your VA PCP. If your PCP is not a good fit, ask for a transfer. As long as you have a good reason for wanting a transfer after the first one, you can get it no matter what the local VA policy is. Also, make it personal - make sure your VA PCP knows about you and your family - pull out pics of your kids, grandkids, etc. Talk about your hobbies, interests, and your life - they're human. I've been with mine for the past 4-years - she ain't perfect, but she'll read/listen to anything I bring in to her and she's made some huge mistakes (I either agree to disagree or let her think it was a good choice, but come up with something better a couple of days after your appointment). Don't complain and don't accuse - just do your homework and present things.

Get a fax machine and use it. They love faxes - write a note to your PCP accompanied with whatever you found on the Internet or a copy of a magazine article, etc. Faxes are read at the end of the day and they are more receptive to those than playing phone tag with you. A fax gives them a chance to deal with you and your problem when they have time to give you their attention - then, your PCP nurse will call you back. Get educated about whatever you're trying to discuss. They aren't able to fax you back, but believe me they prefer dealing with you via a fax rather than a phone call. Keep it short, to the point, and always mention thanks for taking their time to help you. My PCP's patient load has doubled in the past 2 years - but, I assure you they all can recognize me by first name.

AND....get to know your PCP nurse - they have increasingly more freedoms that you could ever imagine. Heck, I've even seen my PCP's receptionist put in blood work for me and she isn't even trained in any sort of medical specialty. Don't create an adversarial situation EVER & don't jump the chain of command - I even send Christmas cards and thank you notes. Make sure they can always put a name with a face.

Chicopee116

100% Svc Connected

Vietnam Era, SP5

Share this post


Link to post
Share on other sites

I completely agree. You must suck up to your doctor. I have alot of medical problems so I introduced all my local docs to the VA docs. Now that they are somewhat accquainted and comfortable with one another, my life is much easier. Since the VA is so busy and my comdtion takes so much time(100% S/C), I think the VA doc prefers that my private doc does most of the work then calls her with his recommedation for meds. Most of the time they just show up in the mail. This has taken a few years to cultivate. And yes I send Christmas cards and treats to all of them and remember to say thank you.

The best advise I received was from a social worker with NORD (National Organization for Rare Disordrers). That my disease was rare and there were going to be mistakes made since there is no clear treatment plan. Go to a large hospital with the resourses to run all the very expensive test and can't cancel my isurance. Then she said to make some friends there with the doctors and staff and loose the attitude about what I thought I was entitled too. Life isn't fair and that it has been proven that patients that are likable get better care and have better surivial rates!!!!

None of my 20 drugs are on the VA formulary

SE 100% S/C Non Langerhans Cell Histiocytosis :lol:

Share this post


Link to post
Share on other sites

I looked up my current and best tolerated pain killer.

They appear to be validating their own lack of desire to prescribe.

http://www.pbm.va.gov/Clinical%20Guidance/Criteria%20For%20Use/Oxycodone%20CR,%20Criteria%20for%20Use%20and%20Treatment%20Algorithm.pdf

I've been trying to use less costly pain killers for many years.

Because I pay the whole price outa my own pocket because the VA will not.

Nobody at the VA has the stones to prescribe anything for pain for more

than one month anyway.

When they do 'give' me a pain killer it's never been oxycodone, always

one of the cheaper ones that my system will not tolerate.

The main reason for not prescribing oxycodone is the cost to the VA.

Except for addicts, I don't know anybody who likes pain 'or the pills'

that give some relief.

Would I be buying most of my medications and all of the

over-the-counter stuff that is prescribed if I did not have to?

NO.

The VA has the best health care!

Compared to Ethiopia or Somalia.

The private sector is using the VA model of delivering health care to

model their own.

That's why private sector health care has gone down the tubes.

Copying something that the VA does to veterans is not something that

I would be proud of.

sledge

Share this post


Link to post
Share on other sites

Get a prescription for oxycontin, demerol or dilaudid from private doctor and see if your VA PCP will fill it. I bet you they will not fill it unless you are dying from cancer. I asked pain doctors at the VA for vicodin and they refused and gave me morphine. Morphine is cheaper than vicodin. They do prescribe generic vicodin. It is cheap and very habit forming as is oxycodone. The shorter acting the drug the more addictive it is.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Ads


  • Advertisemnt


  • Latest News
  • Our picks

    • If you are a Veteran, represented by MOPH, you need to know that MOPH is closing down its offices.  This can have a drastic effect on your claim, and it wont be good for you.  You likely need to get a new representative.  

      This station confirms MOPH is closing its doors:

      http://www.kwtx.com/content/news/Waco--Purple-Heart-veterans-service-center-to-close-its-doors-480422933.html

       
      • 0 replies
    • Retroactive Back Pay.
      Retroactive Back Pay - #1Viewed Post Week of March 19. 2018

      My claim is scheduled to close tomorrow for my backpay.
      Does anyone know if it does close how long till the backpay hits the bank?
      Also does information only get updated on our claims whenever the site is down?
      • 44 replies
    • Examining your service medical records...
      * First thing I do after receiving a service medical record is number each page when I get to the end I go back and add 1 of 100 and so on.

      * Second I then make a copy of my service medical records on a different color paper, yellow or buff something easy to read, but it will distinguish it from the original.

      * I then put my original away and work off the copy.

      * Now if you know the specific date it's fairly easy to find. 

      * If on the other hand you don't know specifically or you had symptoms leading up to it. Well this may take some detective work and so Watson the game is afoot.

      * Let's say it's Irritable Syndrome 

      * I would start page by page from page 1, if the first thing I run across an entry that supports my claim for IBS, I number it #1, I Bracket it in Red, and then on a separate piece of paper I start to compile my medical evidence log. So I would write Page 10 #1 and a brief summary of the evidence, do this has you go through all the your medical records and when you are finished you will have an index and easy way to find your evidence. 

      Study your diagnosis symptoms look them up. Check common medications for your IBS and look for the symptoms noted in your evidence that seem to point to IBS, if your doctor prescribes meds for IBS, but doesn't call it that make those a reference also.
      • 9 replies
    • How to get your questions answered on the forum
      Do not post your question in someone else's thread. If you are reading a topic that sounds similar to your question, start a new topic and post your question. When you add your question to a topic someone else started both your questions get lost in the thread. So best to start your own thread so you can follow your question and the other member can follow theirs.

      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.



      Leading to:

      Post clear questions and then give background info on them.



      Examples:

      A. I was previously denied for apnea – Should I refile a claim?



      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?




      B. I may have PTSD- how can I be sure?


      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?





      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
    • I have a 30% hearing loss and 10% Tinnitus rating since 5/17.  I have Meniere's Syndrome which was diagnosed by a VA facility in 2010 yet I never thought to include this in my quest for a rating.  Meniere's is very debilitating for me, but I have not made any noise about it because I could lose my license to drive.  I am thinking of applying for additional compensation as I am unable to work at any meaningful employment as I cannot communicate effectively because of my hearing and comprehension difficulties.  I don't know whether to file for a TDUI, or just ask for additional compensation.  My county Veterans service contact who helped me get my current rating has been totally useless on this when I asked her for help.  Does anyone know which forms I should use?  There are so many different directions to proceed on this that I am confused.  Any help would be appreciated.  Vietnam Vet 64-67. 

Ads



How to get your questions answered.

All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

Tips on posting on the forums.

  1. Post a clear title like ‘Need help preparing PTSD claim’ ...
  2. Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title ... 
  3. Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help ...
Continue Reading


  • Advertisemnt

  • latest-posts-activity.pngstart-new-topic.pngsearch.png

  • Advertisemnt

  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×

Important Information

{terms] and Guidelines