Champva Recipienets

[Berta]

About 2 years ago my pharmacist told me CHAMPVA would not pay for a DAW prescription for Toprol XL and I had to get the generic.(metoprolol)

I have suffered from side affects ever since and they got worse when my doctor recently upped my dosage a little.After doing hours of research on the generic metoprolol I demanded the pharmacy give me the real Toprol.They charged me 66 bucks and said CHAMPVA will not pay for it.

Then I called my doctor to find that the prescription was DAW all of this time and NY state law prohibits changes to a DAW prescription.

I am considering how I will handle that part of my problem.

But my point here is this- I called CHAMPVA and they are always as helpful as they can be and they referred me directly to the SXC Health Solutions department which has the formulary as to what CHAMPVA will and wont pay for.

SXC called my pharmacist right away.

Long story- The Pharmacy has my refund waiting-My cost has been reduced to the regular co pay- for the med (Toprol)I should have been given all along.

I am really ticked off by this because how many CHAMPVAers are given generic when the real med will not cost them that much more.

The SXC number is 1-888-546-5502 and they can tell you right away if your prescription is on their formulary list. Most brand names are.

I am angry at myself knowing prescribed meds were part of my wrongful death FTCA award regarding my husband.

I should have questioned the pharmicist 2 years ago but I bought what he was selling:

He said

CHAMPVA wont pay -WRONG and

the generic is the same -REALLY WRONG!

I guess all of us have to be very proactive in any medical issues as well as our claims.

I have had serious side affects from the metoprolol and reported them to my doctor and am writing complaint to the FDA.

My doctor thought I was getting Toprol as prescribed but I wasnt.

The pharmacist didn't realize that CHAMPVA is not like the other forms of Insurance so we CHAMPVAs have to make sure they know the benefits we get and dont try to pull this on anyone else.

[jbasser]

Thank you Berta. Great topic.

J

[bobbyq]

Question: Is it true that CHAMPVA is discontinued when the spouse achieves 65 years of age and has to go on MEDICARE? CHAMPVA is better than nothing and that is about it............they do not have dental, vision, etc. Here in AZ CHAMPVA folks can be seen in TUCSON but not in Phoenix, quite a drive for some of us, though they do have a NP at an outlet clinic. Enough said.

[jbasser]

It is my understanding that at 65, Champ VA becomes secondary to Medicare.

In order to clarify this, you need to listen to any archive with Glenn Johnson SVR broadcast.

J

[Berta]

Jim Strickland asked me to do an article for the Pharmacy section of VAWatchdogToday.com on this.

Will let you all know when it appears there.

I have some more research to do and am awaiting more feedback from TOPS markets as to the fact they lied to me about my CHAMPVA benefit.

I thought they knew the CHAMPVA criteria better then I did since they are a pharmacy who accepts CHAMPVA.

I was wrong and never questioned what they said until yesterday.

As I said

"I am really ticked off by this because how many CHAMPVAers are given generic when the real med will not cost them that much more."

I am sick and tired of dealing with a system that craps on our rights (VA) and am completely unwilling to allow anyone else to do it.

[Stretch]

Berta,

The Hadit/SVR show that Jerrel did on 2-23-2011, with Glenn Johnson, did have some great information. Glenn Johnson even remarked that ChampVA was going to try and get Dental this year for ChampVA recipients.

http://svr-radio.com/archives.html

[Bonzai]

My curiosity finally got the better of me and I had to look up DAW - "Dispense As Written"

I hope this helps anyone else with the same question.