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]

My wife takes metropolol and champ VA pays us back on her copays like clockwork. If the RO were as efficient as CHamp VA then we would be dancing in the streets.

I think Glenn Johnson needs to be promoted to run the rest of the VA. Thats how impressed I am by him.

Basser

[Pete53]

My wife prefers generic and in the past the cost of brand over generic was usually pretty close. Less that 5 to 10 dollars more. She got a new prescription yesterday and my copay for generic was 15 and for brand 85. I suspect that the VA is trying to ween us off of brand. I bought the generic and so far have not heard a complaint.

Most of my meds are generic that I get from VA.

I am really getting disgusted by the sleazy way insurance handles us.

[GuaymasJim]

Bronco, have you been talking to my little boy behind my back? He has been using (very successfully) your suggested tactics for several years!

[WAC-Vet75]

I have an interesting scenario.... two 100% disabled Vets, married. Can they also be eligible for ChampVA , so that they can see a "civilian" Doctor, to get a second opinion from an opinion by a VA Doctor? Too difficult to get a second opinion from another VA Doctor, as one will NOT go against the other, especially if an error is found.

[broncovet]

Wac Vet..

That is an interesting scenario..dont know the answer, but my first impression would be that they could use their preferred insurance, but not combine them.

If I were eligible for Champva, I would use it instead of the VA. I think the VA has figured that out...and they dont want a mass exodus to to Champva..that is why Vets are told, "Take the VA health care or leave it". If VA health care were truly, like the politicians boast, "world class", there would be no problem with Vets leaving for the private sector, and Vets would not be "forced" to use VA medical care or do without. Government employees are often offered a choice of several health care plans...I wonder why they dont do that with Vets?

[Pete53]

Not only would I take ChampVA I would even endure the co pays and that would mean a substantial amount cause they don't have any of the donut hole provisions.

My wife has ChampVA and Medicare and I cannot think of a better combination. After the 50 dollar deductible there is only a copay of 25% for meds and ChamoVA really does not have a formulary it is for all meds including generic or brand. Also the meds are negotiated so much lower than Medicare.

Good Luck

In an ideal world the VA would put all service connected Veterans on Insurance and pay the co pays