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.

[WAC-Vet75]

With ChampVA, where private insurance leaves off, even instances of having Medicare affords eligibility, then ChampVa kicks in, so isn't that combing insurances? I called the ChampVA office up, and they don't seem to know the answer either!

There are Veterans who use the VA and have private insurance. They can use VA or civilian medical services, or both, at will. I do know you can not use CITI, and use outside Doctors through ChampVA, that a choice has to be made for only one.

Trying to get health insurance coverage, when you're 100% disabled, is financially prohibitive. To deny a person ChampVA, because they happen to be a 100% disabled Veteran, MARRIED to a 100% disabled Veteran, surely seems like such a couple is being penalized, discriminated against. Will be interesting to find out how they decide this one!!