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Champva As Secondary For Perscriptions


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  • HadIt.com Elder

My wife as Blue Cross as her primary insurance which has RX. She went to the drug store and asked for the pharmacy to bill ChampVA as secondary. ChampVA said "we won't accept electronic claims for secondary drugs bills". Then they said there are some programs in ChampVA that do accept electronic claims. My wife has to pay $15 dollars co-pay on her one script and if we want money back we have to use the manual claim forms and itemized bill etc. What kind of crap is that? What century are they in besides 19th century? Is this just to save money by making it a pain in the ass to ask for $15 bucks. Is Champva blowing smoke at me or does every spouse who has champva as secondary have to send in claim forms by mail to get her money back? What if spouse had 6 drugs and $150 co-pay and was 80 years old? They have to download claim forms and get itemized bills etc and wait a year to get paid? I don't like being cheated out of a dime much less 15 bucks just because the VA has rigged the system to make it hard on people.

John

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That's SOP for ChampVA, 999. My better half sends in a claim form every 6 months along with the itemized statement she gets from the pharmacy. Usually gets a check back in 2 to 3 weeks.

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  • HadIt.com Elder

I am trying to teach my wife that the little dollars add up and not to just blow it off becasue it is 15 bucks and we can afford it for now. I want her to learn the system. On medical she knows how to deal with ChampVA, but the pills......she does not get it. The only reason I can think as to why ChampVA won't accept electronic billing is because they know a good percentage won't bother with the paperwork.

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FWIW, this is the same procedure when TriCare Standard is the secondary payer.

I see neither secondary payer - ChampVA nor TriCare Standard - as "rigged(rigging) the system". This is pretty much like getting funds from an FSA. I don't perceive it as a big issue. As another poster mentioned, you can get a printout from whichever pharmacy(s) and submit a quarterly - or an as occurred or an annual basis - request for reimbursement.

My wife as Blue Cross as her primary insurance which has RX. She went to the drug store and asked for the pharmacy to bill ChampVA as secondary. ChampVA said "we won't accept electronic claims for secondary drugs bills". Then they said there are some programs in ChampVA that do accept electronic claims. My wife has to pay $15 dollars co-pay on her one script and if we want money back we have to use the manual claim forms and itemized bill etc. What kind of crap is that? What century are they in besides 19th century? Is this just to save money by making it a pain in the ass to ask for $15 bucks. Is Champva blowing smoke at me or does every spouse who has champva as secondary have to send in claim forms by mail to get her money back? What if spouse had 6 drugs and $150 co-pay and was 80 years old? They have to download claim forms and get itemized bills etc and wait a year to get paid? I don't like being cheated out of a dime much less 15 bucks just because the VA has rigged the system to make it hard on people.

John

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  • HadIt.com Elder

John - I'd check w/another pharmacy and try, but to my knowledge she needs to pay the co-ins amount and seek reimbursement from ChampVA. My ex has Medicare, ChampVA and Medicaid & needs to submit her prescription copays to ChampVA. They reimburse regularly and quickly. This only happens w/prescriptions, not medical visits. Sorry I can't help more.

pr

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