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Does CHAMPVA cover diabetic supplies?


Vync

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  • Content Curator/HadIt.com Elder

One of my dependents is diabetic. Does anyone know if CHAMPVA will cover and/or reimburse for out of pocket diabetic supplies? For example, glucometer, test strips, lances, alcohol pads, etc...

I tried looking on the CHAMPVA site and must have missed it. I'll call them at some point later in the week, too...

Thanks!

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I know for my wife, she pays that supplimental and then the $300 and they reimburse for the rest.  She has not had an issue with any of her medications.

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Great question, please let us know when you find the answer.  

My intuition tells me that it will, but I cant say about "over the counter" supplies.  My wife has Champva and also Anthem medicare advantage plan.  

A local person told us of this health care plan, and we enrolled this year.  

Speaking for my wife (over 65 and on medicare), she gets her cpap supplies via medicare advantage not champva, but we have not bothered to try wiht champva.  

I do know that my medicare advantage "not only" puts $50 per month back on our social security check, "but also" another, shall I call it a gift card, which allows a purchase of $50 per month of OTC supplies, such as bandaids, Aspirin, vitamins, blood pressure cuff, OTC medications, such as Alleve, and a bunch more stuff limited to $50 per month..($150 per quarter).  If you dont use this by the end of the year, you forfeit any balance left on the OTC card, which mostly needs to be used at a special website which I think is called "nations benefits".  

I think our "part B" portion of medicare supplement deducts $140 per month from social security, but, we get 50 of that back so the net is $90 per month.  The card can also be used for dental deductibles and the like.  

I can not speak for other dependents, my only dependent is my spouse..the kids are grown and on their own.  

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  • Content Curator/HadIt.com Elder

Thank you for the information!

Medicare is not involved here, but that info is very good to know. I have been quite busy with work, so I have not had the opportunity to call CHAMPVA yet. Definitely will share what they tell me so others might benefit.

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  • Content Curator/HadIt.com Elder

I spoke with CHAMPVA and they referred me to the OptumRX hotiline 888-546-5502. It's an odd situation which is based on your circumstances.

In my case, my wife and I both work and have separate health insurance through our employers. They said employer medical insurance must go through first payer, second payer, etc... and then we can file a claim for any out of pocket. The items are limited to what is on the CHAMPVA formulary list which explains what they will cover and adhere to their rules and guidelines. I was told when you get CHAMPVA it goes back to the effective date, but you only have a year to apply. Otherwise, the one year to reimburse applies going forward. Everything has to have a doctor's prescription, nothing over the counter can be reimbursed. Just file a claim with CHAMPVA like you would for any prescription reimbursement. I just go to the pharmacy and ask for a printout of what insurance paid and what was leftover as my responsibility. I do this anyway for my wife and kids because their system does not allow a third insurance system to be entered. I make a copy and mail it to CHAMPVA. Currently, they are about two months behind opening their mail. They estimated it could take up to an additional two months to process and issue any reimbursement payment which might be due. Please realize that I do not have Tricare, so that does not apply to my situation.

I don't know how it might work for medicare or other situations. They did tell me that if employer covers prescriptions, I can't use their MedsByMail service. However, they said that in some situations they might make an exception. Of course that program appears to provide only generic meds, nothing brand named.

Best bet is to call the CHAMPVA or OptumRX hotline because the system is so convoluted. I don't know if the info I was told was accurate because some of it seemed to conflict with the web site, but I have seen a lot of that with the VA in the past.

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