VA Medical Drugs vs Medicare Part D

[bks]

I checked with VA and two options are going to VA hospital pharmacy which is a bit of drive or mail order which can take 5-8 days for delivery.

With the inconvenience and time delay I am debating if maybe better pay Part D premium thru a Medicare Advantage plan which drugs can be picked up at a local pharmacy.

What are veterans experiences with this situation ?

Thanks

 

[mickeyd]

If VA meds are free, and they often are, why fool around with Part D? If you have to pay for them, then it depends...

 

[Brat]

Also check prices at Costco. You don't need to be a member to use their pharmacy.

 

[Senator]

I get VA meds for $8 a month, per prescription. If the medication is cheaper at Walmart, I get them there.

It's nice to have the Dr. at the VA just input the prescription, and it arrives. There are items that the VA doesn't offer, so maybe a Part D premium may be worth it.

 

[rodi]

If it were me (but it's not) I'd get the part D and do price comparison. Most part D's aren't expensive. FIL had VA benefits (purple heart WWII) and the VA handled his care. He also had spousal coverage for federal retiree insurance... Between the two he paid zero for prescriptions and pretty much everything - because the VA would bill the retiree insurance plan - then cover any balance that was left.

 

[aja8888]

If it were me (but it's not) I'd get the part D and do price comparison. Most part D's aren't expensive. FIL had VA benefits (purple heart WWII) and the VA handled his care. He also had spousal coverage for federal retiree insurance... Between the two he paid zero for prescriptions and pretty much everything - because the VA would bill the retiree insurance plan - then cover any balance that was left.

(my bold)....no, most drugs under Part D are not "too expensive", until you have a serious illness. Or you hit the donut hole, like my DW is in right now. Or both happens.

Yesterday we paid $420+ for one 6 month injection (not the actual injection, just the drug) of Prolia. Today, I picked up her monthly COPD treatment drugs (2), Brio and Spiriva (sp?). The two today with the Part D 30% donut hole discount came to $286. So we dropped $706 for Part D drugs. I estimate our OOP for her drugs this year will be ~$7,000 after Part D plan discounts. Add about $360/yr for plan premiums too. And yes, we SHOP the plan annually.

My DW is an exception since she is pretty ill with some uncurable problems. Unfortunately, she never served in the military.

 

[RetiredGypsy]

I checked with VA and two options are going to VA hospital pharmacy which is a bit of drive or mail order which can take 5-8 days for delivery.

With the inconvenience and time delay I am debating if maybe better pay Part D premium thru a Medicare Advantage plan which drugs can be picked up at a local pharmacy.

What are veterans experiences with this situation ?

Thanks

It'd be a pain maybe for the initial wait of 5-8 days, but after that you just call a couple weeks in advance and they'll mail out refills before the current fill is out. I do that all the time.

Alternatively, you can sign up for the VA online portal and check your prescriptions for refills whenever, and they automatically get sent out before the current fill runs out.

 

[bks]

It'd be a pain maybe for the initial wait of 5-8 days, but after that you just call a couple weeks in advance and they'll mail out refills before the current fill is out. I do that all the time.

Alternatively, you can sign up for the VA online portal and check your prescriptions for refills whenever, and they automatically get sent out before the current fill runs out.

My concern is some meds that need to be taken same day after diagnosis using Private care and the referral to VA doctor.
I understand it would not much of a issue for longer term needs for refills.

I am in Priority group 5 now, but will probably shift to group 8 in a year.

 

[Brat]

It was Dateline, I think, that demonstrated that many meds are available cheaper at a pharmacy if you don't use insurance. Antibiotics are likely in that group. Talk to the pharmacist you would use.

 

[badatmath]

I have no idea how discount programs compare to what you have, but I have to buy human medicine for a pet and used lowestmed website to check prices, printed a coupon and filled it nearby with no issues. I know there are other sites similar to this, perhaps even better. Not sure it would be of benefit to you considering your other options but quick to check and wanted to mention in case it helps anyone. There was a substantial price difference among the pharmacies.

 

[RetiredGypsy]

My concern is some meds that need to be taken same day after diagnosis using Private care and the referral to VA doctor.
I understand it would not much of a issue for longer term needs for refills.

I am in Priority group 5 now, but will probably shift to group 8 in a year.

There's also a program to take scripts you have from out in town directly to the pharmacy and have them filled at the VA same day if they have the medication in stock. I've done this a few times, though I don't know if every Priority group can do this.

 

[audreyh1]

It was Dateline, I think, that demonstrated that many meds are available cheaper at a pharmacy if you don't use insurance. Antibiotics are likely in that group. Talk to the pharmacist you would use.

Yeah - I have wondered about this.

Antibiotics are very cheap. My last Cipro was $4.

 

[rodi]

(my bold)....no, most drugs under Part D are not "too expensive", until you have a serious illness. Or you hit the donut hole, like my DW is in right now. Or both happens.

Yesterday we paid $420+ for one 6 month injection (not the actual injection, just the drug) of Prolia. Today, I picked up her monthly COPD treatment drugs (2), Brio and Spiriva (sp?). The two today with the Part D 30% donut hole discount came to $286. So we dropped $706 for Part D drugs. I estimate our OOP for her drugs this year will be ~$7,000 after Part D plan discounts. Add about $360/yr for plan premiums too. And yes, we SHOP the plan annually.

My DW is an exception since she is pretty ill with some uncurable problems. Unfortunately, she never served in the military.

Yeah... I didn't consider the donut hole. I was talking about premium costs.

I remember when Part D came along. All my older relatives (parents, extended family) were griping. Many wear on a medicare advantage plans with Kaiser Permanente - which had no donut hole... just $10/script. And Part D comes along and the donut hole gets introduced. Boy was my dad grumbling about that.

 

[audreyh1]

Yeah... I didn't consider the donut hole. I was talking about premium costs.

I remember when Part D came along. All my older relatives (parents, extended family) were griping. Many wear on a medicare advantage plans with Kaiser Permanente - which had no donut hole... just $10/script. And Part D comes along and the donut hole gets introduced. Boy was my dad grumbling about that.

If they were on Medicare Advantage then they didn't need a Part D. Right?

 

[Brat]

Correct.

 

[bks]

If you have an Advantage plan without Part D without some maintained creditable drug coverage such as VA or work insurance you will be penalized an extra fee per month on months no Part D was enrolled in.
This is fee is addition to the monthly Part D amount and remains for the life of policy holder.

 

[Brat]

FEHB health insurance provides benefits equal to parts B and D. When I suspended participation to signup for Kaiser's Advantage plan I just needed to provide proof that I had FEHB coverage.