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VA to change cost structure for outpatient medication

The Department of Veterans Affairs (VA) announced in a press release today (Dec. 12) that it is amending its regulation on copayments for Veterans’ outpatient medications for non-service connected conditions.

The VA currently charges non service-connected veterans either $8 or $9 for each 30-day or less supply of outpatient medication.

According to the press release, the VA will be switching to a tiered system on Feb. 27, 2017 that will keep outpatient medication costs low for veterans.

The tiers are as follows:

  • Tier 1: Preferred generics – $5 for a 30-day or less supply
  • Tier 2: Non-preferred generics including over-the-counter medications – $8 for a 30-day or less supply
  • Tier 3: Brand name – $11 for a 30-day or less supply

These changes apply to veterans without a service-connected condition, or veterans with a disability rated less than 50-percent who are receiving outpatient treatment for a non-service connected condition, and whose annual income exceeds the limit set by law.  Copayments stop each calendar year for veterans in Priority Groups 2-8 once a $700 cap is reached. More information on the new tiered medication copayment can be found here. https://www.regulations.gov/document?D=VA-2016-VHA-0003-0001

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