How Do I Get The VA To Pay For Prescriptions?

Usually, the VA pays a VA pharmacy or an eligible in-network community pharmacy directly. If you paid for a prescription yourself, reimbursement is limited to specific circumstances—most notably an eligible emergency prescription from an out-of-network pharmacy. VA reimbursement is not a general promise to repay every non-VA pharmacy purchase.^[1]

When can the VA reimburse a prescription?

In most cases, VA pays non-VA providers and pharmacies directly for eligible community care. You may file a reimbursement claim if you paid for an emergency prescription at a pharmacy that isn’t in VA’s network. You can’t use this process to seek reimbursement for copays or deductible payments.^[1]

Use the current VA Form 10-320, Veteran Reimbursement Claim Form. For a prescription claim, VA says to include a valid receipt showing the amount paid, pharmacy name and address, prescribing provider, fill date, medicine name, amount, and dosage. VA reviews the claim under its current eligibility and coverage rules; check the official instructions before filing.^[1]

What happens at an urgent-care or community pharmacy?

If you’re eligible for community care, an urgent-care prescription may be filled at an in-network community pharmacy. The pharmacy must generally be in the same state as the urgent-care visit, the medicine must meet VA’s urgent/emergent formulary rules, and VA pays for up to a 14-day supply. Opioids may be limited to 7 days or the state limit, whichever is less. A regular non-urgent prescription, or a supply longer than 14 days, generally must be filled through VA.^[2]

VA must authorize community care before a Veteran receives most non-emergency care from a community provider. Emergency care has its own requirements, including use of an emergency department and notification to VA within 72 hours.^[6][7]

Does Walgreens cover VA prescriptions?

VA announced a Walgreens care-coordination and health-information exchange on August 17, 2018, for VA-enrolled patients who obtained prescriptions or immunizations at Walgreens. The announcement described providers’ access to medication and immunization history; it did not mean every Walgreens prescription is automatically covered or paid by VA.^[8]

Current payment depends on the prescription, your eligibility, network status, formulary, and applicable VA instructions. Confirm the current rules with VA before filling or paying at a community pharmacy.^[8][2]

How much do VA prescriptions cost?

Some Veterans pay no medication copay, while others may pay for medicines treating non-service-connected conditions or for over-the-counter medicines obtained from a VA pharmacy. Priority group, service-connected rating, income, medication tier, and days of supply can affect the amount. Priority group 1 Veterans generally don’t pay medication copays.^[3][4]

The current VA copay page says applicable medication copays stop after $700 in a calendar year. This is a cap on applicable VA medication copays—not a promise to reimburse retail-pharmacy charges. Rates, exemptions, priority-group status, and coverage rules can change, so check the current VA copay page for the applicable year.^[3]

What did the VA’s drug-price comparison show?

The Government Accountability Office’s GAO-21-111 report compared selected drugs using 2017 data. In its sample of 399 drugs, VA paid an average 54% less per unit than Medicare Part D after applicable rebates and concessions. VA prices were 68% lower on average for the 203 generic drugs and 49% lower for the 196 brand-name drugs.^[9]

Those are historical sample results, not a prediction of the price, formulary coverage, or patient cost of a particular medicine today. VA and Medicare Part D also use different purchasing and coverage systems.^[9]

How does VA prescription coverage relate to Medicare Part D?

VA prescription coverage is generally treated as creditable coverage for Medicare Part D. Verify your current status, keep the annual notice or other records, and understand that going 63 days or more without Part D or other creditable coverage can lead to a Part D late-enrollment penalty. Compare formularies, pharmacies, premiums, and out-of-pocket costs before changing coverage.^[5]

You generally can’t use VA and Part D to pay for the same prescription. Part D may be useful for prescriptions from non-VA doctors or local pharmacies, but the plan’s network and drug rules apply. For help sorting out VA and Medicare choices, see our VA health care and Medicare guide and Veterans Medicare FAQ.^[5][10]

How do I refill a VA prescription?

Use the current VA prescription-management instructions in My HealtheVet on VA.gov or contact the VA pharmacy that manages your care. Eligible users can refill and track VA prescriptions online. Do not rely on this article for older mailing, original-prescription, or Social Security-number instructions; requirements and accepted submission methods may change. Confirm exactly what information VA currently requests before sending health or identity information.^[11]

1. Identify the pharmacy situation Separate a VA pharmacy, an eligible in-network urgent-care pharmacy, an emergency out-of-network purchase, and a routine retail prescription. The payment rules differ.^[2][1]
2. Ask before you pay Confirm the network, formulary, authorization, supply limit, and whether VA will pay directly. If you use an out-of-network pharmacy, you may owe the full cost.^[2]
3. Keep complete documentation For a potentially eligible reimbursement claim, keep the receipt and the prescription details VA lists, then use the current Form 10-320 instructions.^[1]
4. Review Medicare coordination If you also have Part D, verify creditable coverage and compare the drug plan before changing how you fill prescriptions.^[5]

If you want help understanding Medicare options alongside VA health care, you can book a call with Veterans Advantage Financial®. We are an independent insurance agency, not part of or endorsed by VA, Medicare, CMS, Social Security, TRICARE, or any government agency. There’s no cost to you for our help. If you enroll, we’re paid by the insurance company.

This is general education, not personal advice, and it isn’t a recommendation of any specific plan. Veterans Advantage Financial® is a licensed insurance agency, not affiliated with or endorsed by Medicare, Social Security, VA, TRICARE or any government agency. Plan availability, costs and benefits vary by plan, county and year. Check your own situation with the agency or plan before making changes.

About the author

Christopher Duncan

Certified Medicare Insurance Planner™ · Retirement Income Certified Professional®

Christopher founded Veterans Advantage Financial® and has helped people with Medicare since 2006. He is a licensed insurance agent in all 50 states and DC (NPN 8613503). His dad, Wallace, is a Vietnam-era veteran.

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