MA Only Question - Using the VA for Drugs

[lifeismylife76]

Hello. I have quite a few clients on MA Only Plans with the Give Back, no problems with any of them until now. This one person said the VA told him to get a Part D plan. Can I sell him a Part D plan? Why can't he just get them from the VA like my other clients? Any ideas? Thanks!

 

[vic120]

I have client's with MA only and use VA never had an Issue, For 10 years, I would guess that is misinfo

I also have clients with VA and MAPD< because they get some $0 copays for gen and get Tier 3's though VA no problem for years also

What You cant do is MA and stand-alone PDP unless it is a PFFS or MSA

 

[LostDollar]

Hello. I have quite a few clients on MA Only Plans with the Give Back, no problems with any of them until now. This one person said the VA told him to get a Part D plan. Can I sell him a Part D plan? Why can't he just get them from the VA like my other clients? Any ideas? Thanks!

(caveat, not an agent)

Is it possible he was asking VA for coverage for medications not obtained from a VA facility?

and here is a background article on VA and Medicare that I found:
(just noticed it is NOT a gov site, but the info sounds accurate to me)
https://champva.us/veteran-medicare-supplement/

 

[vic120]

(caveat, not an agent)

Is it possible he was asking VA for coverage for medications not obtained from a VA facility?

and here is a background article on VA and Medicare that I found:
(just noticed it is NOT a gov site, but the info sounds accurate to me)
https://champva.us/veteran-medicare-supplement/

Correct You have to have VA Doc prescribe the med you want VA to cover

You have Outside doc prescribe Med covered by MA plan

Unless you mean something else I did not read article

 

[Up In Smoke]

MA only is a pretty universal solution in most cases. The reason for MA/MAPD for VA clients is that they need to go to a fixed location for their medical needs, and it may not be convenient for them to do so. Since they have Medicare so they might as well get a MA/MAPD for some extras and the ability to see Dr.s and get medicines outside theVA location. There’s Champ-VA out there and they can usually go anywhere. You want to distinguish those people from regular VA as well.

 

[sshafran]

Can I sell him a Part D plan?

If you are asking this, you should go back and study before selling anything else.

Seriously.

And I'm not being too harsh - this is quite basic and you need to learn your stuff before you mess people up.

 

[DonP]

Lol . If you sell him part d then he won’t get $50- $100 part b back more great dental . He doesn’t need part d as he has great rx threw the va . He wants this plan for the above I just said and if he can’t get an appt or doesn’t feel good doing a procedure at the va he can go outside . Gives him some choice and other options than just the Va

 

[Up In Smoke]

Here is the reference. About VA health benefits | Veterans Affairs
Always good to get some extra readings for your profession outside of the required training. The info is actually free 99.9% of the time...AHIP is just that compilation of info that we have to pay for in exchange for the Ready-to-Sale status. If you try to find the pieces separately it will be free and much more comprehensive.

 

[Todd King]

Correct You have to have VA Doc prescribe the med you want VA to cover

You have Outside doc prescribe Med covered by MA plan

Unless you mean something else I did not read article

If you see another doc outside of the VA and they prescribe you medication, you can get the VA to fill it...if it is a handwritten prescription.

 

[Bill_Kiray]

Per the previous poster, you cannot have a stand alone PDP along with an MA-only plan (minus MSA or PFFS). That's a non-starter.

Not sure why the VA would be suggesting to get a stand alone plan. I would agree with Todd that I know of clients who have gotten non-VA doc prescriptions through the VA.