SNPs and VAs getting rx through VA?

Feb 22, 2008

  1. honestagent
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    honestagent Guru

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    Has anyone written VAs and SNPs?

    If so, I am wondering if you can please help with this question.

    If you enroll a VA in a SNP plan, (prospect is full medi medi) can the prospect still go to the VA and get his/her meds with no disruption from plan? The plan is HMO.

    So, in other words, if they want to go to VA to get meds, they can and no interference just as they were getting before I came into they're life. If VA is too far or they don't like the VA, they have an alternative to use but they keep the best of both worlds.

    Thanks in advance.
     
  2. allhealthandlife
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    allhealthandlife Guest

    yes but VA won't fill civilian doctor prescription. I stress the convenience of being able to use the pdp at their local pharmacy for things they may need unexpectedly like antibiotics or Viagra for when the time is right. ( if they have an erection that last for more than four hours then they can use the MA plan to go to their neighborhood primary doctor instead of having to drive to the regional VA clinic with a throbbing woody )
     
  3. GreenSky
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    You couldn't have come up (no pun intented) with a different example?

    Maybe, if they have 101 degree fever and they don't want to drive to the regional VA....etc.

    Rick
     
    GreenSky, Feb 22, 2008
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  4. arnguy
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    arnguy Guru

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    If the veteran is in the VA Medical Program, the VA will fill an Rx written by his civilian doctor. However, the prescription must be forwarded to the VA facility where he is registered and to the attention of his VA doctor or VA Nurse Practitioner and must be approved by them before it will be filled by the VA Mail order program. It is a great plan for maintenance drugs, but if he needs a one-time fill of a drug, it is best to go through a private pharmacy to save time.
     
    arnguy, Feb 22, 2008
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  5. michellea
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    michellea Super Genius

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    I stress that they can use local pharmacies for unexpected needs also, but I have never mentioned the viagra problem, ha. So to answer the original post, yes MAPDs and SNPs work together with an individual who has VA benefits.
     
  6. honestagent
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    Everyone, thanks for the grand responses!!!

    Arnguy, here's what I don't understand and perhaps you can ellaborate please? There are VAs out there who have VA benefits but do not have VA Medical Program benefits? If so, then what VA non Medical Program Benefits do they have or what does that entail?

    Also, I know it's important to ask the customer if they get mail order now through VA, and if the customer does, explain what you stated above if he/she wants to continue the mail order through the VA? If he or she does not get mail order, then what? The customer has a choice whether to go down to VA clinic and pick up directly through VA (showing no MApdp card just VA card)? or, the customer (assuming lives too far from VA or doesn't want to go to VA clinic to get drugs) goes to local CVS or whatever pharmacy chain nearby home and shows MApdp card and get drugs that way?

    Thank you so much in advance!
     
  7. arnguy
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    Honestagent. To get the best information I refer you to the websites: myhealth.gov.va and also to va.gov/Health benefits/. A vteran must register specifically for the Pharmacy Benefits Program. If I recall correctly, there are eight levels of coverage depending on service or non-service related illnesses. Also, it is dependent on the percentage of service related disability, POW status, etc. You can find the details on the websites cited.

    The prescription drugs are sent to the veteran through a mail order program. In my case, I secure a prescription from my private physician and fax it to my VA Nurse Practicioner. She then inputs into the VA pharmacy system. I am required to have an exam every 6 months with my VA-NP at which time she also reviews my drugs as well as my overall health. If a particular drug prescribed by my personal physician is not on the VA formulary, they will dispense a substitute drug. I must also submit a lab report (blood work) every six months to the VA. The VA also has a tier system for dispensing drugs, which means that certain criteria (health conditions) must be met to qualify for a particular drug.

    There is a Pharmacy at the VA Medical Center in Philadelphia. The only time I have used that is when I was running out of a medicine and needed a small refill intil the mail order arrived from the VA Center in Carol Stream, IL. However, I have seen vets getting their meds there and I assume they have just received prescriptions from a visit to their VA doctors. Mail order refills are usually on a 90 day basis with a few exceptions.

    The VA issues an ID card which must be used to access VA Medical Center. There is magazine published by the "VA Stars and Stripes Health Network." BTW, I know some guys who use the VA medical system exclusively----no private physicians.

    I hope that this helps. If you need any more infor, please PM me.
     
    Last edited: Feb 25, 2008
    arnguy, Feb 24, 2008
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  8. honestagent
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    honestagent Guru

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    Well I have some more digging to do that's for sure and Arnguy I genuinely appreciate your extensive reply.

    You have provided much and thank you; I will PM you if I have further questions. I appreciate it very much! :)
     
  9. honestagent
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    Well I have some more digging to do that's for sure and Arnguy I genuinely appreciate your extensive reply.

    You have provided much and thank you; I will PM you if I have further questions. I appreciate it very much! :)
     
  10. arnguy
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    BTW, the VA Health System is open to all veterans who meet certain criteria, not just combat veterans. Generally, the criteria are: an Honorable Discharge, General Discharge, or Discharge under Honorable Conditionsand are (a) Former enlisted personnel who started active duty before September 8, 1980, (b) Former officer who first entered active duty before October 17, 1981, or (c) Is a veteran who has 24 months of continuous active duty military service. In addition there is a list of about exceptions for eligibility that is too long to list here, but is available on the VA website

    I met one guy who had only 8 months of active duty but was eligible because his service was prior to 09/08/1980..
     
    arnguy, Feb 25, 2008
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