VA co-pay for prescription drugs

My wife and I take the same blood pressure medicine, Diltiazem. For a 90-day supply, hers with our insurance cost $4.14 at a retail pharmacy. In comparison, mine cost $24 (co-pay) at the VA pharmacy. I questioned billing. She insisted I had to pay the co-pay. She then said I could ask my doctor to write out my prescription and take it to a retail pharmacy. I did, and four prescriptions cost me $8.35 for a 90-day supply. VA had been charging me $69 for these same four prescriptions. I asked my insurance (Blue Cross) and also VA Billing to send me a statement of cost. For the year 2017 VA stated I had paid $276.25. My insurance stated my cost should have only been $22.99.

VA has Consolidated Patient Account Centers (CPACs). CPAC bills our insurance and bills us the co-pay. On the back of VA Billing Form 10-0246 it states, your insurance may "REDUCE OR ELIMINATE YOUR COPAYMENT."

I asked CPAC for an audit. After much delay, I was forced to ask West Virginia Sen. Joe Manchin to get me the audit. It went back to 1992. I have gotten refunds totaling over $1,000.

This is to alert other veterans with insurance, to check and see if you are being overcharged and due a refund.

John Jarrett Peters
Huntington, W.Va.

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