Copayment for Pharmacy Services

Unless exempt from paying a copayment for medications, veterans receiving medication for a non-service-connected condition must pay a copayment in order to have the prescription filled at a VA pharmacy. There are 3 tiers (or classes) of medication, and the copayment amount is fixed based on the tier of the medication. In the following circumstances, veterans are not charged a medication copayment: (1) the medication is for the treatment of a service-connected condition; (2) the medication is for the treatment of any condition if the veteran has a service- connected disability rated 50 percent or more (including based on unemployability); (3) the veteran is a former POW; or (4) the veteran is considered by the VA to be catastrophically disabled; (5) the veteran’s annual income as determined under VA pension rules does not exceed the maximum annual rate of pension that would be applicable to the veteran; (6) the medication is authorized under 38 U.S.C.S. § 1710(e) for Vietnam-era herbicide-exposed veterans, radiation-exposed veterans, Gulf War veterans, post-Gulf War combat-exposed veterans, or Camp Lejeune veterans; (7) the medication is for treatment of sexual trauma; (8) the veteran is a Medal of Honor recipient; or (9) the veteran is a wartime-era veteran receiving care for a psychosis that developed within a presumptive period, or a Persian Gulf War veteran receiving care for other mental disorders that developed within a presumptive period. Other veterans may also be exempt from the copayment charge under limited circumstances.

If a veteran is receiving a higher level of compensation or pension benefits because he or she is in need of aid and attendance or is permanently housebound, the veteran may have non-VA prescriptions filled by the VA without charge.