Woodford County of Illinois
Frequently Asked Questions about VA

How do I get prescriptions filled at the Veterans Affairs Pharmacy?
1.  You must enroll or be enrolled at a VA Medical Center.  Peoria, IL, is the closed one.
2.  You must have a VA Doctor write you the prescription.

How do I get enrolled into the VA Medical Center?
1.  You need a copy of your DD214 or equivalent.
2.  Will need your last year's household income.
3.  Will need your spouse and dependent's Social Security numbers, birth dates, and date of marriage.
4.  Will need last year's non-reimbursed medical expenses for the whole family.
5.  What you had to pay for a funeral of your spouse or dependent child, if applicable.
6.  If you the veteran went to school last year, need the amount you paid out of pocket that
    was not reimbursed to you.
7.  Will need to know how much money you have in checking and savings accounts, CD's,
    Retirement IRA's, stocks, bonds, etc.
8.  Need market value of land and buildings minus mortgages and liens, including value of
    farms, second homes, business assets, etc.  Do not count your primary home.

How do I get my prescriptions refilled?
1.  You sign the slip that is included with your bottle and mail it back to the VA.
2.  Or, you can call 1-800-228-5459, and follow the instructions.

Will my prescriptions cost me any money?
1.  Yes, the Department of Veterans Affairs (VA) charges a co-payment for each 30-day or
    less supply of medication provided on an outpatient basis for the treatment of a non-
    service connected condition.  The co-payment as of now is set at $8.00.
2.  At times the VA issues a 90-day supply of medications and this will cost $24.00 if you
    pay a co-payment.

Why does VA require a medication co-payment?
1>  By law (PL101-508 and PL106-117), VA must charge veterans a co-payment for their
     outpatient medications.  The Veterans Millennium Health Care and Benefits Act
     (PL106-117) authorized VA to increase the co-payment amount and to establish an
     annual cap on the amount of medication co-payments charged.

Who decides if a medication is for treatment of a non-service connected condition?
1.  The VA doctor makes this determination.
2.  If the medication prescribed is for treatment of a service connected condition, no co-
    payment is required.

Will the amount of the co-payment and the annual cap ever change?
1.  Yes, the amount of the medication co-payment and the annual cap may change on an
    annual basis.
2.  For the specific current annual amounts, contact the VA Revenue Coordinator at the
    St. Louis VA health care facility at 1-800-228-5469, then dial "0" and ask for the
    revenue coordinator's office.

Can I get prescriptions obtained from my private health care provider filled at the VA pharmacy?
1.  To qualify for pharmacy benefits, you must be enrolled in and receiving health care
    from the VA health care system.  A VA health care provider will review any prescriptions
    from a private health care provider to determine if they can be rewritten by a VA health
    care provider and dispensed from a VA pharmacy.

What is covered by the medication co-payment?
1.  The medication co-payment applies to medications and over the counter medications
    (aspirin, cough syrup, etc.) that are dispensed from VA pharmacy.  You are not charge a
    co-payment for medical supplies (syringes, alcohol wipes, etc.).

Are there any exemptions from the medication co-payment?
1.  Service connected veterans rated greater than 50 percent are exempt.
2.  Medications dispensed for service connected conditions are exempt.
3.  Veterans with low income (by law, a veteran whose annual income is determined to be
    lower than the VA pension level).

What is the outpatient co-payment?
1.  The Department of Veterans Affairs (VA) is required by law (PL99-272) to charge
    veterans, in certain income categories, a co-payment for their outpatient visits.  The
    Veterans Millennium Health Care and Benefits Act (PL106-117) authorized VA to
    decrease the outpatient co-payment amount provided for some services.  As a result,
    VA has made changes and has implemented a three-tiered outpatient co-payment

What is a three-tier co-payment?
1.  The co-payment will be based on primary care visits ($15.00), specialty care visits ($50),
    and no co-payment designations.
2.  A primary care outpatient visit ($15.00) is an episode of care furnished in a primary care
    clinic that provides health care services.  Veterans do not need a referral to access the
    primary care clinician.
3.  A specialty care outpatient visit ($50.00) is an episode of care furnished in a clinic that
    does not provide primary care, and is only provided through a referral.  Some examples
    of specialty care clinic are surgical consultative services, audiology, optometry, MRI and
    CAT scans, cardiology, nuclear medicine studies and ambulatory surgery.
4.  Service for which there will be no co-payments are publicly announced VA public health
     initiatives (for example:  a health fair).  An outpatient visit solely consisting of preventa-
     tive screening and immunizations (example:  influenza immunization, pneumonococcal
     immunization, hypertension screening, hepatitis C screening, tobacco screening,
     alcohol screening, hyperlipidemia screening, breast cancer screening, cervical cancer
     screening, education about the risks & benefits of prostrate cancer screening or others.

Are all veterans charged an outpatient co-payment?
1.  Service connected veterans are exempt from outpatient co-payment charges.  Most non-
    service connected veterans and non-compensatory -0- percent service connected
    veterans are required to complete an annual means test.  The means test is a measure
    of your family's income and assets.  Means test threshold levels change on an annual
    basis.  If your income and assets fall below the threshold, you will not be charged co-
    payments for outpatient care.

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