Veteran’s Administration Drug Claims

If you are a Veteran’s Administration beneficiary, your prescription drugs can be purchased at the VA. Because the VA will submit your claims to Express Scripts for you, please follow these pointers:

1. Be sure to provide your Express Scripts pharmacy card to your VA office. When you get a prescription drug filled, the VA will bill the NEA MemberCare Medicare Supplement Program for your expenses through Express Scripts.
2. Do not pay any cash up-front at the VA when you get your prescriptions.
3. You will receive in the mail from the VA your “Statement of Medical Care Cost Recovery Account Activity.” It will show a copay for each prescription you have had filled at the VA. The current copay (2006) is $8 per 30-day supply. You may pay this bill if you wish.
4. DO NOT submit your Statement of Medical Care Cost Recovery Account Activity to NEA or Express Scripts for reimbursement of the copay.
5. Once your claim is processed through Express Scripts, your copay that you have paid for covered drugs that appeared on your Statement of Medical Care Cost Recovery Account Activity will be either credited back to you or reduced.
6. If you are still meeting your NEA Plan deductible, the VA copay is your responsibility. The amount that Express Scripts pays to the VA for your prescription is the amount that will count towards your deductible (not the copay amount).
7. If you wish to receive a record of the payments made by Express Scripts on behalf of the NEA Plan for your VA and your other prescriptions, please call 1-866-843-8349 or log on to http://www.express-scripts.com/.
8. If the VA indicates that your claim has been rejected due to your coverage not being in effect (and this is an error), please contact the NEA Program Administrator (1-800-541-4119). When you have confirmed that your coverage is active, you can resubmit your prescription claim to the VA.