CHAMPVA: Simplify pharmacy claims

Save time by letting pharmacies submit your prescription claims for you.

If you are enrolled in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), the easiest way to get reimbursed for your prescriptions is to let the pharmacy electronically file your claim for you.

Pharmacies know what is required, and electronic filing means faster processing and payment. All you need to do is give them your prescription (or have your doctor electronically send it to your pharmacy) and show them your pharmacy card. 

If CHAMPVA is your secondary payer, the pharmacy can bill electronically and save you the hassle. If you haven’t received your pharmacy card or misplaced it, you can get a temporary card until your replacement card arrives. To request a replacement card, call OptumRx at 888-546-5502.    

Why pharmacy electronic claims are better

Saves you time. By letting your pharmacy do the work for you, you only pay a cost share and deductible, and you won’t have to wait up to 90 days to get reimbursed. You will also save time spent filling out paperwork and mailing your claim in.

Prevents errors that delay processing. Having your pharmacist submit your claim ensures all the necessary information is included. If a claim is submitted with missing data, VA has to request that missing data, which extends the reimbursement timeline.

Let your pharmacy do the legwork so you can gain back valuable time to focus on yourself and your loved ones.

Take advantage of CHAMPVA pharmacy cost-savings

Enroll now. Make sure to enroll in CHAMPVA to take advantage of CHAMPVA pharmacy benefits. Check your eligibility before applying.

No other health insurance, no problem. If you’re using CHAMPVA (and do not have other insurance with prescription coverage) you can use both OptumRx and Meds by Mail services.

Amplify your other health insurance. If you have other health insurance, like Medicare, CHAMPVA can help cover the cost of medications as a secondary payer within the OptumRx network.

Find out which option is right for you:

1. Find a participating pharmacy near you in the OptumRx network to fill your prescriptions. OptumRx offers over 66,000 participating retail pharmacies that can electronically submit your claims. (Note: You can take advantage of OptumRx if CHAMPVA is your primary or secondary health care benefits provider).
2. Use Meds by Mail to get prescription medications delivered to your door with no extra fuss. Meds by Mail is a safe and easy way to get non-urgent or maintenance medications. (Note: Only available if you do not have other health insurance.)
3. You can elect to use a non-network pharmacy.

When you take advantage of your CHAMPVA pharmacy benefits, let your pharmacy do the work for you to electronically file your claim.

About CHAMPVA

CHAMPVA shares the cost of covered health care services and supplies with eligible beneficiaries. Qualified spouses, widows(ers) and children of a Veteran are eligible if their Veteran is rated by VA as permanently and totally disabled from a service-connected disability or was rated permanently and totally disabled at the time of death.

To receive CHAMPVA benefits, you cannot be eligible for TRICARE.

Support and resources

• Pharmacy Benefits – Community Care (va.gov)
• Meds by Mail (MbM) – Community Care (va.gov)
• CHAMPVA – Community Care (va.gov)
• CHAMPVA Eligibility – Community Care (va.gov)
• How to Apply for CHAMPVA – Community Care (va.gov)