The short answer
No. Part D isn't required, and CHAMPVA drug coverage counts as creditable, so there's no Part D late penalty while you have it. With Part D, you can't use free Meds by Mail. Without it, you pay CHAMPVA's deductible and 25% at retail pharmacies. The better choice depends on your drugs and plan.
Is Part D required?
No. VA's CHAMPVA care page says you don't need Part D to get CHAMPVA, and the CHAMPVA Guidebook calls it optional. That's different from Part B, which most people with Part A need. More here: CHAMPVA at age 65.
Will you get a late penalty without Part D?
Not while you have CHAMPVA. VA says CHAMPVA drug coverage is creditable, meaning at least as good as Part D. Medicare's creditable coverage page explains that creditable coverage prevents the penalty.
If CHAMPVA ever ends, a gap of 63 days or more without creditable drug coverage can trigger the penalty later. VA says you can request a creditable coverage letter. Keep it.
CHAMPVA with Part D vs. without
| CHAMPVA only | CHAMPVA + Part D | |
|---|---|---|
| Meds by Mail | Yes, free | Not allowed |
| Retail pharmacy | CHAMPVA pays: deductible, then 25% | Part D first, CHAMPVA second; usually no CHAMPVA cost share |
| Monthly premium | None | Part D premium |
| Drug list | CHAMPVA's rules | The Part D plan's formulary, with CHAMPVA second |
VA's Meds by Mail page says anyone with other drug coverage, including Part D, can't use Meds by Mail.
How do you decide?
- List your medications. For each, check whether the Part D plan covers it and at what cost, whether CHAMPVA covers it, and whether it's on the Meds by Mail list.
- Compare yearly costs, not just copays: Part D premiums and deductibles vs. CHAMPVA's deductible and 25%, or free Meds by Mail.
- Check if your drug coverage is part of a Medicare Advantage plan. Dropping it may affect the whole plan. Ask before changing anything.
- Think about how much Meds by Mail would help. If most of your regular drugs are available, it can save a lot.
Medicare's Part D cost page has more on plan costs.
If you have Part D
- Give the pharmacy both cards. Part D pays first, then CHAMPVA.
- Tell CHAMPVA with VA Form 10-7959c and a copy of both sides of your Part D card.
If you're thinking about dropping Part D
VA says to ask CHAMPVA for a creditable coverage letter and use it when you contact Medicare. Then update CHAMPVA so pharmacy claims bill in the right order. More here: CHAMPVA prescription coverage.
Common mistakes
- Confusing Part D with Part B.
- Thinking you need Part D to avoid a penalty while you have CHAMPVA.
- Expecting Meds by Mail to keep working after adding Part D.
- Not telling the pharmacy or CHAMPVA about Part D.