Outpatient Prescription Copay

There is an $8 copay for each 30-day or less supply of medication provided on an outpatient basis for treatment of a nonservice-connected condition. Copays for medication are charged only for outpatient treatment.

Veterans enrolled in priority groups 2-6 will continue to have a cap on the amount that they can be charged for medication copays each year. This cap is now $960 per year. This means that veterans in Priority Groups 2-6 will not pay more than $960 annually for medicine they receive on an outpatient basis. As in the past, there is no cap on annual copay amounts for outpatient medications provided to veterans in Priority Groups 7 and 8.

Medication copays do not apply to former Prisoners of War (POW) or those covered by other exceptions as set by law.

There are additional times when a copay will not be charged for your medicine. These are listed below.

Exceptions to Copay Rules for Medications

VA does not charge a copay for medications used for treatment of —

• A veteran who is 50% or more service-connected
• A veteran who has been determined by VA as unemployable due to their service-connected conditions
• A veteran’s specific service-connected disability
• A veteran who is a former POW
• A veteran whose income is below the maximum annual rate for VA pension
• A veteran’s conditions related to a veteran’s exposure to:
• Herbicides during the Vietnam-era, OR
• Ionizing radiation during atmospheric testing, OR
• Ionizing radiation during the occupation of Hiroshima and Nagasaki
• A service-related condition of a veteran who served:
• In the Gulf War, OR
• In combat in a war after the Gulf War, OR
• During a period of hostility after November 11, 1998
• A veteran’s military sexual trauma
• A veteran’s cancer of head or neck caused by nose or throat radium treatments given while in the military
• A veteran participating in a VA approved research project

Reduce or Eliminate VA Medical Care Copays

If you are now receiving VA compensation for a service-connected disability or VA pension benefits, your VA medical care and/or prescription copays may be reduced or eliminated. You may also be eligible for a refund of copay charges you have previously paid based on this decision. For further information, please call our Health Benefits Service Center at 1-877-222-VETS (8387) or contact the Enrollment Coordinator at your local VA medical center.

Federal Benefits for Veterans and Dependents
VA National Means Test Income Threshold | GMT Income Threshold
Viewers, Plug-Ins, & Readers | VA Health Care Eligibility & Enrollment Site Map

For questions about Health Care Eligibility, please visit the VA inquiry website.