Welcome to Optum Rx

Change happens. We’re here to help you have a smooth transition and access to your medication.

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Welcome to OptumRx

OptumRx is a focused, collaborative and innovative leader in the pharmacy benefit management (PBM) industry. Every day, we serve millions of people through our national network of community pharmacies.

Reminder: On January 1, 2024, the annual deductible requirement for your CHAMPVA benefits will begin again.

• The deductible is applied to the first medical or pharmacy claims processed in 2023 until the deductible is met.
• The deductible is $50 per beneficiary or a maximum of $100 per family per year.

Please, DO NOT mail checks to CHAMPVA to satisfy your deductible requirement. It will automatically be deducted from your submitted claims. Any amount paid over your deductible due to the timing of claim processing will be refunded to you by CHAMPVA.

Pharmacy Benefits - Community Care (va.gov)

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Your prescription drug benefits

OptumRx is the Pharmacy Benefit Manager for three programs offered by the VETERAN FAMILY MEMBER PROGRAMS (VFMP). These programs include:

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) - CHAMPVA is the VA's health benefit program for dependents of permanently and totally disabled Veterans, survivors of Veterans who died from service-connected conditions, or who at the time of death, were rated permanently and totally disabled from a service-connected disability.

Spina Bifida Health Care (SB) - The Spina Bifida Health Care Program is a federal health benefit program administered by the Department of Veterans Affairs for Vietnam Veterans' birth children who have been diagnosed with spina bifida (except spina bifida occulta). The program is a fee-for-service (indemnity plan) program that provides reimbursement for medical services and supplies related to spina bifida and conditions associated with spina bifida.

Children of Women Vietnam Veterans Healthcare (CWVV) - The CWVV Health Care Program is a federal health benefits program administered by the Department of Veterans Affairs for children with certain birth defects born to women Vietnam Veterans. The CWVV Program is a fee-for-service (indemnity plan) program. The CWVV Program provides reimbursement for medical care related to conditions associated with certain birth defects except spina bifida, which is covered under the VA's Spina Bifida Program.

Meds by Mail (MbM) If you are eligible and do not have any other prescription drug coverage you may want to use the CHAMPVA Meds by Mail program. MbM offers nonurgent, maintenance prescription medications delivered directly to your home. The best part of MbM is that there is NO cost share or copay, and no annual deductible. The medication is provided with no out-of-pocket cost to you! Meds by Mail also offers certain specialty medications that could save you hundreds or even thousands of dollars. If you have been diagnosed with Hepatitis C, cancer, or another costly health condition, please contact Meds by Mail to see if your medication is available.