Every day, we serve millions of people by providing access to Optum's state-of-the-art home delivery pharmacy and a nationwide network of community pharmacies.

Reminder: On January 1, 2025, the annual deductible requirement for your CHAMPVA benefits will begin again.

• The deductible is applied to the first medical or pharmacy claims processed in 2025 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 or OptumRx 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)

CHAMPVA changes coming in January 2025 for weight loss medications

Beginning January 1, 2025, CHAMPVA will only cover the medications, Ozempic and Mounjaro, if you have a Type II diabetes diagnosis. These medications are FDA-approved for the management of Type II Diabetes and are not covered for any other uses such as pre-diabetes, weight loss or managing obesity. In general, CHAMPVA does not cover weight loss medications, including Saxenda, Wegovy, and Zepbound.

If you do not have a diagnosis for Type II diabetes but you’ve been receiving these medications, for example you’ve been receiving these prescriptions for pre-diabetes, your prescriptions will no longer be filled. Your pharmacy may alert you that your prescription isn’t covered under your current diagnosis.

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