The Board found that VA is not required to waive the copayment for prescriptions filled through VA, as the amount charged by VA was sufficient prior to March 18, 2011. After this date, the amount charged did not cover the Veteran's copayment.
The deciding factor: VA's prescription billing policy change allowed private insurers to pay less than the total cost of a prescription plus an administrative fee, resulting in insufficient reimbursement for the Veteran's copayment.
- Claimed conditions
- Not specified in this decision
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 29, 2015
- Citation
- 1522814
This is a plain-language summary generated by AI from a public Board of Veterans’ Appeals decision. It can contain errors — always verify against the original. Look up the original decision on VA.gov (opens in a new tab) using citation 1522814.
What this means for you
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What you can do next
Related decisions
Other Board decisions on a similar condition or argued the same way.
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- Denied
The Board denied the Veteran's claim for an initial evaluation in excess of 10 percent for his service-connected coronary artery disease, finding that the evidence did not support a higher rating based on the severity of his condition.
- Denied
The Veteran's service-connected musculoligamentous strain, right knee, is currently rated at 10 percent and the Board finds that a higher rating is not warranted.
- Granted
The Veteran's claim for service connection for PTSD is granted as the evidence shows a current diagnosis of PTSD, an in-service stressor, and a medical link between the two.
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