The Department of Veterans Affairs (VA) maintains its own national formulary for veterans enrolled in VA healthcare. The VA formulary is managed by the VA Pharmacy Benefits Management (PBM) program and its National Formulary Committee. VA negotiates drug prices directly with manufacturers, resulting in some of the lowest prescription costs in the country.
Key Facts
Check Your Specific Plan's Formulary
Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerSources and standards behind this page
Drug coverage in the United States is governed by published rules rather than by any one insurer's summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.
- FDA Orange Book publishes the therapeutic-equivalence ratings that decide whether a generic may be substituted for a brand-name drug.
- FDA generic drug facts sets out what "generic equivalent" means and what a manufacturer must prove.
- CMS prescription drug coverage defines the rules a Medicare drug plan formulary must follow and how it may change mid-year.
- Medicare.gov drug coverage (Part D) states what a Part D plan is required to offer a member.
- CMS prescription drug appeals documents the coverage-determination and exception process when a drug is denied.
- VA health care copay rates lists the medication copay tiers, the annual cap and who pays no medication copay.
- 38 CFR 17.110 is the regulation that sets VA medication copays and every exemption from them.
- VA Pharmacy Benefits Management publishes the VA National Formulary.
This page describes how coverage and formularies work. It is not medical advice, and a reader's own plan documents and prescriber decide what applies to them.
Frequently Asked Questions
The VA national formulary is available on the VA PBM website (pbm.va.gov). You can search by drug name to see if it is on formulary. It is the only formulary VA uses: VHA policy prohibits regional (VISN) and facility formularies, so coverage is the same at every VA medical center. Ask your VA pharmacist or provider for help checking coverage.
Many veterans pay $0 for prescriptions. No medication copay applies to veterans with a service-connected rating of 50% or more, to medication for a service-connected condition, to veterans whose income is at or below the VA pension limit, to former prisoners of war and Medal of Honor recipients, and to the other groups listed in 38 CFR 17.110. Other veterans pay a tiered copay per 30-day supply: $5 preferred generic, $8 non-preferred generic, $11 brand-name, capped at $700 per calendar year.
Yes, you can have both VA and Part D coverage, but they do not coordinate. VA fills prescriptions at VA pharmacies with VA pricing, while Part D covers drugs at retail pharmacies. You cannot use Part D at VA pharmacies. Having both gives you more pharmacy options but requires managing two systems.
Related Resources
- TRICARE Formulary 2027
- Medicare Part D Formulary 2027
- Medicaid Drug Coverage 2027
- Metformin cash price comparison on RxGrab
- Lisinopril cash price comparison on RxGrab
- Atorvastatin cash price comparison on RxGrab
- Sertraline cash price comparison on RxGrab
- Gabapentin cash price comparison on RxGrab
- Drug interaction checker tool
- Patient assistance program finder
Get Formulary and Coverage Updates
Subscribe to receive alerts on formulary changes, new drug approvals, and insurance coverage updates.