CHAMPVA, which stands for Civilian Health and Medical Program of the Department of Veterans Affairs, is a health-benefit provider that shares the cost of health care and supplies with beneficiaries who qualify for the program. Both medical and psychological needs are covered through CHAMPVA.
Below is an overview of the qualifications and benefits of CHAMPVA.
History
CHAMPVA was authorized by the Veterans Health Care Expansion Act of 1973 and first became effective on Sept. 1, 1973. It is intended to cover veterans and dependents not eligible for TRICARE.
From 1973 to 1986, CHAMPVA applications were processed in VA centers across the country. From 1986 onward, processing of CHAMPVA paperwork was centralized in Denver, Colorado.
Qualifications and Restrictions
Eligibility is most often determined by disability as a result of military service. The following people qualify for CHAMPVA:
Spouse and children of military personnel permanently disabled as a result of military service. The disability rating must come through a VA regional office.
Surviving spouse and children of soldiers who have died as a result of a VA-rated disability.
Surviving spouse and children of a deceased veteran who was permanently disabled at the time of death.
Surviving spouse and children of military personnel who die in the line of duty, whose death was not a result of misconduct.
A primary restriction is that a person cannot be eligible for both TRICARE and CHAMPVA.
A change of status such as marriage and divorce can impact eligibility. Any change of status needs to be reported to:
CHAMPVA, ATTN: Eligibility Unit
PO Box 469028
Denver, CO 80246-9028
1-800-733-8387
Using CHAMPVA with Other Insurance
CHAMPVA can be used in conjunction with other insurance. If a person has other insurance including Medicare, CHAMPVA should generally be the last to pay. The exception is when traveling overseas. In that case, CHAMPVA is the first to pay.
CHAMPVA is the secondary payer because the intent of CHAMPVA is to provide coverage for those who do not have coverage.
Coverage and Cost
CHAMPVA generally pays the same amount that TRICARE and Medicare pay. Each eligible family member pays $50 per year as a deductible for outpatient charges and as much as 25 percent of the allowable charges for treatment.
CHAMPVA Providers
CHAMPVA does not provide a list of providers. However, most doctors that take Medicare also accept CHAMPVA. It is important to check with a provider directly to make sure they accept CHAMPVA before scheduling appointments.
If you do receive treatment from a provider that does not accept CHAMPVA you will likely need to pay all charges out of pocket initially and then be reimbursed by CHAMPVA.
Applying for CHAMPVA Benefits
You may apply for CHAMPVA benefits online or request an application by calling 1-800-733-8387. Notification regarding eligibility and acceptance can take as many as 45 days. To expedite the process, it is important to fill out the application form completely and attach the required documentation, which includes a Medicare card (if applicable) and school certification for children between the ages of 18 and 23.
Tags: accept CHAMPVA, Surviving spouse, Surviving spouse children, change status, children military, children military personnel, military personnel
