Question:

What is CHAMPVA and am I eligible for it?

Answer:

CHAMPVA is a health benefits program in which the Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with eligible beneficiaries. CHAMPVA is managed by the VA’s Health Administration Center (HAC) in Denver, Colorado who processes CHAMPVA applications, determines eligibility, authorizes benefits, and processes medical claims.

To be eligible for CHAMPVA, the beneficiary cannot be eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and to the children of a veteran where:

  • The Veteran is permanently and totally disabled (P&T) because of an adjudicated service-connected disability, or
  • The Veteran died as a result of an adjudicated service-connected disability or who at the time of death was rated P&T, or
  • The Veteran died while in an active duty status and in the line of duty, not due to misconduct. The term “active duty” may include periods of inactive duty for training.

Effective October 1, 2001, CHAMPVA benefits were extended to beneficiaries age 65 and older. To be eligible, you must also meet the following conditions:

  • if the beneficiary was 65 or older prior to June 5, 2001, and was otherwise eligible for CHAMPVA, and was entitled to Medicare Part A coverage, then the beneficiary will be eligible for CHAMPVA without having to have Medicare Part B coverage.
  • if the beneficiary turned 65 before June 5, 2001, and has Medicare Parts A and B, the beneficiary must keep both Parts to be eligible.
  • if the beneficiary turn age 65 on or after June 5, 2001, the beneficiary must be enrolled in Medicare Parts A and B to be eligible.

In most cases, CHAMPVA pays equivalent to Medicare/TRICARE rates. CHAMPVA has an outpatient deductible ($50 per person up to $100 per family per calendar year) and a cost share of 25% up to the catastrophic cap (up to $3,000 per calendar year).

If you have any questions about this topic or any other topic regarding veterans benefits please feel free to contact us at Ask VetsFirst. Ask VetsFirst is a free support service for veterans and their family members. You can find Knowledge Books on a wide range of veterans issues and topics. You can also submit a request and have one of our counselors answer your questions.

Please feel free to browse our extensive VetsFirst Knowledge Books for answers to your questions and if you are unable to find an answer you can submit your question directly to a VetsFirst counselor. Click here to Ask VetsFirst.