CHAMPVA Medical Benefits for Veterans Explained

Veteran's Wife
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What are CHAMPVA medical benefits?

CHAMPVA is a medical insurance program, very similar to Medicare in coverage and costs, available to dependents and survivors of certain disabled veterans. Someone can be enrolled in both Medicare and CHAMPVA; if so, Medicare is the primary payer of medical bills, with CHAMPVA paying many of the coinsurance amounts and co-payments that Medicare doesn't pay.

Who's eligible for CHAMPVA medical benefits?

A veteran's spouse and dependent children are eligible for CHAMPVA if one of the following applies:

  • The veteran has been rated by the V.A. as totally and permanently disabled as the result of a service-connected disability.

  • The veteran died as the result of a V.A.-rated service-related disability.

  • The veteran was V.A.-rated as totally and permanently disabled at the time of death.

To receive CHAMPVA coverage, a veteran's surviving spouse mustn't remarry before age 55. If a veteran's surviving spouse remarries before age 55 but that marriage later ends in death or divorce, the veteran's surviving spouse may then receive CHAMPVA coverage.

What medical coverage does CHAMPVA provide?

CHAMPVA can provide medical coverage in either of two ways:

  • CHAMPVA can work as medical insurance, much like Medicare, paying a share of most medical bills for inpatient and outpatient care. For people who are also enrolled in Medicare, CHAMPVA operates like a Medigap supplemental insurance policy, paying coinsurance amounts that Medicare doesn't pay. To get details on what CHAMPVA covers and how claims are processed, see the official CHAMPVA Handbook.

  • For any particular medical service, someone enrolled in CHAMPVA but not enrolled in Medicare can receive care directly from a V.A. medical center under the CHAMPVA In-House Treatment Initiative (CITI). If CHAMPVA care is received through CITI at a V.A. medical center, the patient has no co-payments or other out-of-pocket expenses. However, because of space and financial limits, not all V.A. facilities participate in CITI. To find out more about how CITI works, and whether a particular V.A. medical facility participates in CITI, check the V.A.'s CITI web page.

How can I apply for CHAMPVA?

The dependent or survivor of a veteran can begin the application process for CHAMPVA by visiting the official CHAMPVA How to Apply website page.

Where can I get help applying for CHAMPVA medical benefits?

You can get free assistance with any V.A.-related question or problem by phone or in person through one of the V.A.'s Vet Centers, which are located in every state. You can also get assistance by contacting the V.A.'s Veterans Benefits Administration office nearest you. The V.A. also has a toll-free telephone help line at 800-827-1000.

Joseph L. Matthews

Joseph Matthews is an attorney and the author of numerous books, including Social Security, Medicare, and Government Pensions, Long-Term Care: How to Plan and Pay for It; How to Win Your Personal Injury Claim; and The Lawyer Who Blew up His Desk. See full bio

15 days, said...

What do I need to do to assure continued coverage through CHAMP VA upon my enrollment in Medicare this fall?

2 months, said...

I am a disabled Veteran 100% because of service connected PTSD and issues causeing Seizures and me to be Incompasitated, My wife has Medical thru ChampVA bit since she had to leave her job inorder to take care of me, She no longer had dental and Vision. which by the way most older people need, How can she get that under ChampVA..

5 months, said...

I have been married to a veteran for 40 years, I have CHAMPVA as my only insurance. He is divorcing me, and I am not seeing a way to keep my CHAMPVA. Is there anything I can do?

12 months, said...

How can I get my spouse off my champva benefits

about 1 year, said...

Does champ pat Medicare premium I have my first dr appt coming up for the year an not sure to no how much I am to pay don't think I have ever paid anything

almost 2 years, said...

If Champ VA is only insurance carried will Harvoni be approved for treatment for Hepatitis C that spouse has been infected with due to her husband being infected with a blood transfusion while in service?

about 2 years, said...

When a person calls for information, demanding an address should not be part of the process, especially if it is WRONG at YOUR end. I know where I live, it isn't my fault you don't.

about 2 years, said...

I have Medicare part A & B and an Advantage Plan. My plan will not cover Hyaluronic Acid knee injections. Champ VA said they will not cover either. I have called dozens of times and gotten busy signals, and the one or two times I was connected and waited over an hour, the representative could not answer my question. If I drop my Advantage Plan, will Champ VA pay for the injections?

almost 3 years, said...

my son and I referred for Champva benefits in January, 2015. Have received no information regarding long does this process take?

over 4 years, said...

will you lose your champva if you work part-time. I am 100% P&T.

over 5 years, said...

Thank you for sharing this information with all of us. It sounds like you really have an excellent program. Sometimes the out of pocket costs can be so expensive, you really need more help. I work with senior citizens every day, helping them cover the out of pocket gaps brought on by government Medicare. It is an extremely rewarding experience and I truly try and help out wherever I can! Out-of-pocket costs and the loss of financial security and peace-of-mind top the list of concerns Medigap enrollees would have if Medigap insurance was no longer available to them. We try and do the absolute best that we can. If you ever get the opportunity, feel free to check out our new website. We'd appreciate any type of feedback! Thanks again.

over 6 years, said...

My husband is a disabled veteran. I have read many publications and articles about what my benefits would be in the event of his death, but never really got any specific amount. It's helpful to know so I can better plan for my future. Also the information about how ChampVA works and can be used was very information. Again, I've read many things, but never got a clear answer. Thanks for clearing this up for me.

over 6 years, said...

ChampVA is totally useless in Seattle. Since my Dr. dropped my coverage, I have not been able to find anyone that accepts ChampVA or even knows what it is for 5 years!!!!

almost 7 years, said...

The CHAMPVA Supplemental Insurance Plan, when combined with your CHAMPVA benefits , is designed to provide you with the protection you need when you need it. The plan will pay your cost share for both covered inpatient and outpatient medical expenses after you satisfy the calendar year plan deductible of $150 per person, $300 family maximum.

almost 7 years, said...

For those of us who work with seniors, sometimes finding undiscovered avenues of assistance can make a world of difference. This entire series of articles on V.A. Benefits will prove to be very helpful to families, veterans and spouses who may have no idea as to available entitlements. Well done. Thank you.