CHAMPVA Medical Benefits for Veterans Explained

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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