CHAMPVA health coverage for families
A VA health program for the spouse, children or survivors of certain Veterans who are not covered by TRICARE.
What it is
CHAMPVA is a cost-sharing health program run by VA for the spouse or widow(er) and children of certain Veterans. VA shares the cost of covered health care services and supplies with you. It is not the same as TRICARE and it is not the same as VA health care for the Veteran.
Who qualifies
You must meet at least one of these:
- You are the spouse or dependent child of a Veteran who VA rates permanently and totally disabled from a service-connected disability.
- You are the surviving spouse or dependent child of a Veteran who died from a service-connected disability.
- You are the surviving spouse or dependent child of a Veteran who was rated permanently and totally disabled at the time of death.
And you must not be eligible for TRICARE. VA lists special rules for children 18 to 23 in school, children permanently disabled before 18, and survivors who remarry (VA says benefits continue if the remarriage is at age 55 or older).
CHAMPVA eligibility
Medicare rule
If you are 65 or older, or qualify for Medicare at any age, VA says you must have Medicare Part A and Part B to get or keep CHAMPVA. A Medicare Advantage plan also meets this.
How to apply, step by step
- Fill out VA Form 10-10d, Application for CHAMPVA Benefits.
- Apply online, or mail it to VHA Office of Community Care, CHAMPVA Eligibility, PO Box 137, Spring City, PA 19475, or fax it (the fax number is printed on the form).
- If you have other health insurance, VA also uses VA Form 10-7959c.
Things to know
- CHAMPVA is always the secondary payer except to Medicaid, Indian Health Services, State Victims of Crime Compensation and supplemental CHAMPVA policies.
- For claims, VA lists CHAMPVA Claims, PO Box 30750, Tampa, FL 33630-3750, and says electronic claims process faster.
- CHAMPVA is cost-sharing, not free. Under VA's rule (38 CFR 17.274), there is a yearly deductible of $50 per person or $100 per family. After that you pay 25 percent of the CHAMPVA allowable amount. Your out-of-pocket costs are capped at $3,000 per family per calendar year. Some services, such as hospice, inpatient care and listed preventive services, skip the deductible, and some inpatient and mental health services are shared differently.
- Read VA's CHAMPVA guidebook before you count on a number for a specific claim.
Where to call and where to go
Phone
- CHAMPVA customer call center: 1-800-733-8387 (TTY: 711), Monday through Friday, 8:05 a.m. to 7:30 p.m. ET. Source: VA CHAMPVA page
Official pages
- CHAMPVA benefits
- Apply for CHAMPVA online (VA Form 10-10d)
- VA Form 10-10d
- VA Form 10-7959c (other health insurance)
Free accredited help
- Find an accredited representative (attorney, claims agent or Veterans Service Organization representative). VA says help from an accredited VSO representative is always free.