The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a program available to spouses, including surviving spouses, and children of Veterans who had a disability and passed away. In order to submit a CHAMPVA application, you can’t qualify for TRICARE benefits. CHAMPVA will provide you with coverage for many supplies and services related to your healthcare. Not everyone is eligible for the cost-sharing program but for those who are, CHAMPVA is a great program to help the military community avoid expensive medical costs.
You can send the VA a CHAMPVA application if you are a spouse, surviving spouse, or child of a Veteran who cannot qualify for TRICARE and also has one of the following apply:
In some cases, family members with a CHAMPVA status may also qualify for VA healthcare because of their own status as Veterans.
If this is the case, you can choose to use either the VA or CHAMPVA coverage when applicable.
If you need to check your CHAMPVA application status, you can do so by calling the CHAMPVA call center at 800-733-8387. However, there are additional factors to consider.
Whether or not you qualify for CHAMPVA can be complicated by additional factors, even if you meet the eligibility requirements mentioned above. Here are some key scenarios to remember:
Some newborns may be eligible for CHAMPVA. However, if you wish to apply for your child, you’ll need to apply at your nearest Social Security Administration office, while providing the baby’s Social Security number.
Furthermore, you must also contact your nearest VA regional office to set up and confirm the child’s dependent status connected to the Veteran.
Surviving spouses who qualify for CHAMPVA, but remarry before the age of 55, lose eligibility beginning midnight of the date of their remarriage. However, if you tie the knot on or after this age, you keep your benefits.
Once you do remarry, however, you may be able to regain access to your benefits if the marriage ends due to an annulment, divorce, or death. You become eligible again on the first day of the month after your remarriage is over.
Children between the ages of 18 and 23 can qualify for benefits; however, they must prove they are pursuing education through either college or another qualifying institution.
While stepchildren can qualify for benefits, you cannot submit a VA CHAMPVA application for stepkids who no longer are a part of the qualifying Veteran’s household due to either a divorce or remarriage.
Veterans with disabilities may have family caregivers who qualify for CHAMPVA. However, in order to qualify, you can’t be entitled to healthcare services because of another form of coverage.
It’s worth noting that you can also receive benefits due to the caregiver support benefits Veterans are provided through the Program of Comprehensive Assistance to Family Caregivers.
If you have Medicare, you can still receive benefits from CHAMPVA. However, you must meet these requirements:
Anyone who either is 65 years old or older and turns this age before June 5, 2001, can also receive CHAMPVA if they are eligible. They must be enrolled in Medicare Part B to receive their benefits.
Those who qualify for CHAMPVA can receive coverage for services and supplies. This includes: ambulance services, durable medical equipment (DME), inpatient services, outpatient services, and much more.
To learn more about the specific benefits you receive, be sure to check out the VA’s CHAMPVA Program Guide. Here’s how you sign up for coverage:
Depending on your application, you may be able to speed up the process by submitting copies of the following documents:
Applications must be signed and dated and if the Veteran who qualifies is applying for a spouse, the date of the marriage needs to be included on the application. You can mail your CHAMPVA application form to the following:
VHA Office of Community Care
CHAMPVA Eligibility
PO Box 469028
Denver, CO 80246-9028
Alternatively, you can fax your application for CHAMPVA benefits to 303-331-7809.
Keep in mind submitting a CHAMPVA application that isn’t complete will result in a return with additional instructions. If everything goes smoothly, you can expect to receive your ID card in about 6 weeks.
If you only provide the bare minimum documents for your application, the process will take longer with a range of two to eight months.
Beginning May 2024, there is an expansion of CHAMPVA benefits coming to the military community. This expansion is providing telehealth (audio-only), contraceptive services, and additional mental healthcare resources.
Telehealth continues to be an important resource for anyone in a rural setting.
Now, the VA is expanding care with audio-only telehealth that will be retroactive to anyone who has received care since May 12, 2020, and wishes to be reimbursed.
You have until November 26, 2024, to file reimbursement claims for covered healthcare services.
If you receive necessary contraceptive healthcare services as a CHAMPVA beneficiary, you will no longer have to pay a deductible or deal with cost sharing.
The cost-sharing and deductibles are also being eliminated for those who receive contraceptive services/products that are approved, cleared, or granted by the Food and Drug Administration (FDA).
Finally, those who use CHAMPVA will also no longer have a maximum cap for mental health and substance use visits.
Pre-authorizations for outpatient mental health visits after 23 years per calendar year and/or those who use over two sessions per week are also eliminated.
Over 737,500 people use CHAMPVA in the military community. If you believe you may qualify for coverage, don’t forget to take the necessary steps above to submit your CHAMPVA application to utilize your benefits.
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