What You Need To Know About CHAMPVA

Understanding CHAMVA

Are you a spouse or a child of a veteran with disabilities or a surviving spouse or surviving child of a veteran who has passed away and you do not qualify for TRICARE? If so, then you may be able to receive health insurance through CHAMPVA – the Civilian Health and Medical Program of the Department of Veterans Affairs. 

What is CHAMPVA?

CHAMPVA is a comprehensive healthcare program where the VA shares the cost of certain covered healthcare services and supplies with beneficiaries who are eligible. The coverage is free and there are no premiums, however, there are deductibles and co-pays that apply with this type of coverage. Medical providers that accept Medicare must also accept CHAMPVA.

Who is Eligible?

In order to be eligible for CHAMPVA, you cannot be eligible for TRICARE. You must also fit in one of the following categories:

  • You are a child or a spouse of a veteran rated permanently and totally disabled due to a service-connected injury.
  • You are a surviving child or spouse of a veteran who has passed away from a VA-rated and service-connected disability.
  • You are a surviving child or spouse of a veteran who was rated permanently and totally disabled from a service-connected injury or illness at the time of their death.
  • You are the surviving child or spouse of a member of the military who died honorably in the line of duty.

Note: A disability is service-connected if the VA concludes it was caused or made worse by active-duty service. Permanently and totally disabled means the disability is not expected to improve.

What are the Benefits of CHAMPVA?

CHAMPVA covers most medically and psychologically necessary healthcare services and supplies. 

Some of the covered services include:

  • Ambulance service
  • Ambulatory surgery
  • Durable medical equipment (DME)
  • Family planning and maternity
  • Hospice
  • Inpatient & outpatient services
  • Mental health services
  • Prescription medicines
  • Skilled nursing care
  • Transplants

General Exclusions

Certain services and supplies may not be covered by CHAMPVA. These include, but are not limited to:

  • Medical services and supplies received as part of a research program, grant, or study.
  • Medical services and supplies not provided within accepted professional medical standards. 
  • Medical services and supplies related to experimental or unproven procedures or treatments.
  • Medical care provided outside of the scope of the providers license or certification.

The full list of services covered and excluded can be found in the CHAMPVA Handbook.

How Do I Apply?

In order to apply, you must provide all of the required documentation to the VA. After your application is correct and complete, it takes about six weeks to receive your CHAMPVA identification care and related educational materials. 

What If I need Help?

Filing a claim with the VA can be stressful and confusing. Veterans Guardian VA Claim Consulting can support you in filing a VA claim. Our team will guide you through the paperwork and prepare you for a meeting with the VA’s representatives, so there aren’t any surprises when the time comes. Fill out this form for a free consultation.

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