CHAMPVA: Health Insurance for Veterans' Families

What it is

CHAMPVA is a health benefit for the family of certain veterans. It isn't TRICARE, and it isn't VA health care. It's a separate plan that VA runs, which shares the cost of medical care, prescriptions, mental health care and more.

Here's how the costs work:

• You pay a deductible of $50 per person, or $100 per family, each calendar year. It applies to outpatient care and urgent prescriptions, not hospital stays.
• After that, CHAMPVA usually pays 75% of what it allows, and you pay 25%.
• Your household won't pay more than $3,000 a year for covered care. After that, CHAMPVA pays 100% for the rest of the year.
• Meds by Mail sends regular prescriptions to your home for free, if you have no other drug coverage.

There's no network. You can see any provider who "accepts assignment," meaning they agree to take CHAMPVA's payment. Hospitals that take Medicare must also take CHAMPVA.

Who qualifies

You can't be eligible for TRICARE, and you must be one of these:

• The spouse or child of a veteran rated permanently and totally (P&T) disabled from a service-connected condition
• The surviving spouse or child of a veteran who died from a service-connected condition
• The surviving spouse or child of a veteran who was P&T at the time of death
• In some cases, the surviving spouse or child of a service member who died in the line of duty

Children are covered until 18, or until 23 if in school (you'll need to confirm school each year). A child who became permanently disabled before 18 may stay covered for life. Marriage ends a child's eligibility.

Surviving spouses who remarry at 55 or older keep CHAMPVA. Remarrying before 55 ends it, but you may get it back if that marriage ends.

CHAMPVA and Medicare

If you qualify for Medicare, you must have Part A and Part B (or a Medicare Advantage plan) to keep CHAMPVA. Medicare pays first, then CHAMPVA helps with what's left. If you're 65 or older and don't qualify for Medicare, you'll need a letter from Social Security saying so.

How to apply, step by step

1. Confirm the veteran's P&T status or the survivor's eligibility. Check the veteran's rating letter.
2. Fill out VA Form 10-10d online or on paper.
3. Add VA Form 10-7959c if you have other health insurance, including Medicare.
4. Include documents like Medicare cards if they apply.
5. Submit it online, by mail to CHAMPVA Eligibility, PO Box 137, Spring City, PA 19475, or by fax.
6. Get your card and start using it. Ask providers if they accept CHAMPVA before your visit.

Mistakes to avoid

• Dropping Medicare Part B. You'll lose CHAMPVA if you're eligible for Medicare and don't have it.
• Not updating school enrollment for kids 18 to 23.
• Seeing a provider who doesn't accept assignment without knowing you'll pay up front.
• Assuming you need TDIU or 100% to qualify. The rating must be P&T. Check the letter.

Related benefits

See our guides on DIC survivor benefits, the Fry Scholarship and DEA, adding dependents, TDIU, and caregiver support.