Section 1
What Is CHAMPVA?
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides healthcare coverage for the spouse, surviving spouse, and dependents of veterans who meet one of these criteria:
⭐ Veteran is rated 100% permanently and totally (P&T) disabled
💜 Veteran died from a service-connected disability
🎖️ Veteran was rated 100% P&T at time of death
Important: If you are eligible for TRICARE, you are not eligible for CHAMPVA. CHAMPVA is specifically for family members who do not have access to TRICARE.
Section 2
What's Covered?
🏥 Inpatient and outpatient care
💊 Prescription medications (Meds by Mail or retail)
🦽 Durable medical equipment
Limited dental: Dental is only covered when related to a covered medical condition (e.g., jaw surgery needed for a medical diagnosis).
Section 3
What's NOT Covered?
❌ Long-term / custodial care
Secondary payer: If you have another health plan, CHAMPVA acts as the secondary payer and covers what your primary insurance does not.
Section 4
What Does It Cost?
$0
Monthly Premium
Free to enroll
$50
Annual Deductible
Per person ($100/family)
25%
Cost Share
Of allowed amount after deductible
$3,000
Catastrophic Cap
Per family per year
Medicare + CHAMPVA: If you also have Medicare, CHAMPVA covers most of what Medicare doesn't. Together they provide nearly complete coverage.
Section 5
How to Enroll
1
Complete VA Form 10-10d — Application for CHAMPVA Benefits
2
Gather supporting documents: marriage certificate, DD-214, VA rating decision showing P&T
3
Include copies of any other health insurance cards (Medicare, employer plans)
4
Mail to: VHA Office of Integrated Veteran Care, CHAMPVA, PO Box 469028, Denver CO 80246-9028
5
Processing time: approximately 6-8 weeks
Section 6
CHAMPVA vs. TRICARE
|
CHAMPVA |
TRICARE |
| Who's eligible | Dependents of P&T veterans | Dependents of active duty and retirees |
| Monthly premium | $0 | Varies by plan |
| Cost share | 25% after deductible | Varies by plan |
| Annual deductible | $50/person, $100/family | Varies by plan |
| Catastrophic cap | $3,000/year per family | Varies by plan |
| Can have both? | No — TRICARE-eligible individuals are not eligible for CHAMPVA |
Section 7
Meds by Mail
CHAMPVA beneficiaries can get prescriptions mailed directly to their home through the Meds by Mail program — at no cost.
💊 90-day supply of maintenance medications
💰 No copay through Meds by Mail
📦 Delivered directly to your home
📋 Easy enrollment through CHAMPVA
How to Enroll in Meds by Mail
- Have your doctor write prescriptions for a 90-day supply
- Mail the original prescriptions to the Meds by Mail address on the CHAMPVA website
- Include your CHAMPVA member ID and shipping address
- Refills can be requested online or by phone
Section 8
Tips for CHAMPVA Beneficiaries
🪪 Carry Your Card
Always carry your CHAMPVA authorization card. You'll need it at every appointment and pharmacy visit.
📞 Verify Providers
Not all providers accept CHAMPVA. Call ahead and verify before scheduling appointments to avoid surprise bills.
📅 File Claims Promptly
File claims within 1 year of the service date. Late claims may be denied regardless of merit.
🏥 Medicare + CHAMPVA
If you have Medicare, enroll in both. CHAMPVA picks up where Medicare leaves off, giving you nearly full coverage.
Section 9
Frequently Asked Questions
A: No. CHAMPVA has no monthly premium. It is free to enroll. You only pay the annual deductible and 25% cost share.
A: CHAMPVA does not have a provider network like TRICARE. You can see any provider who accepts CHAMPVA, but not all providers do. Always verify acceptance before your appointment.
A: If the veteran loses their P&T status, CHAMPVA eligibility ends. However, P&T ratings are rarely reduced, especially if the veteran has rating protections (5-year, 10-year, 20-year rules).
A: Yes. If you have Medicare, it pays first and CHAMPVA covers most of the remaining costs. This combination provides excellent coverage.
A: Yes. Dependent children are eligible until age 18, or up to age 23 if enrolled full-time in an approved educational institution. Children who became permanently incapable of self-support before age 18 may be covered indefinitely.