CHAMPVA Civilian Health and Medical program of the Department of Veterans Affairs.
Editor’s Note: In 2005 the CHAMPVA website underwent radical change. It is now a much more informative, user friendly package. To access the website go to:
http://www.va.gov/hac/forbeneficiaries/champva/champva.asp
There is now a way to electronically monitor many aspects of your own healthcare through the use of MyCHAMPVA. It is an online service. The link to this is on the main CHAMPVA website.
Eligibility:
1. Spouse, or child of a veteran who has a total disability resulting from a service connected disability. In plainer terms, a veteran who is 100% SC.
2. The surviving spouse or child of a veteran who dies as a result of a service connected disability, or who at the time of death had a total disability resulting from service connected disability.
NOTE: Individuals are not eligible for both TRICARE and CHAMPVA. Once an individual has TRICARE, CHAMPVA is not an option.
Benefits:
1. Functions like health insurance
2. Care usually provided in non-VA facilities.
3. VA facilities may be used if they are equipped to provide care.
Medicare terminates coverage at age 65, unless the individual enrolls CHAMPVA for Life, details given below.
In limited instances the spouses of veterans are provided health care at a VA under the CITI program. You need to check with CHAMPVA to see if these services are available in your area.
Change in CHAMPVA in 2002: Remarriage use to end a spouse’s CHAMPVA eligibility, however now remarriage at age 55 or older allows the individual to remain in the CHAMPVA program.
CHAMPVA for Life
The 2001 law change on CHAMPVA in many ways mirrors the changes in TRICARE for Life. The program allows enrollment and excludes the individual from being enrolled in another HMO.
To be eligible a person must meet the following conditions:
Turned 65 prior to June 5, 2001 and only have MEDICARE Part A, you will be eligible for CHAMPVA without having to have MEDICARE Part B.
If you turned 65 before June 5, 2001 and have MEDICARE Parts A and B, you must keep both parts.
If you turn age 65 on or after June 5 2001, you must be enrolled in Medicare Parts A and B to be eligible.
NOTE: A disabled child of a veteran might be considered eligible for this program.
It is possible that a non eligible for MEDICARE individual who is over 65 and the spouse of a veteran is eligible for CHAMPVA for Life.
As with TRICARE for Life, CHAMPVA for Life always pays after MEDICARE.
CHAMPVA does have a Pharmacy System.
If you have a Pharmacy Plan under another provider CHAMPVA may pay the deductible.
There is a “Meds by Mail” options that is supposed to provide medications for free.
There is also a Medical Matrix of 45,000 pharmacies that require a 25% cost share after an initial deductible.
CHAMPVA has some quirks. It will pay the MEDICARE Deductible for an inpatient stay. This is very positive. However, like any HMO there are patient costs. These need to be carefully researched before choosing any health option.
For more information on CHAMPVA or CHAMPVA for Life contact:
Editor Note: In San Antonio you can reach the local CHAMPVA representative at (210) 949 3524. The office is no longer in Audie Murphy, it is in a nearby building. I recommend you call first.
Recorded explanation of CHAMPVA (24 hours a day) 888 289 2411
Address The Health Administration Center
PO Box 469028
Denver, CO 80246-9028
Email hac.inq@med.va.gov
Phone 1 800 733 8387
Phone times: 9 a.m. – 1:30 p.m. and 2:30 – 5:00 p.m. (all Eastern Time)
Website: http://www.va.gov/hac/forbeneficiaries/champva/champva.asp
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