CHAMPVA benefits | Veterans Affairs (2024)

Are you the spouse or surviving spouse of—or a child of—a Veteran with disabilities or a Veteran who has died? If you don’t qualify for TRICARE (the Department of Defense’s health care program for active-duty and retired service members and their families), you may be able to get health insurance through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). Through this program, we cover the cost of some of your health care services and supplies. This is called cost sharing. Find out if you qualify for CHAMPVA and how to apply.

Am I eligible for health care through CHAMPVA?

You may only be eligible forhealth care through CHAMPVA if you don’t qualify for TRICARE and at least one of these descriptions is true for you.

At least one of these must be true:

  • You’re the spouse or child of a Veteran who’s been rated permanently and totally disabled for a service-connected disability by a VA regional office, or
  • You’re the surviving spouse or child of a Veteran who died from a VA-rated service-connected disability, or
  • You’re the surviving spouse or child of a Veteran who was at the time of death rated permanently and totally disabled from a service-connected disability, or
  • You’re the surviving spouse or child of a service member who died in the line of duty, not due to misconduct (in most of these cases, family members qualify for TRICARE, not CHAMPVA).

A service-connected disability is a disability that we’ve concluded was caused—or made worse—by the Veteran’s active-duty service. A permanent disability is one that’s not expected to improve.

Note: A Veteran who’s the qualifying CHAMPVA sponsor for their family may also qualify for the VA health care program based on their own Veteran status. If 2 spouses are both Veterans who qualify as CHAMPVA sponsors for their family, they both may now qualify for CHAMPVA benefits. Each time they need medical care, they may choose to get care through the VA health care program or using their CHAMPVA coverage.

What else might affect whether I can get CHAMPVA benefits for myself or a family member?

There are other factors that may affect whether you or other family members qualify for CHAMPVA. Please click on the description that matches your status to learn more:

A new or expectant parent

If you’re expecting a baby, you’ll need to take the 2 steps listed here before you can apply for CHAMPVA for your newborn:

  • You’ll need to get a Social Security number for your baby by applying at the nearest Social Security Administration office, and
  • You’ll need to set up the baby’s status as a dependent of the Veteran sponsor by contacting your nearest VA regional office.

Medical claims can’t be paid until you sign your baby up under CHAMPVA, so please get them a Social Security number and set their status as a dependent as soon as possible.

Find a Social Security office near you

Find a VA regional office near you

A surviving spouse who’s currently remarried

If you’re the surviving spouse of a qualifying CHAMPVA sponsor and you remarry before age 55, you no longer qualify for CHAMPVA as of midnight on the date of your remarriage.

If you remarry on or after your 55th birthday, you can keep your CHAMPVA benefits.

A surviving spouse whose remarriage has ended by death, divorce, or annulment

If you’re the surviving spouse of a qualifying CHAMPVA sponsor and you remarry, but the remarriage ends by death, divorce, or annulment, you may qualify again for CHAMPVA.

The first date that you qualify again is the first day of the month after your remarriage ends or December 1, 1999—whichever date is later. You’ll need to provide us with copies of your marriage certificate and death, divorce, or annulment documents (as appropriate).

An 18-to-23-year-old dependent child of a Veteran

If you’re covered under CHAMPVA and you turn 18 years old, you’ll need to send us proof that you’re enrolled in college or another educational institution to keep getting benefits.

Download our fact sheet on school enrollment certification requirements for CHAMPVA benefits (PDF)

A Veteran’s stepchild who leaves the Veteran’s household

If you were covered under CHAMPVA as the stepchild of a Veteran, and you leave the Veteran’s household because of a divorce or remarriage, you no longer qualify for CHAMPVA.

A primary family caregiver of a Veteran with injuries and/or disabilities

If you’re a family member caring for a Veteran with disabilities, and you’re not entitled to care or services through another health plan, you may qualify for CHAMPVA.

Download a fact sheet on CHAMPVA for primary family caregivers (PDF)

Get more information about CHAMPVA for primary family caregivers

If the Veteran you are caring for sustained or aggravated a serious injury (or illness) in the line of duty in the active military, naval or air service during any service era, you may qualify for health care benefits and other caregiver support through the Program of Comprehensive Assistance to Family Caregivers.

Find out if you qualify for this program and how to apply

A CHAMPVA beneficiary who’s 65 years old or older—or who qualifies for Medicare at any age

CHAMPVA is always the second payer to Medicare. Here are some requirements you need to know:

If you’re under 65 years old, you’re eligible for CHAMPVA if you meet both of these requirements.

Both of these must be true:

  • You have both Medicare Parts A and B, and
  • You’re otherwise eligible for CHAMPVA

If you’re 65 years old or older, you’re eligible for CHAMPVA if you’re eligible for Medicare. If you turned 65 before June 5, 2001, and you’re entitled to either Medicare Part A or B, you’ll also need to enroll in Medicare Part B to be eligible for CHAMPVA.

Note: You don’t need to enroll in Medicare Part D to qualify for CHAMPVA.

Download a fact sheet on Medicare and CHAMPVA (PDF)

What benefits do I get with CHAMPVA?

With CHAMPVA, you’ll be covered for services and supplies when we determine they are medically necessary and were received from an authorized provider. When providers are performing services within the scope of their license or certification, we consider them to be authorized.

Covered services include:

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

When you’re signed up for CHAMPVA, you’ll get a copy of the CHAMPVA Program Guide. This guide will tell you more about covered and non-covered services and supplies.

  • Download the CHAMPVA Program Guide (PDF)
  • Download fact sheets on CHAMPVA benefits

How do I get CHAMPVA benefits?

You’ll need to apply for these benefits.

To apply, submit these required documents:

  • Application for CHAMPVA Benefits (VA Form 10-10d), and
  • Other Health Insurance Certification (VA Form 10-7959c), and
  • Documents related to your Medicare status:
    • If you qualify for Medicare for any reason, you’ll need to submit a copy of your Medicare card.
    • If you’re 65 years old or older and don’t qualify for Medicare, you’ll need to send us documentation from the Social Security Administration that confirms you don’t qualify for Medicare benefits under anyone’s Social Security number.

To speed up the processing of your application, you can also send copies (not originals) of these optional documents:

  • The page from the VBA rating decision showing your Veteran is permanently and totally disabled (or the death rating if you’re a survivor)
  • Your Veteran’s DD214 (Certificate of Release or Discharge from Active Duty)—or, if the Veteran was a World War II or Korean War Veteran, the Report of Separation. If you don’t have a copy of the necessary form, you can request it by submitting a Standard Form 180, Request Pertaining to Military Records, from the National Archives.
    Find out how to request military service records online, by mail, or by fax
  • Documents related to any dependent children you’re including in your application:
    • A copy of each child’s birth certificate or adoption papers
    • School certification of enrollment for children ages 18-23.
      Download our fact sheet on school enrollment certification requirements (PDF)

If you’re a surviving spouse who remarried but is once again single, also send a copy of the legal document that ended your marriage. This may be a divorce decree, death certificate, or annulment decree.

Be sure to sign and date your application. If your Veteran is applying for you as a spouse, be sure to also include the date of the marriage on the application.

Mail your application to:

VHA Office of Community Care
CHAMPVA Eligibility
PO Box 469028
Denver, CO 80246-9028

Or fax it to:

What happens after I apply?

Once we get your application, we’ll review it to be sure it’s complete and includes all required forms. If it’s not complete, we’ll return it to you with more instructions.

How long will it take to hear back about my application?

If you send us all required and optional documents—and if your application is complete—it’ll take about 6 weeks after we get your package until you get your CHAMPVA ID card and related materials.

If you send us only the required documents, it may take 2 to 8 months since we’ll need to confirm your information with other federal agencies.

Get more information

Get answers to frequently asked questions about CHAMPVA

Find out how to file a CHAMPVA claim

Find out if you can get care at a local VA medical center when you’re covered under CHAMPVA

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CHAMPVA benefits | Veterans Affairs (2024)

FAQs

Do spouses of 100% disabled veterans get benefits after death? ›

If you're the surviving spouse, child, or parent of a service member who died in the line of duty, or the survivor of a Veteran who died from a service-related injury or illness, you may be able to get a tax-free monetary benefit called VA Dependency and Indemnity Compensation (VA DIC).

Is Champva free for 100 disabled veterans? ›

The coverage is free. However there are deductibles and co-pays associated with using this coverage. After an annual deductible of $50, the participant pays 25% of the covered amount.

Can I check my Champva status online? ›

To apply for VA benefits and services, view your benefit status, and many more services go to www.va.gov and either logon with your eBenefits sign on or use www.Logon.gov to enroll. VA.gov is a one-stop source for information on Department of Defense and Department of Veterans Affairs benefits and services.

What is not covered by Champva? ›

For example, CHAMPVA does not cover dental, chiropractic services, routine eye exams or corrective lenses. It is possible that Medicaid recipients could have less of a financial burden if covered by Medicaid than under CHAMPVA program.

How much does the widow of a 100% disabled veteran receive? ›

Benefits for the Surviving Spouse of a 100% Disabled Veteran

If your spouse dies with a 100% disability rating, you may be entitled to Dependency and Indemnity Compensation (DIC). For 2024, the base rate of compensation for a surviving spouse is $1,612.75/month.

What does Champva cover for spouses? ›

CHAMPVA provides coverage for many services and supplies that are received from an authorized provider and are considered medically necessary. That includes outpatient services, inpatient services, mental health services, family planning, maternity care, skilled nursing care, hospice care, ambulance services and more.

What are the downsides of Champva? ›

The cons of CHAMPVA are that beneficiaries must pay 25% of the allowable amount, leading to significant out-of-pocket costs for unexpected medical bills. CHAMPVA does not cover dental, chiropractic, routine eye exams, or corrective lenses, and beneficiaries may have limited choice in how their care is provided.

Does Champva have a max out of pocket? ›

CHAMPVA has an outpatient deductible ($50 per beneficiary per calendar year or a maximum of $100 per family per calendar year) and a patient cost share of 25% of our allowable amount up to the catastrophic cap ($3,000 per calendar year).

Does Champva offer coverage for the families of veterans who are deceased? ›

Are you the current or surviving spouse or child of a Veteran with disabilities or a service member who died in the line of duty? If you don't qualify for TRICARE, you may be able to get health insurance through CHAMPVA. Through this program, we cover the cost of some of your health care services and supplies.

What is the 70-40 rule for VA disability? ›

To be eligible for schedular TDIU benefits, a veteran must have either: a single service-connected condition with a rating of at least 60 percent; or. (the 70/40 rule) at least two service-connected conditions with a combined rating of at least 70 percent, with at least one of the conditions rated 40 percent or higher.

What is the most common 100% VA disability? ›

The Most Common VA Disability Claims

Among the numerous disabilities veterans may experience, three stand out as the most prevalent: Tinnitus, Hearing Loss, and Post-Traumatic Stress Disorder (PTSD).

Does the VA pay for funeral expenses for a spouse? ›

Burial benefits are gratefully offered to eligible Veterans, their spouses and dependent children by the Federal Government, through the Department of Veterans Affairs' (VA) National Cemetery Administration (NCA) and are earned by military service to our Nation.

Does Champva pay for everything? ›

In general, CHAMPVA covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive a CHAMPVA Guide that specifically addresses covered and non-covered services and supplies.

Do hospitals have to accept Champva? ›

As a rule any hospital that accepts medicare will accept CHAMPVA and all hospitals accept Medicare... (other than a very few specialty centers).

Can I use Champva as primary insurance? ›

CHAMPVA is NOT considered primary health coverage. Find resources and information about Medicare disability benefits.

What are the benefits for the wife of a disabled husband? ›

Currently, the social security disability spousal benefit is 50% of the amount received by the disabled worker. So, for example, if the disabled worker was receiving a $1,000 monthly benefit, the spouse could qualify for a $500 monthly benefit.

What VA benefits is a widow entitled to? ›

As the spouse or dependent child of a Veteran or service member, you may qualify for certain benefits, including health care, life insurance, or money for school. As the survivor of a Veteran or service member, you may qualify for added benefits, including help with burial costs and survivor compensation.

How long does a spouse get survivors benefits? ›

If both payouts are about the same, spouses take the survivor benefit at age 60. It's reduced because the survivor takes it early, but can collect that benefit from age 60 to 70 while their retirement benefit grows. Survivors can collect their benefit at age 70 when it maxes out.

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