CHAMP VA Is My Family Eligible?

Did you know the VA can offer health insurance to your spouse and dependent children? The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMP VA) is a great option if you do not qualify for Tricare. This program is available to families of veterans who are rated permanently and totally disabled by the VA.

Why Not Use Tricare For My Family?

In a perfect world, Tricare would be your first option to cover the family. It is an easy and well known program. However, many disabled veterans do not qualify for Tricare. Tricare requires that the veteran be retired or medically retired from their branch.

As a result, many veterans need to look at CHAMP VA. A veteran with a 10% or higher rating is personally covered through VA health care, but VA health care does not cover the family.

Do All Families of Veterans Get CHAMP VA?

Not all families are eligible for CHAMP VA. This coverage typically requires that the veteran be permanently and totally (P&T) disabled. The VA award letter will designate if you are P&T or not. However, this includes both 100% P&T and TDIU P&T.

However, CHAMP VA also covers the surviving spouse/child of a veteran who was P&T at the time of their time death. This is part of the survivors benefits provided by the VA.

In addition, the surviving spouse/child of a veteran who died from a service connected issue is also eligible for CHAMP VA. For example, a veteran with service-connected cancer dies of that cancer. At the time of death, the veteran was only rated 80%. Typically, the family would not be eligible. However, the service-connected cancer being the cause of death trumps the P&T rule.

What Does CHAMP VA Cover?

CHAMP VA functions much like Tricare, but with some higher costs. As a result, eligible family members are covered for ambulance services, inpatient and outpatient care, prescriptions, mental health, maternity, etc. In addition, CHAMP VA will also cover hospice if needed.

I Heard CHAMP VA Only Covers 75% Of Bills?

Veterans with a disability are used to having all their medical bills covered through VA health care. However, CHAMP VA does have a deductible and copay. The annual deductible is $50 for the family. In addition, the family is then responsible for 25% of the bills after the deductible. However, the annual maximum out of pocket is $3,000 for the family. After that, CHAMP VA covers 100% of all costs.

How Do I Apply For CHAMP VA?

First, you need to fill out the Application for CHAMP VA benefits (VA Form 10-10D) and Other Health Insurance Certification (VA Form 10-7959C). In addition, medicare eligible family members must notify the VA of their medicare status.

In addition, make sure to include a copy of your DD-214, VA rating letter showing P&T, and birth certificates for school age children. Do you have any dependent children age 18-23? They are eligible if they are in school full time. As a result, make sure to include a certificate of attendance from their school.

Mail all these documents to:

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

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