Civilian Health and Medical Program of VA (CHAMPVA)

Civilian Health and Medical Program of VA (CHAMPVA)


The Civilian Health and Medical
Program of the Department of Veterans Affairs, or CHAMPVA, is
a comprehensive health care program in which VA shares the
cost of covered health care services and supplies with
eligible beneficiaries. CHAMPVA covers most health care
services and supplies that are medically and psychologically
necessary. CHAMPVA provides coverage to the
spouse, widow or widower and to the children of a Veteran who: – Is rated permanently and
totally disabled due to a service-connected disability – Was rated permanently and
totally disabled due to a service-connected condition at
the time of death – Died of a service-connected
disability or – Died on active duty and the
dependents are not otherwise eligible for Department of
Defense TRICARE benefits. To be eligible for CHAMPVA, you
cannot be eligible for TRICARE. If you become eligible for
Medicare Part A you must obtain and maintain Medicare Part B to
be eligible for CHAMPVA. To enroll in CHAMPVA, complete
and sign VA Form 10-10d, including required supporting
documentation, and mail it to this address: Or fax it to this number. The form and a list of required
supporting documentation is available on our website Once we receive your form
and required supporting documentation, we will process
it and send you a CHAMPVA identification card along with a
program guide that addresses covered and non-covered services
and supplies. After you receive your
identification card, you can make an appointment with a
local provider that accepts CHAMPVA. You can also make
follow-up appointments as needed. After you receive care, your
provider should send the claim to your other health insurance
first, if applicable. The remaining balance, including
the Explanation of Benefits from your other health insurance,
should then be submitted as a claim to CHAMPVA. If your
provider accepts CHAMPVA, then they agree to accept VA’s
allowable amount as payment in full. A provider cannot bill you
for the difference between VA’s allowable amount and their
normally billed amount. We encourage you to ask your
provider to directly send your claim to VA, since your provider
has better access to all the required documentation that VA
needs to process your claim. Providers can submit claims
electronically using Electronic Data Interchange, or EDI.
Providers and Veterans can visit our website for instructions on
how to submit claims When VA receives the claim, we
will review it to make sure all the required supporting
documentation is present and that the treatment can be paid
for by VA. We will contact you if more information is needed. For more details and to learn
more, including costs to beneficiaries for using CHAMPVA,
visit our website or call us at this phone number.

Author: Kevin Mason

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