HOW TO FILE YOUR CHAMPVA APPLICATION


By bblouin
Stethoscope on a CHAMPVA application.

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a program available to spouses, including surviving spouses, and children of Veterans who had a disability and passed away. In order to submit a CHAMPVA application, you can’t qualify for TRICARE benefits. CHAMPVA will provide you with coverage for many supplies and services related to your healthcare. Not everyone is eligible for the cost-sharing program but for those who are, CHAMPVA is a great program to help the military community avoid expensive medical costs.

Am I Eligible for Submitting a CHAMPVA Application?

You can send the VA a CHAMPVA application if you are a spouse, surviving spouse, or child of a Veteran who cannot qualify for TRICARE and also has one of the following apply:

  • The Veteran was rated by a VA regional office to have a permanent, total service-connected disability.
  • They died due to a VA-rated service-connected disability or died while having the disability.
  • The Veteran died while in the line of duty but not because of misconduct.
  • The Veteran has a permanent service-connected disability that is either due to active-duty service or made worse by it.

In some cases, family members with a CHAMPVA status may also qualify for VA healthcare because of their own status as Veterans. If this is the case, you can choose to use either the VA or CHAMPVA coverage when applicable.

Check CHAMPVA Application Status

If you need to check your CHAMPVA application status, you can do so by calling the CHAMPVA call center at 800-733-8387. However, there are additional factors to consider. Whether or not you qualify for CHAMPVA can be complicated by additional factors, even if you meet the eligibility requirements mentioned above. Here are some key scenarios to remember:

New and Expectant Parents

Some newborns may be eligible for CHAMPVA. However, if you wish to apply for your child, you’ll need to apply at your nearest Social Security Administration office, while providing the baby’s Social Security number. Furthermore, you must also contact your nearest VA regional office to set up and confirm the child’s dependent status connected to the Veteran.

Considerations for Surviving Spouses

Surviving spouses who qualify for CHAMPVA, but remarry before the age of 55, lose eligibility beginning midnight of the date of their remarriage. However, if you tie the knot on or after this age, you keep your benefits. Once you do remarry, however, you may be able to regain access to your benefits if the marriage ends due to an annulment, divorce, or death. You become eligible again on the first day of the month after your remarriage is over.

Adult Dependents

Children between the ages of 18 and 23 can qualify for benefits; however, they must prove they are pursuing education through either college or another qualifying institution.

Stepchildren

While stepchildren can qualify for benefits, you cannot submit a VA CHAMPVA application for stepkids who no longer are a part of the qualifying Veteran’s household due to either a divorce or remarriage.

Primary Family Caregivers

Veterans with disabilities may have family caregivers who qualify for CHAMPVA. However, in order to qualify, you can’t be entitled to healthcare services because of another form of coverage. It’s worth noting that you can also receive benefits due to the caregiver support benefits Veterans are provided through the Program of Comprehensive Assistance to Family Caregivers.

Medicare Enrollees

If you have Medicare, you can still receive benefits from CHAMPVA. However, you must meet these requirements:

  • Are under the age of 65.
  • You have Original Medicare (Parts A and B).
  • Have CHAMPVA eligibility.

Anyone who either is 65 years old or older and turns this age before June 5, 2001, can also receive CHAMPVA if they are eligible. They must be enrolled in Medicare Part B to receive their benefits.

Applying for CHAMPVA

Those who qualify for CHAMPVA can receive coverage for services and supplies. This includes: ambulance services, durable medical equipment (DME), inpatient services, outpatient services, and much more. To learn more about the specific benefits you receive, be sure to check out the VA’s CHAMPVA Program Guide. Here’s how you sign up for coverage:

  • You need to submit both an Application for CHAMPVA Benefits (VA Form 10-10d), and VA Form 10-7959c, and your Medicare card.
  • For those who don’t qualify for Medicare, you have to prove that you don’t qualify under anyone’s SSN by providing the appropriate documents from the SSA.

Depending on your application, you may be able to speed up the process by submitting copies of the following documents:

  • The page showing a permanent, total disability or death rating from the VBA rating decision.
  • The Veteran’s DD214 form. For those who fought in World War II or the Korean War Veteran, the Report of Separation will also qualify.
  • If you don’t have these forms, you can request the right one online.
  • If children are involved, submitting the appropriate paperwork can also help. This includes birth certificates, adoption paperwork, or paperwork fulfilling the school enrollment certification requirements.
  • Surviving spouses who remarry but still qualify will need to provide paperwork involved with the annulment, divorce, or death.

Applications must be signed and dated and if the Veteran who qualifies is applying for a spouse, the date of the marriage needs to be included on the application. You can mail your CHAMPVA application form to the following: VHA Office of Community Care CHAMPVA Eligibility PO Box 469028 Denver, CO 80246-9028 Alternatively, you can fax your application for CHAMPVA benefits to 303-331-7809.

How Long Does a CHAMPVA Application Take?

Keep in mind submitting a CHAMPVA application that isn’t complete will result in a return with additional instructions. If everything goes smoothly, you can expect to receive your ID card in about 6 weeks. If you only provide the bare minimum documents for your application, the process will take longer with a range of two to eight months.

The Expansion of CHAMPVA Benefits

Beginning May 2024, there is an expansion of CHAMPVA benefits coming to the military community. This expansion is providing telehealth (audio-only), contraceptive services, and additional mental healthcare resources. Telehealth continues to be an important resource for anyone in a rural setting. Now, the VA is expanding care with audio-only telehealth that will be retroactive to anyone who has received care since May 12, 2020, and wishes to be reimbursed. You have until November 26, 2024, to file reimbursement claims for covered healthcare services. If you receive necessary contraceptive healthcare services as a CHAMPVA beneficiary, you will no longer have to pay a deductible or deal with cost sharing. The cost-sharing and deductibles are also being eliminated for those who receive contraceptive services/products that are approved, cleared, or granted by the Food and Drug Administration (FDA). Finally, those who use CHAMPVA will also no longer have a maximum cap for mental health and substance use visits. Pre-authorizations for outpatient mental health visits after 23 years per calendar year and/or those who use over two sessions per week are also eliminated. Over 737,500 people use CHAMPVA in the military community. If you believe you may qualify for coverage, don’t forget to take the necessary steps above to submit your CHAMPVA application to utilize your benefits. Suggested reads:

Sources:

  1. CHAMPVA benefits, VA. Accessed May 2024. https://www.va.gov/health-care/family-caregiver-benefits/champva/
  2. How to Apply for CHAMPVA, VA. Accessed May 2024. https://www.va.gov/COMMUNITYCARE/programs/dependents/champva/champva-apply.asp
  3. VA to expand health care coverage to…, VA News. Accessed May 2024. https://news.va.gov/130911/va-expand-coverage-family-caregivers-champva/

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