This infographic guide dispels common myths about CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs). It provides valuable information about its eligibility, benefits, and enrollment process. Here’s a detailed breakdown:

Table of Contents

Myth 1: CHAMPVA is for veterans.

CHAMPVA is exclusively for dependents of veterans, including spouses, widows, widowers, and children. It does not cater to veterans themselves.

Veterans who are medically retired from the military or possess a VA rating for a service-connected disability may qualify for VA care but are not eligible for CHAMPVA.

Myth 2: I can choose between TRICARE and CHAMPVA.

Eligibility for CHAMPVA is distinct and differs from TRICARE eligibility.

Qualifying for CHAMPVA involves specific criteria, including being ineligible for TRICARE and being an immediate family member of a veteran with specific disability-related qualifications. Knowing your eligibility status ensures you access the right healthcare program.

Myth 3: TRICARE and CHAMPVA are essentially the same.

Although TRICARE and CHAMPVA offer comprehensive health benefits, they are separate programs with unique management structures and coverage options.

TRICARE operates regionally, while the Veterans Health Administration Office of Integrated Veteran Care manages CHAMPVA.

TRICARE leverages a network of military hospitals, clinics, and civilian healthcare systems to meet its members’ needs. CHAMPVA providers are civilian doctors and, when available, VA facilities.

Myth 4: With CHAMPVA, I can’t choose my own providers.

CHAMPVA offers flexibility in selecting healthcare providers, allowing you to choose from participating civilian doctors.

To find a CHAMPVA-accepting provider, refer to your area’s list of TRICARE and Medicare providers. When you call to make an appointment with a provider, double-check that they “accept assignments” for CHAMPVA.

You may also seek treatment at participating VA facilities. However, some VA facilities can’t accept dependents from the CHAMPVA program due to the volume of veterans they see.

Myth 5: I must pay premiums and other hidden costs with CHAMPVA.

CHAMPVA does not require premiums for basic coverage; it is entirely free. This affordability ensures eligible dependents can access essential healthcare services without financial burden.

Copays are applicable, with an annual deductible and a cap on out-of-pocket expenses. Certain services, such as hospice care, prescriptions through the VA Meds by Mail program, and preventive services, are fully covered without copays.

Myth 6: I can choose between CHAMPVA and Medicare.

You must enroll in these programs once you are eligible for Medicare Parts A and B. To continue your CHAMPVA eligibility, in almost all cases, you must enroll in and remain in Medicare Part B.

CHAMPVA serves as secondary insurance, covering expenses not addressed by Medicare, but it does not cover Medicare Part B premiums.

Myth 7: It takes FOREVER to enroll in CHAMPVA.

Enrollment times for CHAMPVA can vary, with some experiencing delays while others complete the process promptly. Factors such as application completeness and supporting documents influence the enrollment timeline.

Thoroughly filling out VA Form 10-10d with all required documents is crucial for expediting enrollment. Beneficiaries can expedite access to CHAMPVA benefits by ensuring their applications are complete and accurate.

Additional documents may be necessary based on your circumstances, and including them can expedite the process. Knowing which documents are required streamlines the enrollment process and reduces potential delays.

7 Myths About CHAMPVA