CHAMPVA: VA health coverage for military dependents

What is CHAMPVA?

CHAMPVA stands for the Civilian Health and Medical Program of the Department of Veterans Affairs. It is a VA-administered health benefits program that pays for covered healthcare services and supplies for eligible dependents of certain veterans.

CHAMPVA is not the same as TRICARE. TRICARE is a Department of Defense program for active-duty families and military retirees. CHAMPVA is a Department of Veterans Affairs program for dependents of veterans who were permanently and totally service-connected disabled, or who died from a service-connected condition. The two programs are entirely separate, administered by different agencies, and operate with different provider networks.

CHAMPVA has no monthly premium. Beneficiaries pay an annual deductible and then 25% of covered costs up to an annual out-of-pocket cap. For many families, this makes CHAMPVA significantly more affordable than TRICARE's CHCBP or civilian marketplace plans.

Who qualifies?

CHAMPVA is available to the surviving spouse and dependent children of a veteran who:

• Was rated permanently and totally disabled due to a service-connected condition (including veterans rated 100% P&T by the VA)
• Died from a service-connected condition
• Was rated permanently and totally disabled at the time of death (from any cause)
• Died on active duty or from a line-of-duty condition (with the exception that active-duty family members eligible for TRICARE must use TRICARE first)

Surviving spouses

A surviving spouse is eligible if the veteran meets the criteria above. A surviving spouse who remarries before age 55 loses CHAMPVA eligibility upon remarriage. A surviving spouse who remarries at age 55 or older retains eligibility. If a remarriage ends (through death, divorce, or annulment), CHAMPVA eligibility is restored.

Dependent children

Unmarried dependent children of eligible veterans qualify for CHAMPVA through age 17 (or through age 22 if enrolled full-time in an approved educational institution). Dependent children with permanent disabilities that existed before age 18 may retain CHAMPVA eligibility beyond these ages.

CHAMPVA vs. TRICARE: what's the difference?

Families often confuse CHAMPVA and TRICARE because both are military health benefits. The key distinctions:

• Administered by: CHAMPVA → VA; TRICARE → DoD. Separate agencies, separate eligibility databases, separate processes.
• Who it covers: CHAMPVA → dependents of disabled or deceased veterans; TRICARE → dependents of active-duty service members and military retirees.
• Premium: CHAMPVA → no monthly premium; TRICARE → varies by plan (active duty is free; retiree TRICARE has premiums; CHCBP has substantial premiums).
• Cost-sharing: CHAMPVA → 25% after the deductible, with an annual out-of-pocket cap; TRICARE → varies by plan.
• Provider network: CHAMPVA uses Medicare-participating providers and the VA's approved network; TRICARE uses its own separate network.
• Can they be combined? No. Eligibility for TRICARE disqualifies a person from CHAMPVA. However, CHAMPVA can coordinate with Medicare (see below).

How to enroll

The application form

Apply using VA Form 10-10d (Application for CHAMPVA Benefits). It is available at VA.gov or from the VHA Office of Community Care.

What to submit with the application

• Completed VA Form 10-10d
• Proof of the veteran's qualifying status — a copy of the VA rating decision showing permanent and total service-connected disability, or the veteran's death certificate if the claim is based on service-connected death
• Proof of the veteran's death (if applicable) — certified death certificate
• Proof of relationship — marriage certificate for a surviving spouse; birth certificate for dependent children
• Medicare card — if the applicant is enrolled in Medicare Parts A and B, include a copy (CHAMPVA coordinates with Medicare)
• Any other health insurance information — CHAMPVA coordinates with other insurance as a secondary payer

Where to send the application

Mail the completed application and all supporting documents to:

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

Allow 6 to 8 weeks for processing once the VA receives a complete application.

What CHAMPVA covers

CHAMPVA covers a broad range of healthcare services, including:

• Inpatient and outpatient hospital care
• Physician and specialist services
• Prescription medications (through the CHAMPVA In-house Treatment Initiative or mail-order pharmacy)
• Mental health services
• Preventive care and screenings
• Durable medical equipment
• Home health services in some circumstances

CHAMPVA does not cover cosmetic procedures, custodial care, or services available from VA facilities (where the beneficiary is expected to use VA care).

CHAMPVA and Medicare

CHAMPVA coordinates with Medicare Parts A and B when a beneficiary reaches age 65 or becomes Medicare-eligible due to disability. The coordination works as follows:

• Medicare pays first (as primary) for Medicare-covered services
• CHAMPVA pays second (as secondary) for costs Medicare doesn't fully cover
• The combination of Medicare + CHAMPVA can dramatically reduce or eliminate out-of-pocket costs for many healthcare services

Important: to maintain CHAMPVA eligibility after becoming Medicare-eligible, a beneficiary must be enrolled in both Medicare Part A and Part B. Enrolling in Part A only (hospital) but not Part B (medical) will cause CHAMPVA eligibility to be suspended. This is a common and expensive mistake.

Common mistakes

• Not knowing CHAMPVA exists. Many surviving families of permanently disabled veterans never learn about CHAMPVA. The VA does not proactively enroll eligible families — families must apply. The burden of awareness falls entirely on the family.
• Assuming TRICARE eligibility means no CHAMPVA. This is true while TRICARE is active — but when TRICARE or CHCBP coverage ends, CHAMPVA eligibility may begin. Evaluate CHAMPVA whenever a TRICARE period concludes.
• Not enrolling in Medicare Part B before CHAMPVA renewal. Beneficiaries who become Medicare-eligible must be enrolled in both Part A and Part B to keep CHAMPVA. Enrolling in Part A only will result in CHAMPVA suspension. This mistake can be extremely costly once healthcare needs arise.
• Remarrying before age 55 without realizing it ends CHAMPVA. Unlike DIC (which uses age 57 as the remarriage threshold), CHAMPVA uses age 55. Surviving spouses who remarry before 55 lose CHAMPVA coverage, though it can be restored if the remarriage ends.
• Not telling CHAMPVA about other health insurance. CHAMPVA coordinates with other coverage and pays as secondary. Failing to disclose other insurance can result in claim denials or eligibility issues.

Frequently asked questions