Those who would qualify for CHAMPVA are a spouse or dependent of a Veteran who is classified as permanently/totally disabled due to service or was classified 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 eligible for DoD Tricare benefits). Spouses or dependents eligible for Tricare are not eligible for CHAMPVA.
Does a CHAMPVA beneficiary need to enroll in Medicare Parts A and B when they are eligible? The answer is Yes.
When a CHAMPVA beneficiary becomes eligible, they are required to enroll in Parts A & B of Medicare to continue using CHAMPVA. Medicare will be their primary insurance, and CHAMPVA will be secondary.
It is important to know that CHAMPVA members who become eligible for Medicare will not be able to use VA medical facilities and will need Parts A and B of Medicare to utilize CHAMPVA benefits outside of the VA. They can see any Medicare Provider that accepts Medicare, and Medicare will automatically send the remaining amount to CHAMPVA for their part of the claim. CHAMPVA has no network requirements and very little out-of-pocket cost.
Those on CHAMPVA receive medicine by Mail Order, called Meds by Mail, which is the mail order prescription coverage/pharmacy for CHAMPVA beneficiaries.
It is important to note that someone on CHAMPVA does not need to sign up for Medicare Advantage, Medicare Advantage Prescription Drug Plan, or a Prescription Drug Plan. By doing so, it would put them into a network, and they will not be able to be reimbursed for any out of pocket. Also, being on another prescription drug plan would cause them to lose their access to Meds by Mail (CHAMPVA Mail Order). It is not needed by someone who has CHAMPVA and Medicare. It is key to look at CHAMPVA as a Med Supplement with drug coverage built into it.
CHAMPVA members can enroll in dental coverage through the VA Dental Insurance Program (VADIP). They can also purchase stand-alone dental or vision coverage if there is a plan that meets their needs.
Thank you to all those who have served and those who are currently serving.
The enrollment periods apply to CHAMPVA beneficiaries.
- https://www.va.gov/family-and-caregiver-benefits/health-and-disability/champva
- https://news.va.gov/136600/medicare-open-enrollment-and-your-champva/
- https://news.va.gov/127077/take-advantage-of-champva-pharmacy-benefits/
- https://news.va.gov/141648/affordable-dental-insurance-champva/
If you have any questions, please give Thompson Insurance a call (843) 369-5433.