The first pension benefits for dependents of disabled Veterans came following the War of 1812.
However, the expansion of these deserved benefits to include education and healthcare benefits took decades to arrive.
On June 29, 1956 dependents of disabled Veterans began to receive education benefits, which I discussed in my last post.
On August 2, 1973 dependents finally began receiving healthcare assistance with the creation of the Civilian Health and Medical Program of VA or CHAMPVA.
CHAMPVA is entirely different from TRICARE, the Department of Defense program for active duty military and retirees including their dependents.
This post will overview CHAMPVA, provide eligibility information and explain how to apply for these benefits.
CHAMPVA is a cost sharing healthcare program administered by VA and covers most medically necessary care and equipment.
There is an annual deductible and “catastrophic cap” required from beneficiaries each calendar year.
The mandatory deductible is $50 per person but only $100 per entire family.
CHAMPVA will then pay 75% of allowable charges up to an aggregate $3,000 including beneficiary expenses, after which CHAMPVA will pay 100% of allowable charges.
CHAMPVA, like Veterans healthcare coverage, satisfies Affordable Care Act or ACA requirements.
CHAMPVA is available to dependents of Veterans that meet any of the following criteria:
- Rated permanently and totally disabled due to a service-connected disability
- Rated permanently and totally disabled due to a service-connected condition at the time of death
- Died of a service-connected disability
- Died on active duty and the dependents are not otherwise eligible for TRICARE benefits
Important, spouses lose eligibility if divorce or annulment occurs and widow(er)s lose eligibility if remarriage occurs before age 55.
Children lose eligibility at age 18, or 23 if enrolled in college, and stepchildren lose eligibility when no longer living with the Veteran.
Dependents eligible for both CHAMPVA and TRICARE may not receive both at the same time.
Further, TRICARE is required for spouses of military retirees and service members killed in action.
While CHAMPVA does not include dental coverage, VA recently began offering this option and beneficiaries must contact the following providers directly:
- Met Life 1-888-310-1681
- Delta Dental 1-855-370-3303
CHAMPVA is an excellent resource for eligible beneficiaries and does not require healthcare treatment at VA facilities, although some VA hospitals are willing to provide care to CHAMPVA beneficiaries.
While there is no CHAMPVA provider directory, most TRICARE providers accept CHAMPVA.
Before applying, ensure the local VA Regional Office has verified your dependent status.
Filing a Claim or have questions About the VA disability claims process?
The attorneys at Hill & Ponton are here to support you in your claim.
If you are intending to appeal a denied claim, you can contact us for an evaluation.
We also offer a free ebook The Road to VA Compensation Benefits, to help break down the claims process from start to finish.
Click the link below to learn more.
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