We Speak Veteran™

Veterans Advantage Financial™

We Speak Veteran™

Certified Medicare Insurance Planner™* | Retirement Income Certified Professional®*

Medicare | Retirement | Life Insurance | Veterans Only

Table of Contents

What Is VA Health Insurance Called?

VA health insurance is a term used to describe the health insurance program offered by the United States Department of Veterans Affairs. The VA health insurance program provides coverage for veterans and their families, including those with service-connected disabilities.

The Civilian Health and Medical Program (CHAMPVA) of the Department of Veterans Affairs (VA) is a healthcare benefits plan that distributes the price of approved healthcare treatments and equipment to eligible members.

We will discuss what VA health insurance is called, as well as some of the benefits that come with it. We hope that this information will be helpful to you!

What is Civilian Health and Medical Program of the Department of Veterans Affairs Champva?

The Department of Veterans Affairs Civilian Health and Medical Program (CHAMPVA) is a health insurance plan that offers extensive medical and dental care coverage to qualifying veterans and their families. CHAMPVA is administered by the Veterans Health Administration (VHA) and is available to enrolled veterans who do not have access to other health insurance coverage.

The VHA healthcare program offers comprehensive medical care to enrolled veterans and their families, including preventive care, hospitalization, mental health services, and prescription drug coverage. CHAMPVA also provides coverage for certain types of long-term care services.

To be eligible for CHAMPVA, veterans must have a service-connected disability rating of 50% or higher or be rated as Totally Disabled due to a service-related injury. Veterans who are not qualified for CHAMPVA may be qualified for healthcare under the Veterans Health Administration (VHA).

CHAMPVA provides comprehensive medical and some dental care benefits to eligible veterans and their families. Some of the benefits covered by CHAMPVA include:

  • Preventive care
  • Hospitalization
  • Mental health services
  • Prescription drug coverage
  • Certain types of long-term care services.

What is Covered With CHAMPVA?

CHAMPVA will cover the cost of many medical services and supplies deemed necessary by an authorized provider. That covers both inpatient and outpatient care. That includes mental health, family planning, skilled nursing care, and hospice. Additionally, it covers ambulance transport and more.

There are, however, a few things that CHAMPVA will not cover. These include:

  • Most dental care
  • Cosmetic surgery
  • Acupuncture
  • Private-duty nursing
  • Custodial or personal care
  • Sitters or homemakers
  • Air filters, blood pressure cuffs, and canes are examples of durable medical equipment for use at home (DME). However, DME related to prosthetics or orthotics following a traumatic injury is covered.

Veterans Affairs health insurance plans are an excellent option for veterans and their families who need comprehensive coverage. Several different types of plans are available, each with its own set of benefits. In addition, VA health insurance plans are available to veterans, spouses, and dependent children.

How Do You Qualify for CHAMPVA Benefits?

CHAMPVA is offered to adults 65 and older who are Medicare-qualified. Suppose you turned 65 before June 5, 2001, and are eligible for Medicare Part A or B. In that case, you must enroll in Medicare Part B to be eligible for CHAMPVA. You cannot be eligible for both CHAMPVA and TRICARE.

You may be eligible for CHAMPVA if you are the spouse or child of a Veteran who has been rated as having a service-connected disability by the Veterans Administration (VA), or if the Veteran died as a result of a service-connected condition. You may also be eligible if you are the surviving spouse or child of a Veteran who died while on active service or as a result of an accident or sickness sustained while serving.

What is Difference Between TRICARE and CHAMPVA?

TRICARE is a healthcare program for active-duty, retired, and their families in the military. CHAMPVA is a health insurance program for veterans and their dependents. Both programs provide comprehensive medical coverage, but there are some key differences.

TRICARE has no enrollment fee but does require beneficiaries to pay copayments for some services. There is an enrollment fee for CHAMPVA, but beneficiaries do not have to pay copayments for most services.

TRICARE offers three health plan options: Prime, Select, and Extra. CHAMPVA offers two plan options: Standard and Extended. TRICARE Prime is a managed care program that encourages members to use authorized providers. CHAMPVA Standard is a fee-for-service option that allows beneficiaries to see any provider who accepts CHAMPVA.

TRICARE Select is a preferred provider organization (PPO) that allows beneficiaries to see any TRICARE-authorized provider but offers lower out-of-pocket costs when using network providers. CHAMPVA Extended is an option for beneficiaries who need long-term care or have chronic health conditions. It provides comprehensive coverage and higher benefit levels than standard but also has a higher monthly premium.

Either TRICARE or CHAMPVA does not cover certain services. These include cosmetic surgery, dental care (except for medically necessary services), and private-duty nursing. However, veterans may be able to receive coverage for these services through other programs, such as the Department of Veterans Affairs (VA) or TRICARE Supplement.

Can You Have both TRICARE and CHAMPVA?

You cannot be qualified for TRICARE if you wish to CHAMPVA. CHAMPVA coverage is offered to the spouse or widow(er) and dependant children of a Veteran who has been rated permanently and completely handicapped as a result of a service-related disability, died as a result of a service-related injury, or died while on active duty and was not eligible for TRICARE coverage

To be eligible for TRICARE, you must be one of the following:

  • An active duty service member
  • A retired service member
  • An honorably discharged veteran
  • A spouse or dependent child of any of the above categories

If you are eligible for CHAMPVA and TRICARE, you must choose which one you want to enroll in. You can only have coverage under one of these programs at a time.

How Do I Get Proof of VA Health Insurance?

You can get proof of your VA health insurance in a few different ways. One way is to ask for a printout of your insurance card from your doctor or other providers. Often, providers will keep a copy on file that they can give you. You can also ask the Veterans Affairs office for a copy of your insurance card. Finally, most health insurers will provide you with an electronic version of your insurance card that you can access online or through their mobile app. Whichever method you choose, be sure to have your identification information handy so that you can accurately verify your coverage.

Make Appointment with Chris Duncan

Scroll to Top