How to Get Health Coverage Through the VA CHAMPVA Program

If your loved one served in the U.S. military and has a permanent and total (P&T) service-connected disability, you may qualify for CHAMPVA — the Civilian Health and Medical Program of the Department of Veterans Affairs.

This program helps spouses, dependents, and survivors of eligible Veterans pay for health care costs by sharing expenses for doctor visits, hospital stays, prescriptions, and more.

Learn more directly from the VA here: 👉 https://www.va.gov/family-and-caregiver-benefits/health-and-disability/champva/

🇺🇸 1. What Is CHAMPVA?

CHAMPVA is a cost-sharing health coverage program administered by the VA. It is not the same as TRICARE. CHAMPVA covers most medically necessary care and supplies — inpatient and outpatient services, mental health treatment, prescriptions, and preventive care — when provided by approved health-care providers.

Official VA overview: 🔗 CHAMPVA Information Page

✅ 2. Who’s Eligible

To qualify for CHAMPVA, both the Veteran and the family member must meet certain criteria.

For the Veteran:

• The Veteran must have been rated permanently and totally disabled (P&T) due to a service-connected disability, or

• The Veteran died as a result of a service-connected condition, or

• At the time of death, the Veteran was P&T due to a service-connected condition.

• The Veteran is not eligible for DoD TRICARE coverage (active duty or retired military families are usually TRICARE-eligible, not CHAMPVA).

For the Spouse, Widow, or Dependent:

• Must not be eligible for TRICARE.

• If age 65 or older, must have Medicare Parts A and B.

• Surviving spouses lose eligibility if they remarry before age 55 (unless the remarriage ends or they remarry after age 55).

• Biological and adopted children may also qualify until age 18, or 23 if enrolled full-time in school.

Full eligibility details: 🔗 VA CHAMPVA Eligibility Requirements

🧾 3. What CHAMPVA Covers

CHAMPVA helps cover:

• Doctor and specialist visits

• Hospital stays and surgeries

• Mental health care

• Prescription medications

• Medical equipment and supplies

• Ambulance services

• Preventive care

It works like traditional health insurance — the VA pays a portion, and you may owe a small copayment (typically 25% of the allowed amount).

More about benefits and covered services: 🔗 VA CHAMPVA Benefits Overview

📝 4. How to Apply

CHAMPVA Application Checklist

1. Complete VA Form 10-10D – Application for CHAMPVA Benefits 📄 Download VA Form 10-10D (PDF) More info: Application Instructions

2. Include copies of these supporting documents:

   • Marriage certificate (for spouses)

   • Birth certificate (for dependent children)

   • The Veteran’s VA disability rating letter or DD-214 discharge papers

   • Proof of other health insurance (if applicable)

   • Medicare card (if age 65+)

3. If you have other health insurance, complete VA Form 10-7959C – Other Health Insurance Certification 📄 Download VA Form 10-7959C (PDF)

4. Mail your completed forms and documentation to:

   VA Health Administration Center CHAMPVA Eligibility PO Box 469028 Denver, CO 80246-9028

   Fax: 1-303-331-7809

💳 5. Using CHAMPVA Benefits

Once approved, you’ll receive a CHAMPVA ID card and a benefits handbook.

How it works:

• Present your CHAMPVA ID to any provider who accepts it.

• If the provider doesn’t bill VA directly, pay upfront and file a claim using VA Form 10-7959A – CHAMPVA Claim Form. 📄 Download VA Form 10-7959A (PDF) How to file a claim: VA Claim Instructions

For pharmacy coverage:

• CHAMPVA uses OptumRx for prescriptions. Learn more: CHAMPVA Pharmacy Benefits

🕵️ 6. If You Already Have Medicare or Other Insurance

CHAMPVA acts as secondary insurance to Medicare, Medicaid, or private insurance. That means CHAMPVA covers most remaining costs after the primary payer.

Details on Medicare and CHAMPVA coordination: 🔗 CHAMPVA and Medicare

☎️ 7. Need Help?

For questions or help with your application:

• Call CHAMPVA Help Line: 1-800-733-8387 (Mon–Fri, 8 a.m.–8 p.m. ET)

• Email: hac.inq@va.gov

• Mailing address: CHAMPVA, PO Box 469028, Denver, CO 80246-9028

You can also get personalized support by contacting your local VA Caregiver Support Coordinator: 👉 Find a VA Caregiver Support Coordinator

❤️ 8. Final Tips

• If the Veteran’s disability rating changes to permanent and total (P&T), update CHAMPVA right away to add dependents.

• If you’re applying as a surviving spouse, attach the Veteran’s death certificate showing the service-connected cause of death.

• Keep copies of all documents you submit.

• Processing can take 6–12 weeks — you can call to check status.