If you are a Civilian Health and Medical Program of VA (CHAMPVA) beneficiary—meaning you’re the spouse, widow(er) or child of an eligible Veteran—and you also have other health insurance, you might wonder: How do they work together?
Here’s what you need to know to get the most from your coverage.
Can I use CHAMPVA if I have other health insurance?
Yes, you can have both CHAMPVA and other health insurance. Here’s how it works:
- Your provider bills your other health insurance first.
- Once they get the Explanation of Benefits (EOB), they send it and the bill to CHAMPVA. CHAMPVA can help cover what’s left, like deductibles, co-pays and co-insurance, up to the allowable amount.
Helpful tip: Most providers handle the CHAMPVA part for you. But if your provider does not, just ask for a copy of the claim and EOB from your other health insurance so you can send it directly to CHAMPVA yourself.
When does CHAMPVA pay first?
In most cases, CHAMPVA pays after your other insurance, but there are a few exceptions where CHAMPVA is the primary payer:
- Medicaid.
- State Victims of Crime Compensation Programs.
- Indian Health Service.
- CHAMPVA supplemental insurance.
Need to submit or update your other insurance information?
No problem—just use the online CHAMPVA Other Insurance Certification form (VA Form 10-7959c). This form is also for first-time applications, or you can use it to update your phone number, address or other information. You can also fax or mail the form.
- Online: Visit CHAMPVA Other Insurance Certification.
- Fax: Download the form and fax it to 303-331-7808.
- Mail:
VHA Office of Integrated Veteran Care
CHAMPVA Beneficiary Claims
P.O. Box 500
Spring City, PA 19475
Thinking about a Health Insurance Marketplace plan?
Yes, you can enroll in Health Insurance Marketplace coverage, but there is a catch: If you have CHAMPVA, you won’t qualify for financial assistance, like advance premium tax credits (APTC) or cost-sharing reductions. If you get these credits by mistake, you may need to repay some or all of the APTC when you file your taxes.
Bottom line: Don’t drop CHAMPVA just because you get a Health Insurance Marketplace plan. It can still help with medical costs.
For more information, visit IRS.gov and healthcare.gov.
What about Medicare?
You can have both Medicare and CHAMPVA as long as you have both Medicare Part A (hospital coverage) and Part B (doctor visits). CHAMPVA can help cover costs Medicare doesn’t cover. Just remember, CHAMPVA doesn’t cover Medicare Part B premiums, and you’ll need to provide proof of both Parts A and B to stay eligible.
Need help?
If you have questions about how your benefits work:
- Call: 800-733-8387 (TTY: 711), Monday through Friday, 8 a.m. to 7:30 p.m. ET.
- Online: Visit Ask VA.
About CHAMPVA
CHAMPVA is a health care program for qualified spouses, widows(ers) and children of eligible Veterans. Through CHAMPVA, VA shares the cost of certain health care services and supplies with eligible beneficiaries. You may be eligible for CHAMPVA if you don’t qualify for TRICARE, the Defense Department’s health care program.
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Have had CHAMPVA for years, since retiring and being on Medicare, with CHAMPVA now being secondary. I have also been on a Medicare Advantage plan for a few years, all worked together fine. Last December, all of a sudden my pharmacy benefits were being held, pending “other insurance “. Nothing has changed, I have NEVER had pharmacy insurance thru the Medicare Advantage plan. Ever. After three tries, got thru and the person said it would be fixed, but would take about 30-45 days to complete. After more than 60 days with no change, called again, this person said they could see the request was not uploaded properly. So she made the change again, making sure it went thru this time. Another 30-45 days to wait. Up to about 45 days + now, no change so far. Meanwhile no coverage for meds, hoping for a fix soon. No idea why they thought I had other pharmacy insurance to begin with, ONLY other coverage thru Medicare would be for things like cancer drugs, that part B covers. And wondering if they make the corrections while on the line, why does it take 30-45 days to take effect? May have to call again…
By the way, the “call back” feature hasn’t worked so far, they never call back. Call around 4:30 pm, and expect to wait an hour or two anyway.
This is always a lot of excellent information for all of our Families , &’Thank God for all of the (Bar None) best Benefits for our loved ones &’us as Veterans..found anywhere in the world…Thank You VA
Can my spouse use CHAMPVA if we have Tricare select? We are part of Tricare West because I am retired from the Army. I have been using only the VA but my wife uses Tricare.
Is CHAMP VA coverage a primary or secondary health insurance? Thank you.
We didn’t have any problem with my wife to get on Champ VA but I had the DAV handle it. Any problems, maybe you should contact them or American Legion.
What can be done for the unacceptable wait time for processing into the system? Been trying to get spouse covered for six months.
I would love to get more guidance on this. However, I’ve tried to call and get assist several times, and the wait times were so long, it’s as if they want you to give up. Did that office get DOGE’d?
I have been waiting over a year on my application, it was faxed twice and mailed via certified mail. I placed a help ticket and still no answer as to my CHAMPVA insurance. Also called helpline and on both occasions on hold over 6 hours and had to abort the call.
Lisa, same thing happened to me, if your significant other is the veteran, call using their phone, it will prompt you to leave number to call you back, use their phone as call back number and be prepared to answer on their phone, I know this sounds crazy, BUT for whatever reason they respond to the veterans number, I know , I know WTH!! Totally annoying!!! It has been the ONLY way I can speak to an actual person with ChampVa, good luck!!!