As a primary family caregiver for a Veteran, you have a lot competing for your attention during the winter holiday season.

With multiple responsibilities, it may be difficult to prioritize your own well-being over others who need you daily. To help you with this, the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) offers supportive benefits for the primary family caregiver, especially if you do not have another health care plan.

Not enrolled? Your local VA caregiver support coordinator can help you enroll if you already participate in the Program of Comprehensive Assistance for Family Caregivers.

Providers who accept CHAMPVA can help you set up a health care routine and mental health counseling. It all starts with taking the first step. Once you’re on your way, these benefits can help improve your physical and mental health, allowing you to focus on caring for your Veteran. In addition, CHAMPVA offers financial relief and budget flexibility to eligible caregivers if you don’t have other health insurance.

You can also save on additional pharmacy costs through the OptumRx pharmacy benefits manager and Meds by Mail home delivery. Meds by Mail can help you regain precious time from traveling to pick up your prescriptions and waiting in long lines.

Who is eligible?

You may be eligible for CHAMPVA if you participate in the VA Program of Comprehensive Assistance for Family Caregivers, are over 18 years old and have no other health insurance. Other health insurance includes TRICARE, Medicare, Medicaid, commercial employer, individual health plans and others.

If you have other health insurance and are considering CHAMPVA as a replacement, there are some disadvantages you should know about. For example, Medicaid recipients may have a smaller financial responsibility than they would under CHAMPVA. Another consideration is some health plans have more comprehensive medical benefit services than CHAMPVA. There are other important facts to consider as well.

More information is available in the CHAMPVA Caregiver Support Program Guide.

Benefits covered by CHAMPVA

CHAMPVA covers common health care services, such as:

  • Mental health care (counseling, therapy and medication)
  • Prescriptions
  • Provider office visits
  • Hospital services, including emergency room visits
  • Lab and radiology services
  • Durable medical equipment

What CHAMPVA pays

CHAMPVA pays up to 75% of the allowable amount for covered outpatient benefits, usually the same as the Medicare allowable amount. You are responsible for an annual deductible of $50 plus your cost-share, which is usually 25% of the CHAMPVA allowable amount. CHAMPVA also has a catastrophic cap of $3,000 each year to provide financial protection against the impact of a long-term illness or serious injury.

There’s no deductible for inpatient services, ambulatory surgery facility services, partial psychiatric day programs, hospice services or services provided at VA medical facilities.

Customer service representatives can answer your questions about CHAMPVA at 800-733-8387, Monday-Friday, 8 a.m. to 7:30 p.m. ET. You can also visit our Information for Caregivers webpage.

CHAMPVA coverage is part of a package for caregivers

CHAMPVA coverage is only one part of the support available to family care givers. You also have access to the VA Caregiver Support Program that includes counseling, education, moral support and other benefits.

Participants in the VA family caregiver program can request CHAMPVA through their local caregiver support program team, by contacting the Caregiver Support Line at 855-260-3274 or applying online. 

View this video on how to apply for the Program of Comprehensive Assistance for Family Caregivers.

Support and resources

Topics in this story

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