News article, Do you receive CHAMPVA benefits and have other health insurance? Read this. https://news.va.gov/139919/receive-champva-benefits-other-health-insurance/
CHAMPVA (Civilian Health and Medical Program of VA) 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.
If you are a CHAMPVA beneficiary and have other health insurance (OHI), then here’s what you need to know.
Can I use CHAMPVA if I have other health insurance?
Yes, you can have both CHAMPVA and other health insurance.
- 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. If not, then ask for a copy of the claim and EOB from your other health insurance and send it directly to CHAMPVA yourself.
When does CHAMPVA pay first?
CHAMPVA pays after your other insurance with a few exceptions:
- Medicaid.
- State Victims of Crime CompensationPrograms.
- Indian Health Service.
- CHAMPVA supplemental insurance.
Need to submit or update your OHI?
No problem—just submit the CHAMPVA Other Insurance Certification form (VA Form 10- 7959c). You must submit this form if your OHI changes to include receiving Medicare.
- Online: https://www.va.gov/family-and-caregiver-benefits/health-and-disability/ champva/submit-other-insurance-form-10- 7959c/introduction
- Fax: https://www.va.gov/find-forms/about-form-10-7959c/ and fax 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?
You can enroll in Health Insurance Marketplace (HIM) coverage, but 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 the APTC when you file your taxes.
Bottom line: Don’t drop CHAMPVA just because you get a HIM plan. It can still help with medical costs. Visit IRS.gov and healthcare.gov.
What about Medicare?
You can have both Medicare and CHAMPVA if you have both Medicare Part A and Part B. CHAMPVA can help cover costs Medicare doesn’t (Part B premiums not covered) You’ll need to provide proof of both Parts A and B to stay eligible.
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: https://ask.va.gov/
Brad Anderson and Melissa Crandall are the Lake County Veterans Service Officers and can be reached at 218.834.8326 or cvso@co.lake.mn.us
Karen Christianson is the Cook County Veterans Service Officer and can be reached at 218.387.3639, or karen.christianson@co.cook.mn.us
