CHAMPVA: Health Coverage for Veterans' Dependents

What is CHAMPVA?

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides health insurance coverage to the spouse, surviving spouse, and dependent children of veterans who meet specific criteria.

CHAMPVA is not the same as TRICARE. It is a separate program specifically for dependents of veterans with permanent and total service-connected disabilities.

Eligibility

You may be eligible for CHAMPVA if you are the spouse, surviving spouse, or dependent child of a veteran who:

1. Is rated permanently and totally disabled due to a service-connected condition, OR
2. Died from a service-connected disability, OR
3. Was rated permanently and totally disabled at the time of death from any cause

Who is NOT eligible

• Anyone eligible for or enrolled in TRICARE (including TRICARE For Life)

Medicare requirement

• If you’re eligible for Medicare, you generally need Medicare Part A and Part B — or a Medicare Advantage (Part C) plan — to get or keep CHAMPVA. CHAMPVA then pays after Medicare. A narrow grandfathered exception under 38 CFR § 17.271(b)(4)–(5) covers people who were already 65 or older before June 5, 2001, are entitled to Part A, and had not purchased Part B; those who had purchased Part B must keep it. Confirm your specific eligibility with CHAMPVA before changing Medicare coverage.

Dependent children eligibility

• Under age 18
• Ages 18-23 if enrolled in high school, college, or another educational institution
• Age 18 or older if permanently unable to support themselves because of a disability that began before age 18

A child who is 18 or older, not in school, and not disabled loses CHAMPVA at 18.

What CHAMPVA covers

CHAMPVA covers most medically necessary health care services, including:

• Doctor visits — Primary care and specialist appointments
• Hospital care — Inpatient and outpatient services
• Mental health — Outpatient therapy, inpatient psychiatric care
• Prescriptions — Through the Meds by Mail program or retail pharmacies
• Preventive care — Screenings, immunizations, well-child visits
• Maternity care — Prenatal, delivery, and postnatal care
• Durable medical equipment — Such as wheelchairs and prosthetics
• Ambulance services — Emergency transport
• Skilled nursing care — When medically necessary
• Hospice care — End-of-life care services

What CHAMPVA does NOT cover

• Routine dental care (dental care is covered only in limited cases, with prior approval)
• Eyeglasses and contact lenses, except in certain cases
• Cosmetic surgery
• Experimental treatments
• Services not medically necessary
• Care from non-authorized providers (in most cases)

Costs

After your household reaches the $3,000 catastrophic cap, you don’t pay a cost share for covered services for the rest of the calendar year.

Prescription costs

• Meds by Mail: No cost (no deductible, cost share, or copay) for maintenance medications — but only if you have no other health insurance with prescription coverage
• Retail pharmacy: Deductible and 25% cost share of the CHAMPVA allowable amount apply

How to apply

Step 1: Gather required documents

• VA Form 10-10d (CHAMPVA Application)
• VA Form 10-7959c (CHAMPVA Other Health Insurance Certification) — if you have other insurance
• Copy of the veteran’s VA rating decision showing permanent and total disability
• Marriage certificate (for spouse)
• Birth certificate (for children)
• Medicare card (if applicable)
• Divorce decree (for former spouses, if applicable)

Step 2: Submit your application

Online: Apply on VA.gov.

By mail: VHA Office of Community Care CHAMPVA Eligibility PO Box 137 Spring City, PA 19475

By fax: 303-331-7809

Step 3: Wait for processing

VA doesn’t publish a standard processing time for CHAMPVA applications. You’ll receive a CHAMPVA identification card once approved.

Using CHAMPVA with other insurance

CHAMPVA + Medicare

If you have both Medicare and CHAMPVA:

• Medicare pays first (primary)
• CHAMPVA pays most of the remaining balance (secondary)
• This combination often results in little to no out-of-pocket costs

CHAMPVA + Other Health Insurance (OHI)

If you have employer-sponsored or other health insurance:

• OHI pays first
• CHAMPVA pays the remaining covered costs up to the CHAMPVA allowable amount
• You must report other insurance to CHAMPVA using VA Form 10-7959c

Tips

1. Use Meds by Mail — If CHAMPVA is your only prescription coverage, maintenance medications are free through VA’s mail-order pharmacy program
2. Keep documentation current — Report any changes in other insurance, marital status, or dependent status promptly
3. Pre-authorize when possible — Some services require prior authorization. Check with CHAMPVA before scheduling non-emergency procedures
4. Know where to send claims — CHAMPVA claims and correspondence go to CHAMPVA in Spring City, PA; check VA.gov for the current claims address before mailing

Connection to VA disability rating

CHAMPVA eligibility is directly tied to the veteran’s disability status:

• The veteran must be rated permanent and total (P&T) — a combined 100% rating alone may not qualify if not designated as permanent
• If VA grants P&T with an earlier effective date, contact CHAMPVA about care received after that date — claim filing deadlines apply
• Check your rating decision letter for the words “permanent and total” — if you’re 100% but not P&T, you may need to request a review

Use our VA disability calculator to understand your combined rating. If you’re close to 100%, explore whether TDIU could help you reach permanent and total status.

Correction — October 21, 2026: Added the narrow Medicare Part B grandfathered exception.

This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance, consult a VA-accredited VSO, attorney, or claims agent.