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CHAMPVA

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. The program is administered by the Veterans Health Administration Office of Community Care (VHA CC) in Denver, Colorado.

Due to the similarity between CHAMPVA and the Department of Defense (DoD) TRICARE program (sometimes referred to by its old name, CHAMPUS), the two are often mistaken for each other. CHAMPVA is a Department of Veterans Affairs program; TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors. In some cases a Veteran may appear to be eligible for both/either program on paper. However, if you are a military retiree, or the spouse of a Veteran who was killed in action, you are and will always be a TRICARE beneficiary; you can´t choose between the two.

 Eligibility  |  Benefits  |  Locating a Provider  |  How to File a Claim
Other Health Insurance  |  Change of Address  |  Contacting CHAMPVA

CHAMPVA and the Affordable Care Act

The Affordable Care Act (ACA) is a health care law that was created to expand access to affordable health care coverage for all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will have health coverage that meets a minimum standard (called "minimum essential coverage"). The health care law designates CHAMPVA as fulfilling the minimum essential coverage requirement.

If you are enrolled in CHAMPVA, you do not need to take additional steps to meet the health care law coverage standards. The ACA does not change CHAMPVA benefits or out-of-pocket costs. For additional information, view the ACA information on the VA website at http://www.va.gov/aca or call our customer service center at 1-800-733-8387.

•  Fact Sheet 01-19: CHAMPVA and the Affordable Care Act (ACA)
•  Fact Sheet 01-19A: CHAMPVA and the ACA–Frequently Asked Questions

CHAMPVA will send IRS Form 1095-B, Health Coverage, annually. For 2016, the IRS has extended the deadline for filing Form 1095-B. For more information, please visit https://www.irs.gov.


CHAMPVA eligibility and how to apply

For detailed information on CHAMPVA eligibility and for instructions on how to apply for CHAMPVA, please visit our CHAMPVA Eligibility page and How to Apply for CHAMPVA page respectively.

Benefits

In general, CHAMPVA covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive a CHAMPVA Program Guide that specifically addresses covered and non-covered services and supplies. For a complete listing of non-covered services and supplies please consult the CHAMPVA Policy Manual.

You can also find more information about CHAMPVA in one of our CHAMPVA Fact Sheets and other CHAMPVA documents available on our Publications page.

Pharmacy benefits

Meds by Mail: Meds by Mail is a voluntary service that provides a safe, easy and cost-free way for eligible CHAMPVA and Spina Bifida beneficiaries to receive non-urgent maintenance medications delivered right to your door.

OptumRx (formerly Catamaran) Retail Pharmacy Network: OptumRx electronically processes pharmacy claims nationwide, including Puerto Rico, Guam, and the Virgin Islands. Beneficiaries are serviced through a network of over 82,000 retail pharmacies. When you use a OptumRx pharmacy, the pharmacy may collect a 25% cost share (after the annual deductible has been met) before submiting the claim – saving you time.

Visit our Pharmacy Benefits page for more information.

Locating a provider

CHAMPVA is an open network government health benefit program and has no designated network of providers. For information on locating providers, please visit our Locating a Provider page.

Other health insurance (OHI)

If you have any other health insurance (OHI), you must notify VHA CC of any changes (dropped insurance, changes in health plans, etc.) immediately upon those changes taking effect so that proper payment can be made on your claims.

If you obtain a major medical policy, you must also notify VHA CC that you have a new policy and when it takes effect. We offer several methods to update your other health insurance file. You can fax a signed, completed Other Health Insurance (OHI) Certification, VA Form 10-7959c to 303-331-7808, or mail it to:

CHAMPVA
POB 469063
Denver, CO 80246-9063

You can also inform us of your insurance information by calling our Customer Service Center at 1-800-733-8387 with the name of the insurance company, type of policy, and effective dates of the policy.

More information about OHI

 

How to file a CHAMPVA claim

For information on how to file a CHAMPVA claim, please visit our CHAMPVA claims page.

Change of address

If you change your address, it is vital that you update your address with CHAMPVA. CHAMPVA beneficiaries have several options to update address information. You can change your address by using one of the three contact options below. Please sign and date mailed address change requests. If calling to update your address, please have available your old address information, as our customer service representatives will need to verify this infomation before updating your file.

Contacting CHAMPVA

Phone 1-800-733-8387
8:05 a.m. to 7:30 p.m. EST
Monday through Friday
Email Inquiry Routing & Information System (IRIS)
Mail CHAMPVA
POB 469063
Denver CO 80246-9063

Additional self-service options for CHAMPVA providers

Eligibility, other health insurance
coverage, and claims
Interactive Voice Response (IVR) System
1-800-733-8387
Payment details Vendor Inquiry System
https://www.vis.fsc.va.gov/login.aspx
Eligibility/Claims status inquiry
(Payer ID: VAHAC)
AND
Medical claims/Electronic remittance
advice (ERA) (Payer ID: 84146)
Change Health care (formerly Emdeon Inc.) electronic claim submissions
http://www.emdeon.com
or 1-800-845-6592
For more information on receiving ERAs from VHA CC, please refer to our Electronic claims—Information for providers page.

More information

You can also find a list of addresses and phone numbers for all of the Office of Community Care’s various health care programs on our VHACC Contact Information page.