Chapter 12 Dependents and Survivors
Federal Benefits for Veterans, Dependents and Survivors
Federal Benefits for Veterans, Dependents and Survivors
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). Under CHAMPVA, certain dependents and survivors can receive reimbursement for most medical expenses – inpatient, outpatient, mental health, prescription medication, skilled nursing care and durable medical equipment.
Eligibility: To be eligible for CHAMPVA, an individual cannot be eligible for TRICARE (the medical program for civilian dependents provided by DoD) and must be one of the following:
- The spouse or child of a Veteran whom VA has rated permanently and totally disabled due to a service-connected disability.
- The surviving spouse or child of a Veteran who died from a VA- rated service-connected disability, or who, at the time of death, was rated permanently and totally disabled.
- The surviving spouse or child of a Veteran who died on active duty service and in the line of duty, not due to misconduct. However, in most of these cases, these family members are eligible for TRICARE, not CHAMPVA.
A surviving spouse under age 55 who remarries loses CHAMPVA eligibility at midnight of the date on remarriage. He/she may re-establish eligibility if the remarriage ends by death, divorce or annulment effective the first day of the month following the termination of the remarriage or December 1, 1999, whichever is later. A surviving spouse who remarries after age 55 does not lose eligibility upon remarriage.
For those who have Medicare entitlement or other health insurance, CHAMPVA is a secondary payer. Beneficiaries with Medicare must be enrolled in Parts A&B to maintain CHAMPVA eligibility. For additional information, contact the Chief Business Office Purchased Care at the VA Health Administration Center, CHAMPVA, P.O. Box 469028, Denver, CO 80246, call 1-800-733-8387 or visit www.va.gov/hac/forbeneficiaries/champva/champva.asp.
Many VA health care facilities provide services to CHAMPVA beneficiaries under the CHAMPVA In-house Treatment Initiative (CITI) program. Contact the nearest VA health care facility to determine if it participates. Beneficiaries who use a CITI facility incur no cost for services; however, services are provided on a space- available basis, after the needs of Veterans are met. Not all services are available at all times. The coverage of services is dependent upon the CHAMPVA benefit coverage. CHAMPVA beneficiaries who are covered by Medicare cannot use CITI.
VA’s Comprehensive Assistance for Family Caregivers Program entitles the designated Primary Family Caregiver, who is without health insurance coverage, CHAMPVA benefits. Some of the health plans that would make a Primary Family Caregiver ineligible for CHAMPVA benefits include Medicare, Medicaid, commercial health plans through employment and individual plans.
Children Born with Spina Bifida to Certain Vietnam or Korea Veterans: The Spina Bifida (SB) Health Care Benefits Program is a health care benefits program administered by the Department of Veterans Affairs for birth children of certain Vietnam and Korea Veterans who have been diagnosed with spina bifida (except spina bifida occulta). The SB Health Care Benefits Program provides reimbursement for covered medical services and supplies, such as inpatient and outpatient medical services, pharmacy, durable medical equipment, and supplies. The Chief Business Office Purchased Care in Denver, Colorado manages the SB Health Benefits Program, including the authorization of benefits and the subsequent processing and payment of health care claims. For more information about spina bifida health care benefits, call 1-888-820-1756 or visit http://www.va.gov/hac/forbeneficiaries/spina/spina.asp
Eligibility: To be eligible for the SB Health Care Benefits Program, the child must have received a monetary award under the Veterans Benefits Administration (VBA). The Denver VA Regional Office makes the determination regarding this entitlement. VBA notifies the Chief Business Office Purchased Care after an award is made and the eligible child is enrolled in the SB Health Care Benefits Program.
Children of Women Vietnam Veterans (CWVV) Born with Certain Birth Defects: The CWVV Health Care Program is a federal health benefits program administered by the Department of Veterans Affairs for children of women Vietnam Veterans born with certain birth defects. The CWVV Program provides reimbursement for medical care related to covered birth defects and conditions associated with the covered birth defect except for spina bifida. For more information about benefits for children with birth defects, call 1-888-820-1756 or visit www.va.gov/hac/forbeneficiaries/spina/spina.asp
Eligibility: To be eligible for the CWVV Program, the child must have received a monetary award under VBA. The Denver VA Regional Office makes determination regarding this entitlement. VBA notifies the Chief Business Office Purchased Care after an award is made and the eligible child is enrolled in CWVV.
Bereavement Counseling: VA Vet Centers provide bereavement counseling to all family members including spouses, children, parents, and siblings of Servicemembers who die while on active duty. This includes federally activated members of the National Guard and reserve components. Bereavement services may be accessed by calling (202) 461-6530.
Bereavement Counseling related to Veterans: Bereavement counseling is available through any VA medical center to immediate family members of Veterans who die unexpectedly or while participating in a VA hospice or similar program, as long as the immediate family members had been receiving family support services in connection with or in furtherance of the Veteran’s treatment. (In other cases, bereavement counseling is available to the Veteran’s legal guardian or the individual with whom the Veteran had certified an intention to live, as long as the guardian or individual had been receiving covered family support services.) This bereavement counseling is of limited duration and may only be authorized up to 60 days. However, VA medical center directors.
|Basic Payment Rate||$1,233.23|
|Each Dependent Child||$305.52|
|Aid and Attendance||$305.52|
Special Allowances Add $261.87 if the Veteran was totally disabled eight continuous have authority to approve a longer period of time when medically indicated. Contact the Social Work Service at the nearest VA medical center to access bereavement counseling.
Dependents/Survivors and the Health Care Law
The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to 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”) by January 1, 2014;
- qualify for an exemption; or
- pay a fee when filing their taxes if they have affordable options but remain uninsured.
Key Information for Family Members about the Health Care Law
- VA wants all Veterans and their families to receive health care that improves their health and well-being.
- Family members are a key part of Veterans’ good health and support network.
- Dependents/survivors enrolled in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) or the Spina Bifida Health Care Program meet the requirement to have health care coverage under the health care law and do not need to take any additional steps. The health care law does not change CHAMPVA or Spina Bifida benefits, access to care, or out-of-pocket costs.
Veterans’ family members who do not have coverage that meets the health care law’s standard should consider their options through the Health Insurance Marketplace, which is a new way to shop for and purchase private health insurance. Family members may also get lower costs on monthly premiums or out-of-pocket costs or be eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). For more information about the Health Insurance Marketplace, visit www.healthcare.gov or call 1-800-318-2596. For additional information about the VA and the health care law, visit www.va.gov/aca or call 1-877-222-VETS (8387).