CHAMPVA
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a comprehensive health care program in which the Department of Veterans Affairs (VA) shares the cost of covered health care services and supplies with eligible beneficiaries.
Due to similarities between CHAMPVA and the Department of Defense (DoD) TRICARE program the two are often mistaken for each other. 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 or 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 and cannot choose between the two programs.
Attention: For CHAMPVA beneficiaries impacted by recent hurricanes, we are here to help. There are potential shipping delays in your area. Medications that you receive through Meds by Mail can also be refilled at your local pharmacy during an emergency. If you need a medication refill, please ask your primary care doctor to call it in to your local pharmacy. Medically necessary durable medical equipment may also be covered by CHAMPVA if you are impacted by a natural disaster.
On this page
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. For additional information, view the ACA information on the VA website.
If you are enrolled in CHAMPVA, you do not need to take additional steps to meet the health care law coverage standards. CHAMPVA will send IRS Form 1095-B, Health Coverage, annually. The ACA does not change CHAMPVA benefits or out-of-pocket costs.
VA, Affordable Care Act and You
COVID-19 Vaccine
CHAMPVA beneficiaries are eligible to receive a COVID-19 vaccine in the community and at their local VA medical facility. Your provider will bill CHAMPVA for the administrative fee for the vaccine. To learn more about the COVID-19 vaccine and where you can receive it, visit the COVID-19 vaccines at VA webpage.
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 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.
CHAMPVA Guide CHAMPVA Policy Manual
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 more than 82,000 retail pharmacies. When you use a OptumRx pharmacy, the pharmacy may collect a 25 percent cost share (after the annual deductible has been met) before submitting the claim – saving you time.
Other Health Insurance (OHI)
If you have any other health insurance (OHI), you must notify us 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 us that you have a new policy and when it takes effect.
Other Health Insurance (OHI) Certification, VA Form 10-7959c
Update Your OHI File
We offer several methods to update your other health insurance file.
CHAMPVA Help Line: 800-733-8387
Monday–Friday 8:05 a.m.–7:30 p.m., ET
Call our Customer Call Center with the name of the insurance company, type of policy and effective dates of the policy.
Fax: 303-331-7808
Mail:
CHAMPVA
PO Box 500
Spring City, PA 19475
Change of Address
If you change your address, it is vital that you update your address with CHAMPVA 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 information before updating your file.
CHAMPVA Contacts
Phone:
800-733-8387
8:05 a.m. to 7:30 p.m. ET
Monday through Friday
Mail:
VHA Office of Integrated Veteran Care
CHAMPVA Eligibility
PO Box 137, Spring City PA 19475
Email:
Ask VA (AVA)
Self-Service Options for CHAMPVA Providers
Eligibility, Other Health Insurance (OHI) Coverage,
and Claims
800-733-8387
8:00 a.m. to 7:30 p.m. ET
Monday through Friday
Payments
Customer Engagement Portal
https://www.cep.fsc.va.gov/
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
https://www.changehealthcare.com/
