What Are the Differences Between CHAMPVA and TRICARE (CHAMPUS)?

Many people – beneficiaries and providers alike – confuse CHAMPVA and TRICARE with one another.  Although similar, these are in fact, two completely separate programs.  Each is managed by a different government entity, and each serves its own range of beneficiaries.  You cannot have both CHAMPVA or TRICARE.  When you see a provider, make sure they understand the differences between the two.

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CHAMPVA and TRICARE (CHAMPUS)

To define each type of health coverage:

  • CHAMPVA is a health coverage program for eligible veterans’ families ran by the VA Health Administration Center (VA is the Department of Veterans Affairs).
  • TRICARE (formerly CHAMPUS) is health coverage for active duty and retired members of the Armed Forces.   It is managed by the Department of Defense.

While the two programs bear similarities, such as being government-backed and serving those who have served, they are in fact quite distinct from each other.

CHAMPVA vs. TRICARE Comparison

Note the differences between the two government-backed health care programs:

  • CHAMPVA has one main office in Denver, Colorado; TRICARE is broken into four regions: North, West, South and Overseas.
  • CHAMPVA is managed by the Department of Veterans Affairs; TRICARE by the Department of Defense.
  • TRICARE sponsors must be military retirees; CHAMPVA cannot. Note the difference between veterans and retirees.)
  • CHAMPVA requires the sponsor to meet service-connected disability criteria or death on active duty; TRICARE does not.
  • You cannot have both CHAMPVA and TRCARE! If you qualify for TRICARE, you cannot be eligible for CHAMPVA.
  • TRICARE sponsors can make use of the health care program; CHAMPVA sponsors are ineligible for its benefits.
  • TRICARE offers several plans with different deductible and premium requirements; CHAMPVA has only one plan and no premiums.
  • TRICARE beneficiaries usually receive care from private physicians that are part of the TRICARE providers’ network; CHAMPVA beneficiaries from providers who accept assignment with CHAMPVA or VA medical facilities that take part in CITI.  Also, veterans can get health care at VA facilities.
  • TRICARE beneficiaries can get medicine through military facilities, local pharmacies or mailing service; CHAMPVA beneficiaries can receive only through pharmacies and mail.

Telling Your Provider About CHAMPVA

Some providers mistake CHAMPVA for TRICARE or think the two are identical.  They are not.  When you supply your health insurance information, make sure you:

  • Make sure the provider will bill CHAMPVA directly (“accept assignment” – hence you can’t be “balance billed”)
  • Show your CHAMPVA authorization card
  • Explain your sponsor is a veteran, NOT a military retiree or active duty service member
  • Provide correct CHAMPVA claims address and phone number
  • Provide your Social Security Number (this being your CHAMPVA member ID number)
  • Explain that your health coverage is not TRICARE, and the two aren’t the same
  • Make sure your provider bills the VA Health Administration Center (HAC), not TRICARE

See also CHAMPVA Benefits Application.

Related Articles:

This website, CHAMPVAbenefits.com, is NOT affiliated with the Department of Veterans Affairs or any part of the U.S. government. Please DO NOT send us information about yourself such as your SSN, name, address, etc. for help with CHAMPVA…. The pharmacy network for CHAMPVA now is Catamaran (formerly SXC)…. Further, we cannot guarantee that the information here is accurate and up-to-date. To ensure you have the latest information, please visit the official CHAMPVA home page at http://www.va.gov/hac/forbeneficiaries/champva/champva.asp. Your use of this site means you agree to and understand this disclaimer. Thank you!

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