Prior to a law that took effect in 2001, CHAMPVA beneficiaries could not enjoy their benefits for life. However this is now possible for eligible persons under CHAMPVA for Life or CFL.
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What Is CHAMPVA for Life (CFL)?
When you hear about CFL or CHAMPVA for Life, it isn’t referring to a separate health benefits program. It is the same, only it refers to instances where coverage is extended for people who are over 65 years old.
CHAMPVA for Life became law in June 2001 as part of the Veterans’ Survivor Benefits Improvements Act of 2001, Public Law 107-14. Until then, beneficiaries who turned 65 and were eligible for Medicare lost CHAMPVA coverage.
Now with both CHAMPVA and Medicare covering them, such people will often have nothing or almost nothing to pay out of pocket for their medical care.
How to Get CHAMPVA for Life for a Spouse
If a CHAMPVA beneficiary turns 65 after June 5, 2001, that person must be enrolled in both Medicare Part A and Part B to continue enjoying CHAMPVA benefits.
If the beneficiary had turned 65 prior to June 5, 2001, and had only Medicare Part A, he or she could keep CHAMPVA even without Part B. But if the beneficiary had both Parts A and B at that time, the same must not abandon Part B or they will lose CHAMPVA.
To continue benefits upon enrollment in Medicare, you must purchase Part B and then submit your OHI information and a copy of your Medicare card to CHAMPVA. If ineligible for Medicare, you need to get a letter of non-entitlement from the Social Security Administration instead. See CHAMPVA and Medicare. Once approved for continued benefits, you will receive a CHAMPVA authorization card with new eligibility dates.
In addition, the spouse must not divorce the veteran sponsor. If the spouse gets widowed and wants to remarry, he or she will lose benefits if the remarriage takes place before the widow(er)’s 55th birthday. After this date, the surviving spouse can remarry and keep CHAMPVA benefits.
How to Get CHAMPVA for Life for a Child
For a sponsored child to qualify for lifetime CHAMPVA health coverage, that child must be designated as a permanently “helpless child” by the VA before he or she turns 18 years old. This means the child is unable to support him- or herself and needs others’ care.
A helpless child can keep CHAMPVA benefits for life unless he or she gets married or fails to follow the requirements for combined Medicare and CHAMPVA coverage (see further down). In that case, CHAMPVA coverage automatically stops.
To apply for a Helpless Child rating, one must submit:
- VA Form 21-4138: Statement in Support of Claim
- VA Form 21-4142: Authorization and Consent to Release Information to the Department of Veterans Affairs
- Medical records
- Statements from family and others who know the child
- School records (if applicable)
Applying for Helpless Child status may be done on its own or at the same time one applies for another benefit such as a disability compensation or a death pension. If in conjunction with another application, you must, of course, submit the required paperwork for that as well.
Note on Helpless Children and Medicare
Even if a child is rated helpless by the VA, he or she must still follow the same Medicare rules to keep CHAMPVA for life as an adult spouse or surviving spouse. See Medicare and CHAMPVA Fact Sheet.
CHAMPVA and Medicare
If you enroll in both these programs, Medicare assumes the role of primary health insurance. That means it will pay first. CHAMPVA will pay after Medicare and any Medicare supplement you may have.
CHAMPVA will pay first for overseas health care, since Medicare does not cover that.