Although the CHAMPVA health coverage is comprehensive, it does not cover everything and you do have a patient cost share. The cost share is what’s left of the allowed cost after CHAMPVA has made payments on it, and which the provider will charge you for. To avoid having to pay potentially high cost shares, it’s a good idea to get a CHAMPVA supplemental health insurance.
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How a CHAMPVA Supplemental Insurance Plan Works
A CHAMPVA health supplement requires a regular premium just like any private health coverage plan. In return, the supplement will pay the remaining percentage that CHAMPVA does not pay, so you get 100% coverage. That is, once you have met the annual deductible for that supplement plan and overcome any other restrictions (such as a waiting period for a “preexisting medical condition.”)
Association Membership Requirement
A supplemental plan may require you to join an association by paying a membership fee for it. This may help you get better rates with the supplement plan. An example of such an association would be the RAUS or Retired Association for the Uniformed Services. Another is the AMRA or American Military Retirees Association. The membership fee shouldn’t cost too much.
Reminders About CHAMPVA Supplemental Health Insurance Plans
- It’s a good idea to research and compare rates before you make a choice.
- If you apply for supplemental insurance coverage when you are pregnant or sick, you may need to wait some time before coverage starts, due to a “preexisting medical condition.”
- You must pay a premium to maintain your supplement plan.
- You must meet an annual deductible before coverage begins for each year.
- Look in veterans’ message boards online to find out what other veterans’ families use as CHAMPVA supplement.
- Keep your CHAMPVA Explanation of Benefits (EOBs) so your supplemental plan knows what CHAMPVA has paid. See also Filing a Claim with CHAMPVA Supplement Insurance.
- Don’t forget your pharmacy expenses. Keep all receipts and paperwork. They may be covered by your supplement plan.
Is a CHAMPVA Supplement Plan Necessary?
Paying for a supplement to CHAMPVA may seem like a bother. But anyone who has to pay medical expenses not covered by their primary health insurance (if they have one at all) knows how difficult that is. No one can predict when he or she or a loved one will get sick, or how expensive it would be. Health insurance is one of the most necessary “investments” one can make. At least with CHAMPVA, you only pay for the supplementary plan, the the primary one (since CHAMPVA doesn’t charge beneficiaries a premium).