CHAMPVA is a federal health care coverage program available to eligible beneficiaries. Eligibility requirements for the program are set by law, regulations and policies that govern the program. Before anyone can receive CHAMPVA benefits, the Department of Veterans Affairs, through its Chief Business Office Purchased Care (CBOPC), must determine that the applicant meets these requirements.
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According to the official CHAMPVA eligibility page1:
To be eligible for CHAMPVA, you cannot be eligible for TRICARE, and you must be in one of these categories:
- The spouse or child of a Veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office.
- The surviving spouse or child of a Veteran who died from a VA-rated service-connected disability.
- The surviving spouse or child of a Veteran who was at the time death rated permanently and totally disabled from a service-connected disability.
- The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).
Loss of Eligibility
Grounds for ineligibility as given in the CHAMPVA Guide (publication date Jan 2014) and official CHAMPVA pages are2:
- If a spouse and the sponsoring veteran get divorced
- If a surviving spouse remarries prior to age 55 (though eligibility is possible if that marriage is later terminated)3
- If one becomes eligible for TRICARE
- If one becomes eligible for Medicare Part A but does not have, or does not keep, Medicare Part B
- When a child (who is not rated as a helpless child) turns 18, unless the child is enrolled full-time at an accredited school
- When a child, who has been enrolled as a full-time student as above, either turns 23 or loses full-time student status
- When a child gets married
- If a stepchild’s parent and sponsoring veteran step-parent get divorced, and the stepchild loses eligibility as determined by their VA Regional Office (VARO).
Aside from what is quoted above about stepchildren, here is a quote the CHAMPVA eligibility page:
NOTE: The eligibility of a child is not affected by the divorce or remarriage of the spouse except in the case of a stepchild. When a stepchild leaves the sponsor’s household, the child is no longer eligible for CHAMPVA.
You can find more about full-time school enrollment certification, summer breaks, illness and withdrawal from school in the CHAMPVA Guide. Read it carefully to prevent any interruptions of your child’s coverage.
The same CHAMPVA eligibility page quoted above has this to say about remarriage for surviving spouses:
Eligibility for CHAMPVA ends at midnight on the date of your remarriage, if you remarry prior to age 55. If you remarry on or after your 55th birthday, The Veterans Benefit Act of 2002, Public Law 107-330, allows you to keep your CHAMPVA benefits.
Medicare eligibility has an impact on CHAMPVA benefits. If you become eligible for Medicare, you must take steps to continue eligibility for CHAMPVA. Please refer to said CHAMPVA Guide for information.
1. “CHAMPVA Eligibility – Chief Business Office Purchased Care.” U.S. Department of Veterans Affairs. March 9, 2015. Accessed March 30, 2015. http://www.va.gov/PURCHASEDCARE/programs/dependents/champva/champva_eligibility.asp.
2 . “CHAMPVA Guide.” U.S. Department of Veterans Affairs. January, 2014. Accessed March 31, 2015. http://www.va.gov/PURCHASEDCARE/docs/pubfiles/programguides/champva_guide.pdf.
3.”CHAMPVA Eligibility – Chief Business Office Purchased Care.” U.S. Department of Veterans Affairs. March 9, 2015. Accessed April 6, 2015. http://www.va.gov/PURCHASEDCARE/programs/dependents/champva/champva_eligibility.asp.
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For the most current information about CHAMPVA, please visit the official CHAMPVA site. Or to find a specific page or resource, see a list of CHAMPVA resource links. Please always check with official sources before doing anything with your CHAMPVA coverage!
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