Do you receive CHAMPVA benefits and have other health insurance? Read this.

If you are a Civilian Health and Medical Program of VA (CHAMPVA) beneficiary—meaning you’re the spouse, widow(er) or child of an eligible Veteran—and you also have other health insurance, you might wonder: How do they work together?

Here’s what you need to know to get the most from your coverage.

Can I use CHAMPVA if I have other health insurance?

Yes, you can have both CHAMPVA and other health insurance. Here’s how it works:

1. Your provider bills your other health insurance first.
2. Once they get the Explanation of Benefits (EOB), they send it and the bill to CHAMPVA. CHAMPVA can help cover what’s left, like deductibles, co-pays and co-insurance, up to the allowable amount.

Helpful tip: Most providers handle the CHAMPVA part for you. But if your provider does not, just ask for a copy of the claim and EOB from your other health insurance so you can send it directly to CHAMPVA yourself.

When does CHAMPVA pay first?

In most cases, CHAMPVA pays after your other insurance, but there are a few exceptions where CHAMPVA is the primary payer:

• Medicaid.
• State Victims of Crime Compensation Programs.
• Indian Health Service.
• CHAMPVA supplemental insurance.

Need to submit or update your other insurance information?

No problem—just use the online CHAMPVA Other Insurance Certification form (VA Form 10-7959c). This form is also for first-time applications, or you can use it to update your phone number, address or other information. You can also fax or mail the form.

• Online: Visit CHAMPVA Other Insurance Certification.
• Fax: Download the form and fax it to 303-331-7808.
• Mail:  

VHA Office of Integrated Veteran Care
CHAMPVA Beneficiary Claims
P.O. Box 500
Springfield, PA 19475

Thinking about a Health Insurance Marketplace plan?

Yes, you can enroll in Health Insurance Marketplace coverage, but there is a catch: If you have CHAMPVA, you won’t qualify for financial assistance, like advance premium tax credits (APTC) or cost-sharing reductions. If you get these credits by mistake, you may need to repay some or all of the APTC when you file your taxes.

Bottom line: Don’t drop CHAMPVA just because you get a Health Insurance Marketplace plan. It can still help with medical costs.

For more information, visit IRS.gov and healthcare.gov.

What about Medicare?

You can have both Medicare and CHAMPVA as long as you have both Medicare Part A (hospital coverage) and Part B (doctor visits). CHAMPVA can help cover costs Medicare doesn’t cover. Just remember, CHAMPVA doesn’t cover Medicare Part B premiums, and you’ll need to provide proof of both Parts A and B to stay eligible.

Need help?

If you have questions about how your benefits work:

• Call: 800-733-8387 (TTY: 711), Monday through Friday, 8 a.m. to 7:30 p.m. ET.
• Online: Visit Ask VA.

About CHAMPVA

CHAMPVA is a health care program for qualified spouses, widows(ers) and children of eligible Veterans. Through CHAMPVA, VA shares the cost of certain health care services and supplies with eligible beneficiaries. You may be eligible for CHAMPVA if you don’t qualify for TRICARE, the Defense Department’s health care program.

Resources