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PROVIDER TOOLKIT

The CHAMPVA Provider Toolkit is a complete resource of information regarding, how to connect with CHAMPVA, How to Become a Provider, Submitting Claims and Claims Status, Locate Forms, Publications and Fact Sheets.

PROVIDER CONTACT INFORMATION

CHAMPVA Provider contact information contains the addresses and phone numbers for the various VHA Office of Community Care health care benefit programs. For PC3/Choice providers with concerns, please first contact Health Net and TriWest directly.

Providers may send questions and feedback to HACProviderFeedback@va.gov

CHAMPVA Handbook

The contact information contains important benefit information that is of interest to you. You are highly encouraged to carefully read the handbook prior to using CHAMPVA benefits.

You can view the online version here

LOCATE CHAMPVA PROVIDER

We do not maintain a provider listing. Most Medicare and TRICARE providers will also accept CHAMPVA (but be sure you ask the provider). If you are having difficulty finding a provider, we recommend you visit the Medicare website and use the "Search Tools" at the bottom of that page to locate a Medicare provider.

If you choose to see a provider who does not accept CHAMPVA, the CHAMPVA SUPPLEMENT INSURANCE will pay or reimburse the cost share. Remember that CHAMPVA cost shares are based on the CHAMPVA allowable amount.

CHAMPVA Pharmacy Benefits

General Medications by Mail

The CHAMPVA program offers a robust pharmacy benefit, paying 75% of the allowable charge at any pharmacy for prescription medication. The Meds By Mail program offers prescription medication delivered to your home. The best part of Meds By Mail is that there is NO cost share or co-pay. CHAMPVA also offers a medication by mail program called MEDS BY MAIL.

Pharmacies That Accept CHAMPVA

Pharmacies that are a part of the SXC Health Solutions, Inc. (SXC) network, agree to collect your cost share and send a claim via SXC to CHAMPVA for the remaining amount. However, not all pharmacies are a part of the SXC pharmacy network. In those cases, you may have to pay the entire amount and submit a claim to CHAMPVA yourself. A good way to find a pharmacy that participates in the SXC network, is to visit their website at https://vahac.rxportal.sxc.com.

CHAMPVA SUPPLEMENTAL INSURANCE

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