CHAMPVA | Resources

Provider Contact Information

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. We recommend you carefully read the handbook prior to using benefits.

 

You can view the online version here

Locate CHAMPVA Provider

The VA does not maintain a provider listing. Most Medicare and TRICARE providers will also see beneficaries (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 SUPPLEMENT INSURANCE will pay or reimburse the cost share. Remember that cost shares are based on the allowable amount.

General Medications by Mail

The 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

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  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

An eligible sponsor may be entitled to receive medical care through the VA health care system based on his or her own veteran status. If the eligible sponsor is the spouse of another eligible sponsor, both may now be eligible for CHAMPVA benefits. In each case where the eligible spouse requires medical attention, he or she may choose the VA health care system or coverage under CHAMPVA for his/her health care needs. If you have been previously denied benefits and you believe you would now be qualified, please submit an application following the guidelines as listed on the “How to apply” section.

 

Eligibility can be impacted by changes such as marriage, divorce from the sponsor, or eligibility for Medicare or TRICARE. Changes in status should be reported immediately to:

 

CHAMPVA, ATTN: Eligibility Unit
PO Box 469028
Denver, CO 80246-9028

 

Phone: 1-800-733-8387

 

Email: hac.inq@med.va.gov

How to Apply for CHAMPVA BENEFITS

 

If you provide all of the required and optional documents, and if your application is complete, then it takes approximately six weeks after we get your package until you get your CHAMPVA identification card and related materials.

 

If you provide only the required documents, and not the optional documents, processing can take two to eight months since we have to confirm information with other federal agencies.

 

Once we get your application, we will review it to be sure it is complete and that all the required forms are included. If your application is not complete, we will return it to you with further instructions. For additional information, please refer to Fact Sheet 01-03: Instructions for CHAMPVA Applicants.

Required Documents

 

To apply for CHAMPVA benefits, you must submit the following documents:

 

Optional Documents

 

You can speed the processing of your application if you also send copies (do not send originals):

 

  • Birth certificate/adoption papers for children
  • School certification of full-time enrollment for children ages 18-23 (See Fact Sheet 01-15: School Enrollment Certification Requirements for CHAMPVA Benefits for more information.)
  • If you are a remarried widow/widower and are once again single, provide a copy of the legal documentation that terminated the remarriage. The legal documentation of termination of a remarriage may be a divorce decree, death certificate or annulment decree.
  • The page from the VBA rating decision showing the Veteran is permanently and totally disabled (or death rating for a survivor)
  • Veteran’s DD214, Certificate of Release or Discharge from Active Duty, or if the Veteran was a WWII or Korea veteran, the Report of Separation. If you do not have a copy of the necessary form, you may request it by submitting a Standard Form 180, Request Pertaining to Military Records, from the National Archives.

How to Request Military Personnel Files

 

Online: Click Here

 

Mail:
National Personnel Records Center
Military Personnel Records
1 Archives Drive
St. Louis, MO 63138

 

Fax: 314-801-9195

 

Instructions about who can request Official Military Personnel Files and the information required can be viewed on the National Archives Veterans’ Service Records page at https://www.archives.gov/veterans/military-service-records.

Application Submission

 

Before sending your application, please ensure the application is signed and dated. Also, if applying for a spouse, please include the date of marriage on the application.

 

Mail:
VHA Office of Community Care
CHAMPVA Eligibility
PO Box 469028
Denver, CO 80246-9028

 

Fax: 303-331-7809

APPLY NOW: Application Download

Click the Print Enrollment Form. Fill in the forms, include payment, mail to the address on the Instructions. Applications received by end of the month are made effective the First of the Following Month.

 

If you would like assistance completing the forms, give us a call. 888-654-3129 ext. 3

 

You will receive your packet including Insurance Policy and Supplement ID Card.

 

Download and Enroll Today.

 Print Enrollment Form

 

CHAMPVA Supplement Plan Details
Dental and Vision Insurance Plans

Individual VISION Insurance Plans start $10.67,
Family from $29.34

 

Quote provides VISION & DENTAL plans available in your area. Click & view details to see plan coverage.

Dental and Vision Quote

Medicare and Veteran’s Affair (VA) Benefits

Although the VA Veteran’s Affair (VA) and Medicare are both Government Health Programs and if you are eligible for both, it is important to know your options.

  • Medicare Supplement Insurance
  • Medicare Advantage Plan
  • Part D Prescription Drug Plan

Medicare and Veterans