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My son and I finally got added as my husband’s beneficiaries without having to have SSNs because we are foreign citizens, and we live out of the country, But now CHAMPVA is saying we must have SSNs before we can apply. Does anyone have any information on this issue? Thank you

I am turning 65 this year. I have Tricare Prime (retired military) and Champva (100% P&T). How does all this play to my advantage when enrolling into Medicare? Thanks in advance for replies.

I got 100% total and permanent rating due to PTSD. I just don't know what to do now? I added my spouse to the system and the VA just transferred the amount for the corrected monthly compensation. Will be he eligible for CHAMPVA? I tried to understand on their website but not sure how it will be. He has no health insurance. Tried to check benefits everywhere, used eBenefits to explore, I just don't know what to do with this new situation. I have been looking for a job long time and now I don't have to. But I will need to do something. I also checked this website what can I do but it's still unclear. Any suggestion folks?

Hello friends! Quick question.....I am 90% overall and TDIU 100% with an appointment scheduled at the 1 year mark. Recently i have heard (through a VSO) that my wife and child are eligible for health care. Is this so??? thanks!

What is the recourse if no reply after more than 120 days from the CHAMPVA application? The problem may be because my wife's Japanese National Health Insurance which is first pay when she is in Japan but last pay when out of country. She can claim copays for up to two years when she is in Japan. Her Japanese Health Insurance also covers Dental and Drugs. For Dental she can pay for a trip to Japan for anything more than cleaning by getting it done in Japan. She is diabetic so here Part D copays are huge on drugs. Pays her to return to Japan for a claim every two years.

Frequently Asked Questions About CHAMPVA What is CHAMPVA? Who is eligible for CHAMPVA? What does CHAMPVA pay? Can a beneficiary have other health insurance (OHI) and use CHAMPVA? How can I locate a provider? What is the impact of Medicare on CHAMPVA? What is the difference between CHAMPVA and TRICARE (formerly CHAMPUS)? How can I obtain an application for CHAMPVA benefits? From the time an application is submitted, how long before I get a response from VHA Office of Community Care? Are CHAMPVA benefits available to beneficiaries with other health insurance (OHI) coverage who choose to receive covered services from a provider who is not in their primary insurance's network? Are health care services at VA facilities available to CHAMPVA beneficiaries? How can I find out if the local VA facility is participating in the CITI program? What out-of-pocket expenses can a CHAMPVA beneficiary expect under CITI? What is CHAMPVA? The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health benefits program in which the Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with eligible beneficiaries. CHAMPVA is managed by the Veternas Health Administration Office of Community Care (VHA CC) in Denver, Colorado. We verify CHAMPVA eligibility, authorize benefits, and process medical claims. Who is eligible for CHAMPVA? To be eligible for CHAMPVA, the beneficiary cannot be eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and to the children of a Veteran who: is rated permanently and totally disabled due to a service-connected disability, or was rated permanently and totally disabled due to a service-connected condition at the time of death, or died of a service-connected disability, or died on active duty and the dependents are not otherwise eligible for Department of Defense TRICARE benefits. Effective October 1, 2001, CHAMPVA benefits were extended to those age 65 and older. To be eligible for CHAMPVA, you must also meet the following conditions: If the beneficiary was 65 or older prior to June 5, 2001, and was otherwise eligible for CHAMPVA, and was entitled to Medicare Part A coverage, then the beneficiary will be eligible for CHAMPVA without having to have Medicare Part B coverage. If the beneficiary turned 65 before June 5, 2001, and has Medicare Parts A and B, the beneficiary must keep both Medicare Parts A & B to be eligible for CHAMPVA. If the beneficiary turned age 65 on or after June 5, 2001, the beneficiary must be enrolled in Medicare Parts A and B to be eligible for CHAMPVA. What does CHAMPVA pay? In most cases, CHAMPVA's allowable amount—what we pay for specific services and supplies—is equivalent to Medicare/TRICARE rates. CHAMPVA has an outpatient deductible ($50 per beneficiary per calendar year or a maximum of $100 per family per calendar year) and a patient cost share of 25% of our allowable amount up to the catastrophic cap ($3,000 per calendar year). Beneficiaries should NOT send checks to VHA CC for their annual deductible; as claims are processed, charges are automatically credited to individual and family deductible requirements for each calendar year. If your provider accepts assignment, which means the provider accepts CHAMPVA, the provider agrees to accept our allowable amount as payment in full. A provider cannot bill you for the difference between our allowable amount and their normally billed amount. If the patient has other health insurance, then CHAMPVA pays the lesser of either 75% of the allowable amount after the $50 calendar year deductible is satisfied, or the remainder of the charges and the beneficiary will normally have no cost share. See Payment Methodology Fact Sheet 01-11 for further information regarding payment on other than outpatient type of services. Can a beneficiary have other insurance (OHI) and use CHAMPVA? Yes. If the beneficiary has other health insurance (OHI), the OHI should be billed first. The explanation of benefits (EOB) from the OHI should then be submitted with the claim for reimbursement to CHAMPVA. By law, CHAMPVA is always the secondary payer except to Medicaid, State Victims of Crime Compensation Programs, Indian Health Services, and supplemental CHAMPVA policies. How can I locate a provider? Information about providers can be found on our Locating a Provider page. What is the impact of Medicare on CHAMPVA? As a result of a federal law passed June 5, 2001, CHAMPVA expanded benefit coverage to eligible family members and survivors of qualifying Veteran sponsors effective October 1, 2001. If the beneficiary is eligible for CHAMPVA and also has Medicare Part A entitlement (premium-free hospitalization coverage) and Medicare Part B (outpatient coverage), we will cover many of the costs not covered by Medicare. CHAMPVA will pay after Medicare and any other insurance, such as Medicare HMOs and Medicare supplemental plans, for health care services and supplies. CHAMPVA does not pay Medicare Part B premiums. What is the difference between CHAMPVA and TRICARE (formerly CHAMPUS)? Although similar, CHAMPVA is completely separate with a totally different beneficiary population than TRICARE - a Department of Defense health care program formerly called CHAMPUS. While the benefits are similar, the programs are administered separately with significant differences in claim filing procedures and preauthorization requirements. How can I obtain an application for CHAMPVA benefits? There are a couple ways to obtain an Application for CHAMPVA Benefits (VA Form 10-10d): Complete the online fillable Application for CHAMPVA Benefits (VA Form 10-10d) Call the VHA Office of Community Care at 1-800-733-8387. When calling, select the Application Form option from the Interactive Voice Response menu. From the time an application is submitted, how long before I can expect a response from the VHA Office of Community Care? Generally, applicants can expect to receive written notification from the VHA Office of Community Care within 45 days after mailing their application. To streamline the process, applicants are encouraged to complete the Application for CHAMPVA Benefits (see link above) in its entirety and to attach all required documents. As further explained on the application, required documents include a copy of each applicant's Medicare card (if Medicare eligible) and a School Enrollment Certification for all applicant children between the ages of 18 and 23. Are CHAMPVA benefits available to beneficiaries with other health insurance (OHI) coverage who choose to receive covered services from a provider who is not in their primary insurance's network? CHAMPVA will deny payment on a claim if the beneficiary’s OHI denied payment because the beneficiary obtained the medical services or supplies outside the OHI (HMO, PPO, and Medicare) provider's plan. Are health care services at VA facilities available to CHAMPVA beneficiaries? Under the CHAMPVA Inhouse Treatment Initiative (CITI), CHAMPVA beneficiaries may receive cost-free health care services at participating VA facilities. How can I find out if the local VA facility is participating in the CITI program? Although some VA facilities are not CITI participants due to the volume of Veterans they are responsible for serving, many are. To find out if your local facility is participating, view our online CITI Participating Facilities list. However, CHAMPVA beneficiaries who are also covered by Medicare cannot use a VA medical center because Medicare does not pay for services provided by a VA Medical Center. What out-of-pocket expenses can a CHAMPVA beneficiary expect under CITI? None. CHAMPVA beneficiaries don’t pay a thing when receiving services under the CITI program.

Frequently Asked Questions About CHAMPVA What is CHAMPVA? Who is eligible for CHAMPVA? What does CHAMPVA pay? Can a beneficiary have other health insurance (OHI) and use CHAMPVA? How can I locate a provider? What is the impact of Medicare on CHAMPVA? What is the difference between CHAMPVA and TRICARE (formerly CHAMPUS)? How can I obtain an application for CHAMPVA benefits? From the time an application is submitted, how long before I get a response from VHA Office of Community Care? Are CHAMPVA benefits available to beneficiaries with other health insurance (OHI) coverage who choose to receive covered services from a provider who is not in their primary insurance's network? Are health care services at VA facilities available to CHAMPVA beneficiaries? How can I find out if the local VA facility is participating in the CITI program? What out-of-pocket expenses can a CHAMPVA beneficiary expect under CITI? What is CHAMPVA? The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health benefits program in which the Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with eligible beneficiaries. CHAMPVA is managed by the Veternas Health Administration Office of Community Care (VHA CC) in Denver, Colorado. We verify CHAMPVA eligibility, authorize benefits, and process medical claims. Who is eligible for CHAMPVA? To be eligible for CHAMPVA, the beneficiary cannot be eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and to the children of a Veteran who: is rated permanently and totally disabled due to a service-connected disability, or was rated permanently and totally disabled due to a service-connected condition at the time of death, or died of a service-connected disability, or died on active duty and the dependents are not otherwise eligible for Department of Defense TRICARE benefits. Effective October 1, 2001, CHAMPVA benefits were extended to those age 65 and older. To be eligible for CHAMPVA, you must also meet the following conditions: If the beneficiary was 65 or older prior to June 5, 2001, and was otherwise eligible for CHAMPVA, and was entitled to Medicare Part A coverage, then the beneficiary will be eligible for CHAMPVA without having to have Medicare Part B coverage. If the beneficiary turned 65 before June 5, 2001, and has Medicare Parts A and B, the beneficiary must keep both Medicare Parts A & B to be eligible for CHAMPVA. If the beneficiary turned age 65 on or after June 5, 2001, the beneficiary must be enrolled in Medicare Parts A and B to be eligible for CHAMPVA. What does CHAMPVA pay? In most cases, CHAMPVA's allowable amount—what we pay for specific services and supplies—is equivalent to Medicare/TRICARE rates. CHAMPVA has an outpatient deductible ($50 per beneficiary per calendar year or a maximum of $100 per family per calendar year) and a patient cost share of 25% of our allowable amount up to the catastrophic cap ($3,000 per calendar year). Beneficiaries should NOT send checks to VHA CC for their annual deductible; as claims are processed, charges are automatically credited to individual and family deductible requirements for each calendar year. If your provider accepts assignment, which means the provider accepts CHAMPVA, the provider agrees to accept our allowable amount as payment in full. A provider cannot bill you for the difference between our allowable amount and their normally billed amount. If the patient has other health insurance, then CHAMPVA pays the lesser of either 75% of the allowable amount after the $50 calendar year deductible is satisfied, or the remainder of the charges and the beneficiary will normally have no cost share. See Payment Methodology Fact Sheet 01-11 for further information regarding payment on other than outpatient type of services. Can a beneficiary have other insurance (OHI) and use CHAMPVA? Yes. If the beneficiary has other health insurance (OHI), the OHI should be billed first. The explanation of benefits (EOB) from the OHI should then be submitted with the claim for reimbursement to CHAMPVA. By law, CHAMPVA is always the secondary payer except to Medicaid, State Victims of Crime Compensation Programs, Indian Health Services, and supplemental CHAMPVA policies. How can I locate a provider? Information about providers can be found on our Locating a Provider page. What is the impact of Medicare on CHAMPVA? As a result of a federal law passed June 5, 2001, CHAMPVA expanded benefit coverage to eligible family members and survivors of qualifying Veteran sponsors effective October 1, 2001. If the beneficiary is eligible for CHAMPVA and also has Medicare Part A entitlement (premium-free hospitalization coverage) and Medicare Part B (outpatient coverage), we will cover many of the costs not covered by Medicare. CHAMPVA will pay after Medicare and any other insurance, such as Medicare HMOs and Medicare supplemental plans, for health care services and supplies. CHAMPVA does not pay Medicare Part B premiums. What is the difference between CHAMPVA and TRICARE (formerly CHAMPUS)? Although similar, CHAMPVA is completely separate with a totally different beneficiary population than TRICARE - a Department of Defense health care program formerly called CHAMPUS. While the benefits are similar, the programs are administered separately with significant differences in claim filing procedures and preauthorization requirements. How can I obtain an application for CHAMPVA benefits? There are a couple ways to obtain an Application for CHAMPVA Benefits (VA Form 10-10d): Complete the online fillable Application for CHAMPVA Benefits (VA Form 10-10d) Call the VHA Office of Community Care at 1-800-733-8387. When calling, select the Application Form option from the Interactive Voice Response menu. From the time an application is submitted, how long before I can expect a response from the VHA Office of Community Care? Generally, applicants can expect to receive written notification from the VHA Office of Community Care within 45 days after mailing their application. To streamline the process, applicants are encouraged to complete the Application for CHAMPVA Benefits (see link above) in its entirety and to attach all required documents. As further explained on the application, required documents include a copy of each applicant's Medicare card (if Medicare eligible) and a School Enrollment Certification for all applicant children between the ages of 18 and 23. Are CHAMPVA benefits available to beneficiaries with other health insurance (OHI) coverage who choose to receive covered services from a provider who is not in their primary insurance's network? CHAMPVA will deny payment on a claim if the beneficiary’s OHI denied payment because the beneficiary obtained the medical services or supplies outside the OHI (HMO, PPO, and Medicare) provider's plan. Are health care services at VA facilities available to CHAMPVA beneficiaries? Under the CHAMPVA Inhouse Treatment Initiative (CITI), CHAMPVA beneficiaries may receive cost-free health care services at participating VA facilities. How can I find out if the local VA facility is participating in the CITI program? Although some VA facilities are not CITI participants due to the volume of Veterans they are responsible for serving, many are. To find out if your local facility is participating, view our online CITI Participating Facilities list. However, CHAMPVA beneficiaries who are also covered by Medicare cannot use a VA medical center because Medicare does not pay for services provided by a VA Medical Center. What out-of-pocket expenses can a CHAMPVA beneficiary expect under CITI? None. CHAMPVA beneficiaries don’t pay a thing when receiving services under the CITI program.

Please, welcome new VET2VET podcast episode: https://youtu.be/waV5t0HPtbM Today we are joined by Thomas Wendel, DAV National area supervisor for West Cost Region. Thomas E. Wendel served in the U. S. Marine Corps from 1983 until 1997. Since 1999, Tom has worked assisting veterans in processing various entitlement claims on the local, state and federal levels; first in Clare County as a county service officer and then when he came to work for the Disabled American Veterans in 2000. In 2008 he was promoted to the position of supervisor of the DAV Service Office in Detroit and later he was promoted to the position of supervisor of the DAV National area for West Cost Region. DAV is America’s largest, most effective veterans service organizations dedicated to the needs of those injured, ill or wounded in service. We have more than 1,300 Chapters in communities nationwide to help make sure veterans from all generations and their families get the benefits and support they deserve. Today, nearly 1.3 million veterans belong to DAV, and we encourage you to add your voice to the cause. Our programs and free services help all veterans get the health, disability and financial benefits they earned. Take advantage of our benefits claims assistance, medical transportation and employment resources. Your local DAV Chapter is a great way to connect with fellow veterans in your area. ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.

Please, welcome new VET2VET podcast episode: https://youtu.be/9paX1-FyCaI Today we’re talking about SERVICE CONNECTION. When we talk about service-connecting a medical condition, disease, injury or illness to military service, we are talking about proving the relationship between the two. 1) Direct Service Connection 2) Service Connection by Aggravation 3) Presumptive Service Connection 4) Secondary Service Connection 5) Service Connection due to Injury Caused by Treatment in the VA Healthcare System 6) Special Service Connection Rules for Post-Traumatic Stress Disorder ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.

Please, welcome new VET2VET podcast episode: https://youtu.be/sTH3p-WwXn0 The way VA defines The word "permanent" slightly differently. For that matter, the word total doesn't mean total when discussing a disability. These are just terms to VA. There really isn't a protected rating. Any rating can be modified by VA at any time, depending on the circumstances. How do you know if your benefit is P & T? What is IU? What is substantially gainful employment? Are there any other eligibility requirements? How is the way VA decides total disability different from other agencies? TDIU awards may be permanent or they may be temporary. If I get a 100% rating, should I continue fighting the VA for benefits? SMC compensation Can you think of any other scenarios were a Veteran might want to keep filing to VA after they reach a 100% rating? ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/veterantoveteran/ ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/veterantovetera/lists/vet2vet ▶ youtube.com/channel/UCebXFpogeJ9r4EqRyxHriYQ ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.

Hello, I'll go through this in chronological order: On my initial determination letter for 100% rating (May 10, 2011) it says "An examination will be scheduled at a future date to evaluate the severity of your service connected "PTSD". Further in the letter it states, "The examiner indicated that you would benefit from counseling and other mental health service, therefore, there is evidence indicating a possibility for improvement" The assigned evaluation is not considered permanent and is subject to a future review examination". So, I submitted another application for increased determination, for P&T (August 31, 2013), and received a determination letter (October 29, 2013), stating: 1. "Evaluation of PTSD which is currently 100 percent disabling, is continued". 2. "Eligibility to Dependents' Educational Assistance is not established". (Indicating that it's not P&T I'm thinking). So, I called the VA phone number and asked for a letter so I could receive base access and MWR privileges. I received the following letter: "We are giving you this certificate so you may receive commissary store and exchange privileges from the Armed Forces". "This is to certify that xxxxxx is an honorably discharged Veteran of the Army and receives benefits at the 100% rate". I was able to obtain a Base ID Card (DD Form 2765) using this certificate, which I thought required P&T Status to obtain. Sp now, I've gone onto the MilConnect (www.dmdc.osd.mil) website and when clicking the 'my profile' tab I see the following information: Persona Type: Disabled Veteran Disability Extent: Permanent and Total Disability Begin Date: 08-21-2013 I am trying to figure out where exactly I stand. Am I P&T? Am I not? Is my spouse eligible for CHAMPVA? Any assistance is deciphering all this will be appreciated. - DESERT

It begins on page 8, discussing Chandler vs Shinseki http://www.nvlsp.org/images/products/TVA_AprJun12-PUBLISHED_VERSION.pdf

As most 100% Vets know, our spouse is eligible for CHAMPVA. (We are not eligible, however, for unknown reasons). Champva enables our spouse to go to the VA for care (if approved by the local VAMC) OR go get private care as this insurance pays for it. However, 100% Vets must go to their VA for care and dont have the choice to go for private care and have insurance pay. (Exception: Vets choice, if you meet eligibility requirment of living too far away from VA, or cant get an appointment in 30 days and get your doc to give you a note that he is too busy to see you. (As required by VA choice) Its still unclear how your doc is gonna give you such a note if he is too busy to see you and you cant schedule an appointment in 30 days. More choices for care = Better care. So, why do our spouses who did not serve get better care than we do, when we served? Should not all Vets get "Veterans choice"? Oh, I know why! This is because VA care is substandard and VA does not want to pay for the good stuff! If the VA were truly "world class health care" they would not need "Veterans choice". I know Vets who wont set foot inside a VAMC and they have very valid reasons for this. Lots of Vets recommend signing up for medicare Part B. So, why should a Veteran pay for insurance (part B) if he gets VA care for free? I found out the hard way...VA care is substandard. I still can not figure out why a Vets spouse gets better care than the Veteran. Did I miss something? Its also becoming increasingly clear VA wants to dump some of its burden for caring for vets on medicare. The VAMC always asks if we have other policies or medicare. And, even Champva insists on the spouse having Part B medicare if eligible. (Remember, Part B medicare costs about $104 per month this year, that is, if you dont have late penalties for not siging up in time.) This means that Champva is not free for medicare eligibles. They must pay $104 per month. I will add that I want my wife to have good medical care. Definately. I dont want them to worsen her care, I want VA to raise the level of our care.