Champ Va Problem

[gdsnide]

I was recently granted 100% T&P & my wife has Champ VA.

How does one go about using this?

She has a book but any information would be greatly appreciated.... Thanks

GARY

[Guest Morgan]

I was recently granted 100% T&P & my wife has Champ VA.

   How does one go about using this?

   She has a book but any information would be greatly appreciated.... Thanks

   GARY

<{POST_SNAPBACK}>

Gary,

She first needs to find a doctor who will accept a CHAMPVA patient. If she finds one accepting new Medicare patients, it is common for that doctor to also accept CHAMPVA. My doctor probably wouldn't have accepted me if I hadn't already been seeing him under other insurance coverage (from the job I quit to care for my husband). If she is seeing a primary care physician now, I would start there. Especially if she is self-pay and now she can give them insurance coverage. She will always be explaining that CHAMPVA is not the same as TriCare. (I think TriCare used to be CHAMPUS, so it is often confused.) I tell the clerks upfront every visit that CHAMPVA is NOT TriCare, still they file it wrong many times.

Her responsibility will be 25% of the "allowable charges," which are way below the going rate in doctors' offices these days. Annual individual deductible is only $50, and the out-of-pocket expense cannot exceed $3000 (annual).

CHAMPVA has been very good for me. It has paid quickly and claims can be followed online. The benefits counselors have been courteous, well trained and helpful. Most of them are veterans.

A CHAMPVA benefits counselor told me that once the doctor/medical facility files a claim, that means they agree to accept as full payment the allowable charges. By law, they cannot bill the insured for overcharges (as the CHAMPVA benefits counselor called it).

Don't forget, if you have children in college full time, they are eligible too. The student's coverage requires verification of full-time status from the school, on its letterhead and signed by an appropriate official.

Hope this helps.

Edited September 18, 2005 by Morgan

[Pete53]

If your wife has other insurance ChampVA will not pay till it settles up but than will pay quickly. She can also get her Medicine with just the copay if you go to any pharmacy that is linked to Medical Matrix.

Althought I did not like it at first I think that ChampVA is a solid benefit and I would gladly change what I have to Medicare and ChampVA and be a happy man.

[Wings]

I was recently granted 100% T&P & my wife has Champ VA.

  How does one go about using this?

  She has a book but any information would be greatly appreciated.... Thanks

  GARY

<{POST_SNAPBACK}>

Gary, The CHAMPVA website might be able to answer some of your questions. It is my understanding that CHAMPVA does not provide routine dental coverage - unless the dental problems are the result of severe medical problems (cancer is one listed). ~Wings

CLICK CHAMPVA

[Guest Morgan]

If your wife has other insurance ChampVA will not pay till it settles up but than will pay quickly. She can also get her Medicine with just the copay if you go to any pharmacy that is linked to Medical Matrix.

Althought I did not like it at first I think that ChampVA is a solid benefit and I would gladly change what I have to Medicare and ChampVA and be a happy man.

<{POST_SNAPBACK}>

Good point, Peter. I was tunnel visioned here, thinking about CHAMPVA-only coverage. But CHAMPVA does require a form completed stating whether other health insurance is available. If so, other insurance is primary. Maintenance meds (or others if not needed immediately) are available by mail without co-pay, I think.

[sixthscents]

I have had some difficulty with ChampVA billing thru labs....Somehow they always file it first under TriCare which gets denied, then thru ChampVa, but under (for my child) the mothers name as sponsor...again generating a rejection for "improper relationship"...third time was a charm though, and you can sign up to review your claims etc. at My ChapVa website.