Is Champva Enough Without Ohi?

[mymansavet]

What a great site! I'm the wife of a Vietnam vet (USN) and recently got my CHAMPVA card, so I'm overwhelmed with information. I really appreciate everything I'm learning here.

I plan to cancel my current health insurance, as it has unreasonably high and ever-increasing premiums despite my catastrophic-care deductible, and doesn't cover preventive care adequately. I never fulfill my deductible, so I pay for all my health care each year. Considering how much CHAMPVA covers, I just can't see any advantage in keeping this OHI.

Is there something I'm not understanding? Are there in fact disadvantages to only having CHAMPVA without OHI? And if so, what are they?

I'm thinking about getting CHAMPVA supplemental insurance, but I'm not sure what provider(s) would be appropriate to my situation. I was referred to federalpublishing.com, but the information there is pretty skimpy, and the VA can't give me any recommendations. Most of the coverage seems only to apply to families of retired career military. I think that I might be eligible for AMRA's supplement, but I'm not sure—one chart I looked at seemed as though I'd need to be retired myself to qualify. I'm going to give AMRA a call, but I'm wondering if anyone here has CHAMPVA supplemental coverage with them and can recommend it? Or can recommend/suggest another provider?

Thanks for all your help. I don't know who I'd ask if it weren't for you folks!

[Pete53]

In my opinion you can do just fine with a supplement like USAA and ChampVA is primary. When you are eligible for Medicare remember to drop the supplement and take Part B of Medicare.

The Pharmacy Benefit is quite good and lets you choose between generic or brand.

[mymansavet]

Thanks for your behind-the-scenes perspective, broncovet. I'd just posted my previous reply when I saw yours, and as a new hadit.com member, my posts have to be individually moderator-approved for a while, so their appearances are delayed.

Yes, CHAMPVA’s deductible is $50 a year. Their coverage is more complicated than this, but basically they pay 75% of medical expenses, including prescriptions. I’m not sure if a CHAMPVA supplement such as AMRA’s (with its own deductible of $150) pays that deductible, but this is small change compared to what I’m paying now for my OHI (Other Health Insurance).

AMRA’s supplement pays the 25% of the allowable amount that CHAMPVA doesn’t (my co-pay), for doctors’ visits, prescriptions, and hospitals. Their $540/year premiums plus their $150 deductible plus CHAMPVA’s $50 deductible would still have saved me a lot of money this year. I don’t want to make any money through my insurance, I just don’t want to spend any needlessly.

My OHI private health insurance (different than CHAMPVA supplemental insurance) doesn’t really cover much more than CHAMPVA does—no dental, or routine eye exams, for instance. So I’m still leaning very heavily toward giving it the boot. But I’ll gladly hear other opinions pro and con. I keep thinking this is a no-brainer, but I don’t want to look back in a few months and realize that the no-brainer was me!

[broncovet]

mymansavet

It sounds like you are doing a good job considering your options, and Im guessing that by you doing this thorogh of a job planning, you will make the right choice for you. My brother used to call it the 5 P's....Proper Planning Prevents Poor Performance.

Most agents and those knowledgeable about insurance recommend that insurance be saved for the "catastrophe" and not used for the "fender bender". Remember that insurance companies purpose is to make money...so if you expect them to pay every 5$ copay, be prepared to pay for that service. I dont think its worth it, reminding you that it is not free for the insurance company to process a claim and send you a check for $5, so you are likely to pay $10 in premiums so that you wont have to pay that last five bucks.

However, you do want to analyze if their are any "huge holes" in your coverage. An example might be something like coverage for a heart transplant. If your insurance excudes this along the lines of this being experimental surgery, then you may well want to think about a supplement that would include it.

Bottom Line: REad and analyze both policies and then decide.

Most, if not all states, have a 30 day money back guarntee required from every insurance policy. That is, it is the customers right to read over the policy and not just listen to the salesman touting the benefits of his company, because the policy defines the limitations of the policy. This means you can buy the policy look it over for thirty days and get your premiums back. I recommend reading the policy. In Champva's case, read over the booklet they send you thoroughly.

[titlewave]

The long term care policy was purchased thru USAA.com. Good company. The policy was underwritten thru John Hancock. I shopped long term care with John Hancock with a local agent and USAA was quite a bit cheaper. If use you a local agent you end paying his commission also.

[john999]

I kept the FEHB I got from being a retired federal employee. It is BC/BS. I have medicare which is primary for me. My wife has ChampVA which is secondary. We don't pay anything for medical care if we stay in the BC/BS network which is vast. The thing you want to be sure you are covered for is a chronic illness that requires constant treatment. You also need the coverage for a really major illness That runs in the the tens of thousands of dollars. I tell you that when my wife was in the hospital for her diverticulitus she got the best of care. She went to the hospital with pain in her stomache region. She got all the tests right away and she was in surgery within hours. This is because the hospital knew they would be paid. When I got my foot operated on I was admitted in the morning and operated on within hours by a plastic surgeron. If the hosptial believes there is any chance they won't get paid they will shrug you off and this can be fatal. Look at the VA sending people home with severe infections because they are pinching pennies. When my wife gets medicare I will drop the BC/BS family plan which is expensive.