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Spousal Health Care Options

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I am rated 100% for PTSD and recently retired at 63. My wife is 62 and we are both on Social Security now that I have retired.

I am purchasing Health Insurance through my previous employer for $761.00 a month just so I can cover my wife. They will not JUST cover her, I must be on the plan too. This is through KPS Health plans. Seems awfully high to me.

Questions; Is there a better way (cheaper) to cover my spouse only?

If so, where and how do I begin the process?

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Is your rating P & T?

If you are P & T, your wife is eligible for Champva which is the best insurance she could have in my opinion. Champva has no premiums and her annual deductible would be $50.00.

If you are not rated P & T, your options are limited. Of course, when she turns 65 she will be eligible for Medicare. JMO

Good luck to you and your wife.

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Yes, I am P&T

The Champva forms askes about other insurance which I DO Have now but I want to cancel. Should I tell them I do not have Insurance now even though I have not cancelled it yet/

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You should call Champva and tell them your situation. Unlike the rest of the VA, I have always found the folks at Champva to be helpful and responsive. You can reach them 24/7 at 1-800-733-8387.

In order to insure there is no lapse in your wife's coverage, she may have to complete VA form 10-7959c and report your other health insurance when she completes the enrollment forms to sign up for Champva. While she has other health insurance, Champva will be her secondary coverage. After she receives her Champva package with her ID card, you could then cancel your other coverage and notify Champva immediately so Champva will become her primary insurance. Again, discuss this with the folks at Champva in advance.

Once your wife becomes 65 she will be required by Champva to sign up for medicare part A and part B. At that time, medicare will become her primary insurance and Champva will be secondary. As long as she has no other insurance providing prescription drug coverage, she will be eligible for free Meds by mail drug coverage through Champva. Free prescriptions.

If you have any other Champva questions, let me know. You can probably also find the 2014 Champva Guide online which should answer most of your questions.

Good luck.

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Something else I failed to mention is your wife can request reimbursement from Champva for any out of pocket medical expenses she incurred since her official eligibility date for Champva. Her eligibility date will probably be the effective date of your 100% P & T rating and will be shown on her Champva ID card. Once she receives notification of her eligibility, I believe she has 180 days to file the claims for reimbursement.

You probably already knew this but you were also eligible for reimbursement of VA copays paid for service connected conditions back to the effective date you were rated 50% or higher.

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  • HadIt.com Elder

Every VAMC has a ChampVA person that can answer your questions and assist you to fill out forms.761 is to much when ChampVA is earned and the supplemental insurance is very inexpensive with small copays if any. When she gets Medicare its even better.

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