Champva

[tanker31]

In October 06, I became 100% P&T. My service officer suggested that I apply for CHAMPVA for my spouce. I did, and the process went smooth. Last week my wife attempted to use CHAMPVA at our family doctors office, and also went to have annual mammmogram ( referal from her OBGYN ). On both occasion, they refused to accept CHAMPVA for payment ( or even partial payment--I know Champva is secondary to all other coverages, but this is the only coverage I have for my wife ). Both doctor's office stated : "CHAMPVA is only accepted as a secondary to MEDCICARE". We do not have Medicare.

Is CHAMPVA any good, Am I missing something, or are the doctors not up-to-date?

Input please.

Tanker31

[frosty69]

tanker31

Yes, Champva is secondary to all other insurances, including Medicare, but if you have no other insurance then Use Champva as your Primary Insurance. My wife had it since I got my 100% in May of 1998, and if you happen to have any out standings bills, or if you paid any medicals bills, back to the date you got your 100%, then Champva will reimburse you, as when I got bump up to 100% in 2003, Champva went back to May of 1998, when I filed for a increase, we got several thousands dollars paid back to us. My wife is also on Medicare, having got severely injured on the job in 1989, and couldn't work anymore. Champva is accepted everywhere up, as everyone says it pays really good. I would say, my wife less then 200 a year out of pocket for medical expenses a year, including pills, and if ever your wife gets on pills on a steady basis, then just order it from them, and you have no co-pay at all.

[jlshand]

FROSTY,

What forms did you use to get paid back by Champva for your wife's old medical bills ?

Do you mean that Champva paid her out of pocket medical bills from back before you increased to P&T?

I just got increased to P&T going back to July of 2005. Wife had huge out of pocket med expenses in 2006. Is this like your situation in that they will pay her for the 2006 expenses once we sign her up????

[Berta]

My insurance man said it is the Best (CHAMPVA)

it is an excellent program and an incredible benefit.

And these guys are right- retro to the EED of 100%SC P & T.

Lots of info at:

http://www.va.gov/hac/forbeneficiaries/champva/champva.asp

[john999]

I expect my Blue Cross to become so expensive in future years that ChampVA is going to come in very handy. I think that medical insurance is one benefit you cannot have too much of because one illness can cost thousands and thousands. If a person spent 2-3 weeks in intensive care that would probably be close to 100,000 bucks. Long term care insurance for the spouse is important as well. If the spouse can't pay they look for the other spouse to pay. The VA will pay for us vets 70% and over, but not for a spouse. As long term care becomes more expensive and people live longer I expect the government to try and make it much harder for people to get medicade to pay for nursing homes. They have already increased the "look back" time to check for assets. Very few people have LTC insurance and no one sees themselves or their spouse spending years in a nursing home. We are talking about 75,000.00 bucks a year and medicare won't pay. No one can pay this except Bill Gates. If you get it while you are still young it is much cheaper.

[jlshand]

BERTA,

Also true that by regulation, Champva will

automatically deny any claim submitted more than one year from the actual expense.

This info from the Champva manual/ brochure , downloadable at HAC website

[frosty69]

jlshand

What forms did you use to get paid back by Champva for your wife's old medical bills ?

I don't remember what forms they were, my wife just called the 800 number, and Champva sent the forms to her, the veterans can't request them the wife and/or dependents have to, I tried the first time, they told me on account of the privacy issue, and the insurance is for the wife and/or dependents, so they have to all the calling and paperwork

Do you mean that Champva paid her out of pocket medical bills from back before you increased to P&T?

No, not before I got P&T, but right back to May 28, 1998, the day I filed my original claim for a increase. I was approved in Nov of 2003, so all of my wife medical bills, paid and not paid when back to that day, the ones we paid out of pocket were paid to us, they don't tell you about this part of it, you have to ask. I read about it in their book my wife received, like I said it is in the book, but you still have to request and you have to prove everything, so if you all the paperwork then you are ok, if not ?

I just got increased to P&T going back to July of 2005. Wife had huge out of pocket med expenses in 2006. Is this like your situation in that they will pay her for the 2006 expenses once we sign her up????

Yes, that is the way it was in 2003, unless they changed something, all I look for, every year when she gets your new book, is if there are any new things they might pay for. Like I said if you have all the paper work, and/or copies of the bills and paid from doctors/hospitals, then you should be ok.