100% granted and now what?

[bunny]

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?

[Guest L]

Hi- Here is a very recent link from had it postings., to answer your question.  VA.gov has excellent info,  your award letter should also give information.( at least mine did-  although I am not married)  

 

[Buck52]

bunny

if you was awarded 100% P&T you should have got all of champVA forms to fill out  for your spouse to be covered by champVA Insurance,as well as other benefits that the P&T Has.

Recheck your packet for these forms , some time were just too excited about winning  and forget to check all the paperwork that comes in our packet.

You need to fill out these forms ASAP.

[Berta]

Buck- things must have changed re: CHAMPVA because I never received a CHAMPVA APP with my award letter-but that was many years ago------

I did receive the Chapter 35 applications for me and my daughter with the award.

A few weeks later I received a letter from the VA saying I might be eligible for CHAMPVA and should apply for it,but they only gave CHAMPVA contact info ...no application.So I did contact them directly, applied for CHAMPVA and have been on CHAMPVA for many years.

https://www.va.gov/COMMUNITYCARE/programs/dependents/champva/index.asp

This link with the buttons of the left of this page gives a lot of info and I am sure there is a spot to apply on line with-----also I called CHAMPVA twice since 1991 ( my EED) and got a real person who knew what they were doing.

Also we have had Glenn Johnson who runs CHAMPVA here at our podcasts many tyimes and he always gives out his contact info.

I have been assuming (for many years) that the only way a vet knows they are P & T -if this is not stated clearly in the award letter, is when the DEA Chap 35 Educational apps are included with the 100% P & T award.

If VA is supposed to include CHAMPVA apps now too with a P & T award - that is news to me....

 

 

[Tbird]

From VA.gov

CHAMPVA Eligibility

To be eligible for CHAMPVA, you cannot be eligible for TRICARE, and you must be in one of these categories:

1. The spouse or child of a Veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office.
2. The surviving spouse or child of a Veteran who died from a VA-rated service-connected disability.
3. The surviving spouse or child of a Veteran who was at the time death rated permanently and totally disabled from a service-connected disability.
4. The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).

An eligible CHAMPVA sponsor may be entitled to receive medical care through the VA health care system based on their own Veteran status. If the eligible CHAMPVA sponsor is the spouse of another eligible CHAMPVA sponsor, both may now be eligible for CHAMPVA benefits. In each instance where the eligible spouse requires medical attention, they may choose the VA health care system or coverage under CHAMPVA for their health care needs.

NOTE: The eligibility of a child is not affected by the divorce or remarriage of the spouse except in the case of a stepchild. When a stepchild leaves the sponsor's household, the child is no longer eligible for CHAMPVA.

New and Expectant Parents

If you are expecting and you need to establish CHAMPVA eligibility for your new child, the following must be accomplished before you can submit an application:

1. Obtain a Social Security number for the newborn by applying to the nearest Social Security Administration office.
2. Establish dependency of the newborn to the Veteran sponsor by contacting the local VA regional office.

Since the medical claims cannot be paid until the child is verified as eligible by CHAMPVA, we encourage you to take the above action as early as possible.

Remarried Widows/Widowers

Eligibility for CHAMPVA ends at midnight on the date of your remarriage, if you remarry prior to age 55. If you remarry on or after your 55^th birthday, the Veterans Benefit Act of 2002, Public Law 107-330, allows you to keep your CHAMPVA benefits.

Termination of Remarriage

If you are a widow(er) of a qualifying sponsor and you remarry, and the remarriage is later terminated by death, divorce, or annulment, you may reestablish CHAMPVA eligibility. The beginning date of your re-eligibility is the first day of the month after termination of the remarriage or December 1, 1999, whichever date is later. To reestablish CHAMPVA eligibility, copies of the marriage certificate and death, divorce, or annulment documents (as appropriate) must be provided.

Beneficiaries Age 18 to 23

When a CHAMPVA-eligible beneficiary turns 18, CHAMPVA requires that the beneficiary submit proof to CHAMPVA of full-time enrollment in an accredited educational institution for benefits to continue. Information on submitting proof of enrollment can be found on our School Enrollment Certification Requirements for CHAMPVA Benefits Fact Sheet (PDF).

Primary Family Caregiver

A Veteran's Primary Family Caregiver may also be eligible to receive medical care through CHAMPVA if the Primary Family Caregiver is not entitled to care or services under a health care plan. For more information about CHAMPVA for the Primary Family Caregiver, please visit Information for Caregivers.

More information on the type of caregiver benefits and services that are available can be found at VA Caregiver Support Program.

Impact on Medicare

CHAMPVA is always the secondary payer to Medicare. If you are eligible for Medicare, at any age and for any reason, you must enroll in Medicare Part A and Medicare Part B to keep your CHAMPVA benefits. Social Security Administration documentation of enrollment in both Part A and Part B is required by CHAMPVA. For more information on Medicare, please visit Medicare.gov.

To continue to receive CHAMPVA benefits after age 65, you must meet the following conditions:

• If you turned 65 on or after June 5, 2001, you must be enrolled in Medicare Part A and Part B to remain eligible for CHAMPVA.
• If you turned 65 or older prior to June 5, 2001, and were otherwise eligible for CHAMPVA, and were entitled to Medicare Part A coverage, then you may be eligible for CHAMPVA without having to have Medicare Part B coverage.
• If you turned 65 before June 5, 2001, and have Medicare Part A and Part B, you must keep Part A and Part B to be eligible for CHAMPVA.
• You are not required to enroll in Medicare Part D in order to become or remain CHAMPVA eligible.

NOTE: If you meet the criteria for CHAMPVA eligibility and are not entitled to Medicare Part A, you must submit a "Notice of Disallowance" from the Social Security Administration—indicating why you do not qualify for Medicare benefits—along with your CHAMPVA application.

 

Medicare with Certain Disabilities

Eligibility for CHAMPVA benefits can be impacted by approval of disability benefits. If you are approved by Social Security Administration (SSA) for disability, you may become entitled to Part A: Premium-free hospital insurance. To continue your CHAMPVA eligibility, you MUST enroll in, and remain enrolled in, Medicare Part B: Outpatient insurance, while you are entitled to Part A.

If you qualify for disability under End Stage Renal Disease (ESRD), you must apply for Medicare benefits. Medicare coverage begins with the third (3rd) month after the month in which a course of maintenance dialysis begins.

Termination of enrollment in Medicare Part B may result in loss of CHAMPVA benefits effective with the date of such termination.

To determine CHAMPVA eligibility, SSA documentation of enrollment in both Medicare Part A and Medicare Part B is required. Acceptable documentation includes a copy of the beneficiary Medicare card, a letter from the SSA that provides the dates of Medicare eligibility, or any valid verification from SSA.

If you do not have enough work quarters to qualify for Part A, a “Notice of Disallowance” is required indicating you are not eligible for Medicare benefits under any social security number.

CHAMPVA is NOT considered primary health coverage.

For more information and resources about Medicare disability benefits, please visit Medicare.gov > Disability, Get Medicare.

More Information

• Fact Sheet 01-02: CHAMPVA Eligibility
• CHAMPVA Guide
• How to Apply for CHAMPVA

[Buck52]

Yes Ms berta I could be all wrong and they may still do like you mention send the ChampVA  forms  to the Veterans family later?

but if I remember correctly in 2002 When I recieved my P&T Award  they included the forms for ChampVA Insurance in my Award packet and the forms for the free Life Insurance Policy that the VA Pays for   worth 10.000.00$$$ and how to Disagree with the decision if I disagreed with them.

I was just basing my post on how they did me years ago, but like I mention I could be all wrong and I sure don't want to mislead any Veteran and their family's.

Yes I remember speaking with Glen Johnson about 2 years ago  getting a power chair for my spouse.  he help us get it from a outrageously overpriced medical supply store.

Ms T put up in the above  how to apply for ChampVA.  We should all use that for information.

sorry if I caused some problems.

[Berta]

No need to apologize at all Buck---they certainly could have changed their policy and now send the CHAMPVA apps with the P & T award, along with the DEA Chap 35 apps.It would make  a lot of sense.

Glen is great. He wanted me to change my med to Meds by Mail-so that I would not have the 50$ co pay.

My dead husband ( and another veteran in my locale they could have killed) was a victim of a Meds by Mail error. I would rather pay the 50 bucks at my local pharmacy. This was not a Post Office  delivery error.