CHAMPVA supplements

[bobz]

I am just wondering if any of you that have CHAMPVA are using any supplements other than Medicare/Medicaid?  I had Selman through AMRA but now AMRA is shutting down the only way you could get it was through them.

[broncovet]

My recommendation:

You dont need a supplement to champva UNLESS you are over 65.  

Champva is the best insurance money cant buy.  

When champva pays the claim, they send us a copy of how much they paid and for what.  At the bottom of it it says, to the effect, that the Veteran is not responsible for any more than that.  

If you are over 65, you have to opt in to medicare part B. If you are on medicare part B, THEN you can get a

"medicare advantage plan" which often pays more than regular medicare.  Your spouse can likely get medical care at a VAMC if you have champva.  However, as to whether or not spouses can enroll at VAMC for care is an individual decision made by your local hospital.  

[broncovet]

Even my insurance agent (for medicare advantage plan) agrees that a supplement to champva is a waste of money.  I think the annual deductable for champva is 50 dollars, and it makes no sense to buy insuarnce to try to cover that 50 dollars and the rare copays.  

In my case, the medicare advanatage plan actually hurts us in prescriptions.  Here is why:

With champva you can get "meds by mail" but ONLY if you do not have an medicare advantage plan.  Meds by mail through champva have no copay.  So you would pay "0" without medicare advantage for prescriptions, but "more than that" if you have a medicare advantage with prescription coverage, and champva.  Im not saying it makes sense, but this is the best information I have available, from champva.  

We are dropping the medicare advantage prescription plan, next enrollment period, so she can get meds by mail through champva at no cost.  Emphasize:  we are dropping the prescription part only of medicare advantage, not medicare advantage plan in its entirety, just the prescription part.  Medicare part b or a medicare advantage plan is required by champva when you are over 65.  But not for prescriptions, that part of the plan is not required.  

[Gastone]

Then there's this, CHAMPVA reimburses all my wife's local Pharmacy co-pays. We carry the ARRP United HealthCare Supplemental, her's costs about $25.00 per mos more than mine, I don't have the Rx Rider.

I've never compared the CHAMPVA Rx Formulary to the VMC, but we're all familiar from past experience, with how the VA decides which Rx we're going to get.

As to treatment at the VMC, I'd rather she go to a Private specialist/Hospital anyway, but I don't think CHAMPVA allows VMC treatment any longer.  A good friend, wife's been on CHAMPVA for 20 years and had been receiving care at our VMC, told me that his wife had to find non-VMC PCP/Specialists and Hospital care. I believe this took place about 2 yrs ago when she went on Medicare.

[Rattler]

My wife just went on it in September 2021. We had some issues when we dropped her insurance it took CHAMPVA forever to get it off her account and start paying. There is a $3000 yearly deductible where the co-pay is $75 (Or they pay 75% and you Pay 25%) until you reach the deductible than they pay 100%. As broncovet stated its the best insurance for the money. (it's free if you are 100%)

[broncovet]

While this post is around 5 years old, it is still relevant.   We are not the only ones with questions about Champva, and/or other current insurance.  

Champva works good with other insurance, such as a medicare advantage plan, when over 65 or permanently disabled.  

Remember, Champva is for Vets families, such as the spouse.  I mostly just use VA medical care.  

It worked well for us with both Anthem, and Humana.  There is one critical thing you need to know:

"Meds by mail" at champva will mail you medications at no cost or deductable, "but only if" you have no other prescription insurance plan.  

We actually cancelled the Humana prescription plan, and use champva meds by mail, because on Humana, we would have had to pay $150 per month (copay) on just one of my spouse meds.  More for the others.  

After many phone calls, we canceled the prescription coverage (only prescription) at Humana and use champva meds by mail exclusively, saving hundreds of dollars per month in copays.  

Meds by mail is not always the most convenient..you need to give them a couple weeks to mail out prescription, but it works great with "regular" meds, not so much if you go to the ER and the doc prescribes an antibiotic or other med you need right away.  

So, our solution is "if she goes to ER" and needs meds now, we use a local pharmacy along with a app coupon, I think its called 

GoodRx or something close.  There are several.  So, for us, we wind up paying maybe $15-$30 per year for emergency meds, out of pocket, but save hundreds per month.  Its a no brainer for us to cancel medicare advantage prescription plan, use Champva meds by mail, and pay for it when its an emergency out of pocket.  

You may be able to get reimbursed by champva meds by mail, which did happen for a while, but that fizzed out.  It isnt worth $15 of my time to call champva and deal with them, I just pay it.  All in all, our medical care expenses are exceptionally low, under 50 dollar a YEAR.  Plus, we no longer pay for medicare advantage prescription drug plan, which would be probably 50 bucks a month.  

So, $50 per year or less, is much cheaper than $50 per month in insurance AND, you still have to pay deductables and copays, and with champva no deductable, no copays.