CHAMPVA question.

[56pan]

"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." That's from the VA website covering CHAMPVA eligibility requirements.  My disability rating is 80% but my TDIU decision letter states that: "Basic eligibility to Dependents' Educational Assistance based on permanent and total
disability status is established from August 8, 2022." I called my local VA medical center, Salisbury NC, about a year ago and asked them if I was eligible for VA dental care and told the fellow there that my TDIU decision letter stated that I was permanently and totally disabled. I had read that you had to have a 100% disability rating for VA dental care.  He told me that I was eligible since I was considered permanently and totally disabled. So, I'm getting the dental care.  But I cannot find an answer to if my wife is eligible for CHAMPVA with my 80% disability rating but am considered permanently and totally disabled by the VA?  I did all the paperwork for her CHAMPVA last week and submitted it along with my DD214 and TDIU decision letter.  I'm just wondering if anyone here knows the answer to whether my wife is eligible or not?  

[pacmanx1]

18 minutes ago, 56pan said:

"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." That's from the VA website covering CHAMPVA eligibility requirements.  My disability rating is 80% but my TDIU decision letter states that: "Basic eligibility to Dependents' Educational Assistance based on permanent and total disability status is established from August 8, 2022." I called my local VA medical center, Salisbury NC, about a year ago and asked them if I was eligible for VA dental care and told the fellow there that my TDIU decision letter stated that I was permanently and totally disabled. I had read that you had to have a 100% disability rating for VA dental care.  He told me that I was eligible since I was considered permanently and totally disabled. So, I'm getting the dental care.  But I cannot find an answer to if my wife is eligible for CHAMPVA with my 80% disability rating but am considered permanently and totally disabled by the VA?  I did all the paperwork for her CHAMPVA last week and submitted it along with my DD214 and TDIU decision letter.  I'm just wondering if anyone here knows the answer to whether my wife is eligible or not?  

If you are rated TDIU P & T the extra or additional benefits comes with the Permanent and Total rating part. Read your decision packet again and there should be a VA Form 21-8760 in it that talks about Additional Benefits for Veteran Service Connected with a Permanent and Total Disability. So, yes, your dependents should be covered under CHAMPVA. Make sure you read both pages. 

21-8760 (va.gov)

Edited November 19, 2023 by pacmanx1

[Guest]

Pacman is correct.  Check the age for the children of the requriments for age and going to school and such.  

[56pan]

Thanks very much, sir.  My answer was on page 2 of the form.  My wife can get the CHAMPVA benefit.  One more question if you don't mind: I know that CHAMPVA can replace her medicare, but does it cover prescription drugs?  Again, thank you for your time and help.

[56pan]

Thank you Shrek.

[Guest]

yes after you pay the $300 I think.  There is an out of pocket, but they send her checks all the time.  

[broncovet]

Champva for the spouse "in my humble but unqualified opinion" is the best insurance money cant buy.  

And, to add, yes, Champva covers prescription drugs, but there is a caveat:  It wont cover drugs "if you have other prescription care", such as medicare prescription plan.    This is a big deal and I will explain why.

We found out the hard way.  

Wifey went for the medicare prescription plan, even tho I didnt think it necessary.  So, she gets some issues, such as heart issues and needs a blood thinner.  Cant recall the name of it, but its not comoudin, its a more expensive high tech blood thinner.  

$180 PER MONTh for ONE prescription and she had about 10 different prescriptions.  After many calls back and forth, we finally find out she needed to cancel the medicar prescription portion only (medicare part D, prescription care).  We did cancel the medicare part d.  Now, she pays zero dollars copay, zero dollars a month, with no deductable but only with champva "meds by mail".  

Now, sometimes my wife needs "now prescriptions" and cant wait for meds by mail.  In that case, we get the prescription filled a the local pharmacy and pay for it.  Champva used to have a reimbursement program for that..but it was slow, and not so steady.  So, while we did get some reimbursement for a while, we spend an average of less than 20 dollars "per year" for those "now prescriptions".  It is sometimes a bit of a hassle that her doctor needs to send the prescription to champva, but it is way, way way better than hundreds or even thousands of dollars per month for presctions through medicare.  The key to get champva meds by mail is to "not" repeat NOT have another prescription plan.  My spouse is "insurance crazy" and buys every insurance policy ever offered to her.  Well, not anymore.  

    My sons wife bought a cell phone "protection plan".  It sounded like a good idea to her at the time.  She paid $10 per month for around 30 months ($300) for this "insurance" to replace the cell phone.  So, she has a loss, the phone breaks.  She files a claim.  They said, Ok, there is a $150 deductable, and your cell phone is now worth about $150.  So where can we mail you a check for $0.00 cents for your claim benefits?  

She should have instead used the $300 to light her campfire, at least she would have gotten a warm feeling from it, instead of the insurance.  Part D, at least for Champva people who are willing to wait for meds by mail, has a negative value, in my opinion.  Its worth less than nothing.  They would have to pay us about $1000 per month to take the medicare Part D, for us to come out even.  But that would not be enough, because, with inflation, the drugs would probably be $1500 per month now.