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?  

[Rattler]

So just to let you know. When I moved my wife from her work BC BS I made the mistake of listing BC BS on the application form. ( If you are taking them off other insurance don't do this) CHAMPVA will bill your other primary provider first than CHAMPVA. CHAMPVA will denie  all the claims assuming that your other primary provider will pay first. I will takes 3 to 4 months to process you application just call the 800 no. and listen to the recorded message. I am still dealing with the mess of having to make providers submit claims from September 2022 through April 2023 when CHAMPVA finally fixed the problem. CHAMPVA pays 80% you pay 20% up to the $3000 ductable than it pays 100%

[56pan]

"CHAMPVA pays 80% you pay 20% up to the $3000 ductable than it pays 100%"  So, with CHAMPVA my wife would still need my wife's supplemental insurance to cover the 20% that CHAMPVA does not cover until the $3000 deductible then?  If that's true I see no need for her to change from Medicare.

"The vets advocate at my local VA medical center told me on the phone that CHAMPVA pays on the same "schedules" as medicare." From an earlier post I wrote above.  So, the vets advocate was correct.  She'd still need supplemental insurance but I'm not sure if what she has would pay for the 20% left over from CHAMPVA as they're listed as "Medicare supplemental insurance."  I'll get the vets advocate on the phone next Monday and get to the bottom of it.

[Rattler]

Yes CHAMPVA pays on the same "schedules" as medicare." That is Only medicare not the supplemental medicare. The supplemental medicare pays more than medicare depending on what state you are in and what carrier you have for the supplemental medicare it will pay possibly more. (Vision, Dental, and others)

My wifes Co. policy was about even if not a less than CHAMPVA. You really need to get the co-pay schedule from CHAMPVA and compare it with the supplemental medicare that you are looking at. 

If you were to combined CHAMPVA with the supplemental medicare you would probably have no co-pay on most claims. (Remember CHAMPVA is free to you as a veteran) To be honest the co-pays are not any more than straight medicare. 

[56pan]

"Yes CHAMPVA pays on the same "schedules" as medicare." Thanks, Rattler.  That's what I was wanting to confirm.  So, we'll keep my wife's supplemental plan.  Still going to stop by and see the vet's advocate when I'm at the VA on the 29th and get it all explained.  Again.