CHAMPVA TRICARE is a similar program created by the Veterans Health Care Expansion in 1973. The Civilian Health and Medical Program of Veterans Affairs is effective September 1, 1973. CHAMPVA covers families of veterans who are not eligible for TRICARE and is for spouses and children veterans with total, permanent, service-connected disabilities, and for surviving spouses and children. of veterans who retire from service-connected disabilities. The purpose is a function of benefits and premiums are not (Fordney, 2006, p. 462).
CHAMPVA is very similar to the TRICARE program. The two programs are easy and often confused with each other. CHAMPVA is a consumer Veterans-affairs program, while TRICARE is a regionally administered health care program for active duty and retired members of regular services , families and survivors. There are individual differences between CHAMPVA and TRICARE, as there are very distinct differences between the two (DeLorenzo, 2003, p. 15).
The following people are eligible for CHAMPVA while not eligible for Standard TRICARE benefits and in Medicare Part. A for age 65: Spouse or child of a veteran who is permanently rated 100% and totally disabled due to lack of service by a VA regional or surviving spouse or child of the veteran. who died of a VA-rated duty-connected disability, or who at the time of death was rated 100% permanently and totally disabled, or the surviving spouse or child of a military member who died in the line of duty, through no fault of their own (Eligibility. Necessity).
The Department of Public Affairs is responsible for determining who enters the CHAMPVA program. A prospective beneficiary should go to the nearest VA medical center to determine whether or not they are eligible. When a person is eligible for CHAMPVA and their medical benefits are verified, a VA beneficiary identity is issued (Fordney, 2006, p. 462).
Fuse, CHAMPVA covers most all treatment services and supplies that are medically and psychologically necessary. Upon confirmation of an individual’s eligibility, they receive program material that specifically addresses all covered and all non-covered services and supplies. Restrictions include the following: Care as part of a grant, study or research program; It is considered an experimental or research concern; Treatment of persons eligible for benefits under other government agency programs, other than Medicaid and State Crime Victim Compensation programs; Care for which the beneficiary is not required to pay, such as health services obtained fine; Care provided outside the scope of the provider’s license or certification; Custody, home or respite care; Dental care other than treatment related to certain covered medical conditions; Medicines that do not require a prescription (excluding insulin); Personal convenience and convenience; Services suspended by providers or sanctioned by other federal entities (DeLorenzo, 2003, p.15).
To qualify for the CHAMPVA program, veteran clients must have a social number and their dependents. The veteran sponsor must be appointed by the local VA regional office. Once their dependency is established, they must then obtain and complete an application, which can be done by phone, by fax, or by downloading the application from the VA website (Fordney, 2006, p. 462). Beneficiaries also issue an ID that consists of an old VA instrument number with an alpha suffix. All clients 10 years of age and older must have uniform identification and privilege cardinal services (p. 463).
When someone enrolled in CHAMPVA visits a medical office, the medical administrative assistant must verify the individual’s VA identity. After the card is verified, individuals can see a doctor. With MA requests for professional services, VA form 10-7959A is completed and submitted. Claims must be submitted within 1 year from the date of the patient’s discharge from the inpatient facility or within 1 year from the date of service (Fordney, p. 465). Upon completion of the application process, a payment check is generated and an explanation of benefits document is sent to the beneficiary. The explanation of benefits summarizes the action taken by the applicant and also contains important information (p. 268).
CHAMPVA offers a very beneficial insurance program for those who are not yet eligible for TRICARE. It also includes spouses and children of veterans with total, permanent, service-connected disabilities, as well as survivors of spouses and children of veterans who die due to service-connected disabilities. Without CHAMPVA, many people would be without insurance (Fordney, 2006, p. 462).
References
CHAMPAI Said Form. Retrieved July 14, 2007. from: http://www.usa-federal-forms.com/usa-fedforms-dod-va/dod-va-10-7959a-nonfillable.pdf
CHAMP-VA Eligibility. (2003). Retrieved July 14, 2007, from: http://www.co.sherburne.mn.us/veterans/federal/CHAMPVAEligibility.htm
DeLorenzo, G. Medical Benefits for Veterans. Retrieved July 14, 2007, from:
www.passenter.org/pdf/VeteransServicesGuide.pdf
Fordney, M. (2006). Medical Insurance Handbook Office. St. Louis: Elzevier Inc.
Fordney, M., Follis, J., & French, L. (2004). Administrative Medical Assistant. New York:
Delmar Learning.
