top of page

Understanding VA Health Insurance Options: CHAMPVA, TRICARE, and VA Community Care Network

Sep 16

5 min read

0

4

0


As veterans and their families navigate the complex landscape of healthcare, it's crucial to understand the various insurance options available through the Department of Veterans Affairs (VA) and the Department of Defense (DoD). In this comprehensive guide, we'll explore three major programs: CHAMPVA, TRICARE, and the VA Community Care Network (CCN). Each of these programs plays a vital role in ensuring that veterans, service members, and their families receive the care they need.


CHAMPVA: Civilian Health and Medical Program of the Department of Veterans Affairs


What is CHAMPVA?

CHAMPVA is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. It's designed to provide coverage for the spouses and children of veterans who meet specific criteria.


Eligibility

CHAMPVA is available to:

  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 of 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.


Coverage

CHAMPVA covers most health care services and supplies that are medically necessary. If it's something that a different insurance has covered, CHAMPVA probably covers it as well. Basically, if your doctor says that you need it, they will cover it. They also cover mental healthcare with virtually no limits.


Cost-Sharing

Beneficiaries are responsible for paying 25% of the cost of treatment until they reach a maximum of $3000 out of pocket (for the entire family) for the year. After that, CHAMPVA covers 100% of the cost of care. There is also no premiums.


TRICARE: Health Care Program for Uniformed Service Members and Their Families


What is TRICARE?

TRICARE is the health care program for uniformed service members, retirees, and their families around the world. It provides comprehensive coverage to all beneficiaries, including health plans, special programs, prescriptions, and dental plans.


Eligibility

TRICARE is available to:

  1. Active duty service members and their families

  2. National Guard and Reserve members and their families

  3. Retired service members and their families

  4. Survivors

  5. Medal of Honor recipients and their families

  6. Others registered in the Defense Enrollment Eligibility Reporting System (DEERS)


Types of Plans

TRICARE offers several health plan options to meet the diverse needs of its beneficiaries. For brevity, we won't go into all of them now. The coverage will usually be the same for each of their plans.


Coverage

Like CHAMPVA, TRICARE covers a wide range of services that is very comprehensive. in 99% of situations, If your doctor says that you need it, its going to be covered.


Cost-Sharing

Costs vary depending on the beneficiary category and the chosen plan. Active duty service members typically receive care with no out-of-pocket costs, while other beneficiaries may have enrollment fees, deductibles, and copayments.


VA Community Care Network (CCN)


What is the VA Community Care Network?

The VA Community Care Network (CCN) is not an insurance program but a network of community providers who can deliver care to veterans when the VA cannot provide the care needed. It's part of the VA's commitment to providing veterans with timely, high-quality care.


Eligibility

Veterans may be eligible for community care based on their individual health care needs or circumstances, and if they meet specific eligibility criteria, such as:

  1. The specific care needed is not available at a nearby VA medical facility