CHAMPVA
Serving Veterans and Government Employees Since 1965

CHAMPVA SUPPLEMENTAL INSURANCE PLAN


The plan is designed to wrap around your current CHAMPVA benefit insurance coverage. As a result, in most cases, you will obtain reimbursement for out-of-pocket expenses not paid for by CHAMPVA.
The supplement, like the CHAMPVA health insurance program itself, assists the spouses and dependents of 100% Service Related Disabled Veterans.

Helping Protect Your Family

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. CHAMPVA is administered by the Veterans Health Administration Office of Community Care (VHA OCC) in Denver, Colorado.

In general, the CHAMPVA program covers most health care services and supplies that are medically and psychologically necessary.
Upon confirmation of eligibility, you beneficiaries receive program material that specifically addresses covered and non-covered services and supplies in the form of a CHAMPVA handbook from U.S. Department of Veterans Affairs. For more information about CHAMPVA and the U.S. Department of Veterans Affairs, visit the VA website at https://www.va.gov/.

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THIS PLAN HELPS TO REDUCE OR ELIMINATE YOUR COST FOR

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Emergency Room Visits

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Doctors Visits

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Outpatient Procedures

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Excess Charges

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Hospital Stays

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Prescription Medications

CHAMPVA Pays*
75%

Doctor Office Visits
Hospitalizations
Pharmacy

Supplement Pays*
25%

Doctor Office Visits
Hospitalizations
Pharmacy

You Could Pay
$0.00

on Covered Medical Expenses*


 

Helping Protect Your Family

The table below illustrates who pays with a CHAMPVA Supplement Insurance Plan. You must meet the Supplement Plan Deductible (Individual $250/Family $500) before the supplement pays.
CHAMPVA Pays Supplement Pays You Pay
CHAMPVA Deductible Individual $50 / Family $100 $0 $0 $50 / $100
Supplemental Plan Deductible Individual $250 / Family $500 $0 $0 $250 / $500
Doctor Visits 75% 25% $0
Hospital Stay 75% 25% $0
Ambulance 75% 25% $0
Emergency Room 75% 25% $0
Medications 75% 25% $0

 

Competitively-Priced Premiums

As a GEA member, you benefit from the association’s mass purchasing power, making the rates for this valuable coverage more competitive.**
Age of Beneficiary Quarterly Rate with First Year Discount | Base Rate***
Under 40 $96.12 | $108
40 - 44 $106.80 | $120
45 - 49 $122.82 | $138
50 - 54 $157.53 | $177
55 - 59 $186.90 | $210
60 - 64 $224.28 | $252
Each Child $74.76 | $84
* After the CHAMPVA Deductible and CHAMPVA Supplement Plan Deductible have been met.
**Rates and/or benefits are based on the attained age of the Insured Person and increase as the Insured Person enters each new age category. Rates and/or benefits may be changed on a class basis. Plan or rate changes may be subject to final approval by the applicable regulatory authorities.
*** First year discounted rates are not available to insureds in OH or KY. Members receive an 11% rate discount during their first twelve months of coverage. There are no other discounts. After the 12th month, the rates go up 11%.

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Am I Eligible?

  • Eligible Spouses and Dependent Children of a disabled veteran are eligible if they are covered by CHAMPVA and are GEA members.
  • A widow(er) who is a GEA member is also eligible for coverage as well as their Dependent Children.
  • Unmarried Dependent Children under age 18, or under 23 if enrolled as a full-time student, may also enroll.
  • Eligible Spouse means a spouse who is under age 65 and not legally separated or divorced from the disabled veteran.
  • Individuals who are Medicare beneficiaries may not enroll in the CHAMPVA Supplement Insurance Plan.

PRE-EXISTING CONDITIONS LIMITATION

Any injuries or sickness whether diagnosed or undiagnosed, for which a covered person received medical care or treatment within the 6-month period preceding the effective date of his or her insurance will not be covered until the coverage has been in effect for 6 months. However, treatment related to new conditions will be covered immediately.


Common Questions and Concerns

These conversations are fictitious and for illustrative purposes. Have additional questions? Call a CHAMPVA Supplement Insurance Plan Specialist at 888-214-0794.

Customer: How does the CHAMPVA Supplement work with drug co-pays?
CHAMPVA Supplement: If CHAMPVA covers that prescription, we will reimburse the co-pays after your deductibles are met.

Customer: Our son has been recently diagnosed as a Type 1 diabetic. We’re looking for insurance assistance for glucose monitors and insulin pumps. He is age 15.
CHAMPVA Supplement: We can definitely help your family! There is a six-month waiting period for preexisting conditions†, but once that time has passed, we will pick up the portion that CHAMPVA does not pay.

Customer: My husband is going through a psychiatric treatment of about 39 treatments. A co-pay every time. How would we be reimbursed?
CHAMPVA Supplement: Co-payments are paid when a claim is submitted after a deductible(s) is met (if applicable). After the co-payments are paid, submit the claim to be reimbursed.

Customer: I recently got a prescription and CHAMPVA didn’t pay any of it. Will my CHAMPVA Supplemental Plan cover it?
CHAMPVA Supplement: CHAMPVA Supplement covers most prescription drugs approved by the Food and Drug Administration. Unfortunately, if CHAMPVA does not cover your prescription, your Supplemental Plan will not either.

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The savings examples are for illustrative purposes only. Actual savings may vary by case. CHAMPVA's portion of coverage is provided here for your convenience, but is subject to change by VA (Department of Veteran Affairs); Visit www.va.gov for the most up-to-date information. Important Documents: All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations and terms under which the policies may be continued in force or discontinued. Read details for your type of supplement insurance plan: CHAMPVA.

The CHAMPVA Supplement Insurance Plans are administered by SelmanCo. Underwritten by: Hartford Life and Accident Insurance Company, One Hartford Plaza, Hartford, CT 06155. TRICARE Form Series includes GBD-3000, GBD-3100, or state equivalent. Policy Number: AGP-5928. Not available in all states.
 
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