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\nMISSION STATEMENT  \n\"To fulfill President Lincoln’s  \npromise to care for those who  \nhave served in our nation’s  \nmilitary and for their families,  \ncaregivers, and survivors.\"  \nCHAMPVA Guidebook, updated Jan. 1, 2025 1  \nTABLE OF CONTENTS  \nSECTION PAGE  \n1 ABOUT CHAMPVA 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 3  \n2 CONTACT INFORMATION 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 4 Customer Service 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 4  \n3 ELIGIBILITY 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 5 Factors Impacting Eligibility 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 5 Caregiver Eligibility 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 6 CHAMPVA and Medicare 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 7 A Brief Overview of Medicare Parts A, B, C & D 􀀮 􀀮 􀀮 􀀮 8  \nFrequently Asked Questions on  \nMedicare and CHAMPVA 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 9 CHAMPVA and TRICARE 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 10  \n4 HEALTH BENEFITS AND SERVICES 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 11 CHAMPVA Covered Services and Supplies 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 11 To Obtain Pre-authorization for Mental Health and Substance Abuse Services 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 12  \n5 OTHER COVERED SERVICES 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 13 Behavioral Health Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 13 Dental Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 17 Diabetic Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 18 Durable Medical Equipment Services (DME) 􀀮􀀮􀀮􀀮 19 Extended Care 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 22 Family Care Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 24 General Medical Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 28 Pharmacy Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 31 Preventive Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 33 Reconstructive Surgery 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 35 Testing Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 37 Therapy Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 39 Transplant Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 41 Vision Services 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 42  \nSECTION PAGE  \n6 GETTING CARE 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 44 Finding a Provider 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 45 Getting Pharmacy Services 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 46  \n7 YOUR COSTS 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 49 Understanding Your Costs 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 49 Coverage Outside the United States 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 50 Cost Summary – When You Have No Other Health Insurance 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 51  \n8 OTHER HEALTH INSURANCE 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 52 When You Have Other Health Insurance 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 52 CHAMPVA as Primary Payer 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 52  \nCHAMPVA as Secondary Payer or  \nPayer of Last Resort 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 53 CHAMPVA and Workers’ Compensation 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 54 CHAMPVA and Accidental Injuries 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 54  \n9 FILING A CLAIM 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 55 Filing a C laim 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 55 Claim–Filing Deadlines 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 59 Explanation of Benefits (EOB) 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 59  \n10 APPEALS AND DUTY TO ASSIST 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 61 Decision Reviews and Appeals 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 61 Seeking Help for Your Request for Review 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 63 Timely Requests for Reviews 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 63  \n11 HELP FIGHT FRAUD 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 64  \n12 PRIVACY PRACTICES OVERVIEW 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 65 Complaints 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 65 Requesting My Records 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 􀀮 66 Righ","cbCairxuR6dMmZdv","https://ap.wps.com/l/cbCairxuR6dMmZdv","pdf",2098601,72,"English","# About CHAMPVA\n## Mission statement\n# Contact information\n## Customer service\n# Eligibility\n## Factors impacting eligibility\n## Caregiver eligibility\n## CHAMPVA and Medicare\n## A brief overview of Medicare parts A, B, C & D\n## Frequently asked questions on Medicare and CHAMPVA\n## CHAMPVA and TRICARE\n# Health benefits and services\n## CHAMPVA covered services and supplies\n## Pre-authorization for mental health and substance abuse services\n# Other covered services\n## Behavioral health services\n## Dental services\n## Diabetic services\n## Durable medical equipment services (DME)\n## Extended care\n## Family care services\n## General medical services\n## Pharmacy services\n## Preventive services\n## Reconstructive surgery\n## Testing services\n## Therapy services\n## Transplant services\n## Vision services\n# Getting care\n## Finding a provider\n## Getting pharmacy services\n# Your costs\n## Understanding your costs\n## Coverage outside the United States\n## Cost summary when you have no other health insurance\n# Other health insurance\n## When you have other health insurance\n## CHAMPVA as primary payer\n## CHAMPVA as secondary payer or payer of last resort\n## CHAMPVA and workers’ compensation\n## CHAMPVA and accidental injuries\n# Filing a claim\n## Claim-filing deadlines\n## Explanation of benefits (EOB)\n# Appeals and duty to assist\n## Decision reviews and appeals\n## Seeking help for your request for review\n## Timely requests for reviews\n# Help fight fraud\n# Privacy practices overview\n## Complaints\n## Requesting my records\n## Right to request amendment","[{\"question\":\"What is CHAMPVA and what does it cover?\",\"answer\":\"CHAMPVA is a VA health care program that shares the cost of certain medically necessary procedures and supplies with eligible beneficiaries. It supports access to authorized providers.\"},{\"question\":\"How do I apply for CHAMPVA benefits?\",\"answer\":\"Application information is available on the CHAMPVA section of the VA website or by calling 800-733-8387.\"},{\"question\":\"What are the next steps if a claim is denied or you disagree with a decision?\",\"answer\":\"The guide explains decision reviews and appeals, including how to seek help for a request for review and how to submit timely review requests.\"}]","CHAMPVA Guidebook - updated Jan. 1, 2025 - mission statement and guide | PDF",1789514646,25]