Question:
Jim, Thank you for your continued service here. My situation: Retired from ANG 38 years. Activated multiple times. Age 58 so considered Retired Reserve. 100% P&T rating. Trying to understand if my wife is eligible for CHAMPVA.
Seemingly contradictory information from VA sites. https://www.va.gov/COMMUNITYCARE/programs/dependents/champva/index.asp "Due to the similarity between CHAMPVA and the Department of Defense (DoD) TRICARE program...in some cases, a Veteran may appear to be eligible for both or either program on paper; however, if you are a military retiree, or the spouse of a Veteran who was killed in action, you are and will always be a TRICARE beneficiary and cannot choose between the two programs.
Second VA source: https://www.va.gov/COMMUNITYCARE/docs/pubfiles/programguides/champva_guide.pdf CHAMPVA AND TRICARE TRICARE is a health care program for active duty and retired uniformed Servicemembers and their families. If you become eligible for TRICARE benefits, you are no longer eligible for CHAMPVA, and you must notify us immediately of this change in your status. You may, for example, become TRICARE eligible when the qualifying Veteran sponsor is a retired reservist or National Guard member and begins to receive retired pay at age 60.
First source says if you are retired you are eligible for TRICARE (in my case I am only eligible for TRICARE RETIRED RESERVE which is not subsidized by Fed and at 1044/month.) However second source gives an example of a retired reservist (which is what I am) turning 60 and becoming eligible for Tricare Select therefore no longer eligible for CHAMPVA (indicates that they were prior to age 60).
I have the application in and awaiting their answer, however I suspect is will not come before I have to choose to take the TRICARE RETIRED RESERVE at the super high premium or not... CHAMPVA just keeps saying "we received your application and are reviewing" . If I had confidence in the general answer no problem however they seem to indicate two different answers. Do you have any insight?
Jim's Reply:
I'm sorry but I don't have any insight that will be of any particular help to you. All I can tell you is that both TRICARE and CHAMPVA and MEDICARE and more recently TRIWEST are the best benefits we have going for us and they're often obtuse and impossible to interpret as to how they interact with each other. My wife uses CHAMPVA and has just become eligible for Medicare and the transitions we've experienced between payers have been really difficult to sort out.
Even the experts in insurance and billing departments at local health care providers are often stymied as to how the rules are supposed to work.
The best I have for you is what we learned long ago...persistence and keeping great records of all interactions is required if you want to finally settle on one or the other and have relatively seamless health care. If you stop knocking on doors, nothing gets done.