Question:
Hi Jim, I have been rated 100% Service Connected Disabled by the VA. I am 59 YO and my wife is 57 YO. I currently receive all of my medical care from the VA, and I am very happy with my care. Because I am 100% disabled, the VA has informed me that my wife is eligible for the CHAMPVA medical insurance. I have a couple of questions for you, any help would be greatly appreciated. 1. Is ChampVA recognized by the IRS under the Affordable Care Act? 2. Is ChampVA good insurance? 3. If you were me, would you advise my wife to use ChampVA as her primary medical coverage? 4. Are there any issues that we should be aware of relying on ChampVA as her medical provider? Again, thank-you for your work and the help you provide to Vets. Regards, Bob Panerio
Jim's Reply:
1) Yes
2) Yes
3) Yes
4) Yes
Wow, we nailed 4 in a row. Not bad for a Friday.
My wife has used CHAMPVA for many years (we were about your age when I was awarded mine) and in our estimation it's the best insurance anyone can have. Her health care options are greater than mine and all transactions are simpler. My wife is becoming eligible for Medicare so we're exploring the reality of just how that interaction will work but again, she gets outstanding care locally via CHAMPVA at a very reasonable cost when there is any cost at all. Meds come promptly by mail or via our local grocery/pharmacy.
The trick to our success is like so many others, it depends a lot on the community you're in. We got lucky.
If your civilian health care community is robust and not jam packed, you'll find a lot of doctors happy to take CHAMPVA. You may have to ask around to find the right doctor. We're in a small community with a great little hospital not far from us so it works well. I hear from some who are in more stressed regions that some doctors won't take new Medicare or CHAMPVA patients and that's their right to do so.
All hospitals will accept CHAMPVA, that's never a problem. Hospitals can't afford to turn away any payment these days, CHAMPVA looks good to them.
Dealing with CHAMPVA isn't always simple...after all is said and done, it's VA. We're meticulous in getting and documenting pre-approvals for anything that may cost a bunch and that can be a time consuming proposition when you face down the VA phone system. But it's worth the effort and just like many things VA, persistence pays.
Study all the handouts carefully, it's health insurance and federal language combined...very tricky, so put in the time. Call them and ask questions so you get a feel for what happens when you really need an answer. Practice calling and when the need comes around, you'll be comfortable.
Call her doctor of choice and make an appointment to see the office manager or insurance and billing specialist. You can do that at the hospital you would likely use too. The finance people seriously love when patients do this ahead of time so that everyone knows what's up with payments and billing. Those folks can save you money too...good people to cozy up to before you need them.
In a nutshell, I wish I had my wife's CHAMPVA. Good luck!