CHAMPVA Healthcare for Dependents: Complete 2026 Guide

CHAMPVA is one of the most valuable benefits available to families of permanently and totally disabled veterans, yet many eligible dependents have never heard of it. If your spouse or parent is rated 100% P&T by the VA, you may qualify for comprehensive healthcare coverage with no monthly premiums and a family out-of-pocket cap of just $3,000 per year.

What Is CHAMPVA?

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides healthcare coverage to the spouse and dependent children of veterans who are permanently and totally disabled due to service-connected conditions, or who died from service-connected disabilities.

CHAMPVA fills a critical gap. While disabled veterans can access VA healthcare for themselves, their dependents generally cannot. CHAMPVA extends affordable, comprehensive medical coverage to the people who support and depend on those veterans.

Who Qualifies for CHAMPVA?

To be eligible, you must be the spouse or dependent child of a veteran who meets one of these criteria:

• Permanently and Totally Disabled (P&T): Rated 100% disabled by the VA with a "permanent and total" designation
• Died from a service-connected condition: The veteran's death was caused by or related to a service-connected disability
• Died while rated P&T: The veteran passed while holding a permanent and total rating
• Missing in action or POW: Listed as MIA or prisoner of war for more than 90 days

TDIU Counts

If your spouse receives TDIU (Total Disability Individual Unemployability) at the 100% rate, that qualifies as permanently and totally disabled for CHAMPVA purposes. Your family can receive CHAMPVA even if the veteran's schedular rating is below 100%.

Who Is NOT Eligible

You cannot receive CHAMPVA if:

• You are eligible for TRICARE (active-duty or military retiree family member)
• You are 65+ and eligible for Medicare Part A but have not enrolled in Medicare Part B
• You remarried before age 55 (surviving spouses only)
• The veteran's P&T rating is later reduced below 100%

Eligible Dependents

• Spouse: Lawfully married to the veteran (no minimum marriage length)
• Children: Biological, adopted, or stepchildren under age 18, or up to age 23 if enrolled full-time in school
• Disabled children: Over 18 but permanently incapable of self-support due to disability occurring before age 18
• Surviving spouse: Widow or widower, unless remarried before age 55

What Does CHAMPVA Cover?

CHAMPVA provides coverage comparable to traditional health insurance plans.

Medical Services

• Primary care and specialist visits (no referrals required)
• Hospital inpatient and outpatient surgery
• Emergency room and urgent care
• Diagnostic testing (labs, X-rays, MRI, CT scans)
• Ambulance services

Mental Health

• Outpatient counseling and therapy
• Inpatient psychiatric care
• Substance abuse treatment

Preventive Care

• Annual physicals and well-child visits
• Immunizations and cancer screenings
• Preventive dental for children under 18

Other Covered Services

• Prescription medications
• Maternity and newborn care
• Durable medical equipment (wheelchairs, walkers)
• Physical therapy, occupational therapy, speech therapy
• Home healthcare and hospice care
• Vision exams (one per year) and hearing aids (limited)

What CHAMPVA Does NOT Cover

• Cosmetic procedures (except reconstructive after injury)
• Most adult dental care
• Long-term custodial care
• Services outside the United States (except emergencies)
• Experimental or investigational procedures

CHAMPVA Costs in 2026

CHAMPVA's affordability is its standout feature. There are no monthly premiums. You pay only:

Annual Deductible

• $50 per person per calendar year
• $100 per family maximum

Cost-Sharing

• Outpatient services: You pay 25% of allowable charges after deductible
• Inpatient services: You pay 25% of charges (or a per-day amount, whichever is less)
• Prescriptions: $12 generic / $15 brand name at retail (30-day supply); $9 generic / $12 brand name through mail-order (90-day supply)

Annual Out-of-Pocket Cap

CHAMPVA caps your family's total annual out-of-pocket costs at $3,000. Once you hit that amount in deductibles and cost-shares, CHAMPVA pays 100% of covered services for the rest of the year.

CHAMPVA vs. TRICARE

CHAMPVA and TRICARE are separate programs. TRICARE serves active-duty families and military retirees. CHAMPVA serves dependents of disabled veterans. You cannot be eligible for both simultaneously. If you lose TRICARE eligibility (for example, after a military retiree divorce), you may then become eligible for CHAMPVA if the veteran meets qualifying criteria.

CHAMPVA and Medicare (Age 65+)

When a CHAMPVA beneficiary turns 65, they must enroll in both Medicare Part A and Part B to keep CHAMPVA coverage. CHAMPVA then becomes the secondary payer:

• Medicare pays first (typically 80%)
• CHAMPVA covers most or all of the remainder
• Your out-of-pocket costs drop to near zero

This combination of Medicare plus CHAMPVA provides some of the best healthcare coverage available anywhere, with minimal personal expense.

How to Apply for CHAMPVA

Step 1: Gather Documents

You will need:

• VA Form 10-10d (Application for CHAMPVA Benefits)
• Veteran's VA award letter showing 100% P&T rating (or death certificate)
• Marriage certificate (for spouses)
• Birth certificates (for children)
• School certification for children ages 18-23
• Medicare card if applicable

Step 2: Submit Your Application

Mail your complete package to:

VHA Office of Community Care, CHAMPVA Eligibility PO Box 469028, Denver, CO 80246-9028

CHAMPVA applications can currently only be submitted by mail. Online submission is not yet available.

Step 3: Wait for Processing

Processing typically takes 6-8 weeks. Check status by calling 1-800-733-8387.

Step 4: Receive Your Card

Once approved, each beneficiary receives a CHAMPVA authorization card. Present it with photo ID when receiving healthcare.

Your coverage is effective from the date you became eligible (typically the date of the veteran's P&T rating), not the date you applied. You may be able to file retroactive claims for care received during the gap.

Using CHAMPVA Day to Day

• No network restrictions: See any licensed provider who accepts CHAMPVA
• No referrals needed: Go directly to specialists
• Most providers accept CHAMPVA: Call ahead to confirm before your appointment
• Mail-order prescriptions: Use CHAMPVA Meds by Mail at www.mymilitaryrx.com for 90-day supplies at lower cost

Common Questions

Can my spouse work and still have CHAMPVA? Yes. There are no income or employment restrictions. If your employer also offers insurance, CHAMPVA coordinates benefits and typically pays after the employer plan.

What if we divorce? CHAMPVA eligibility ends upon divorce. However, the 20/20/20 rule may make you eligible for TRICARE instead (married 20+ years, veteran served 20+ years, overlap of 20+ years).

What happens if the veteran's rating drops below 100%? CHAMPVA eligibility ends, though you may have a grace period. If the reduction is incorrect, appeal immediately.

Next Steps

If you are the spouse or dependent of a veteran rated 100% P&T, CHAMPVA can save your family thousands of dollars annually in healthcare costs. Do not delay your application.

Use the Veterans Benefits Finder to discover all the benefits available at your disability rating, including CHAMPVA, Chapter 35 education benefits, and state-specific programs many families never learn about.