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Douglas Katason Lead Congressional Liaison 303-370-7708 PowerPoint PPT Presentation


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Health Administration Center Programs for Veterans and Their Family Members Veteran Service Officer Training. Douglas Katason Lead Congressional Liaison 303-370-7708. The CHAMPVA Program Resources Eligibility Application process Benefits. Overview.

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Douglas Katason Lead Congressional Liaison 303-370-7708

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Douglas katason lead congressional liaison 303 370 7708

Health Administration CenterPrograms for Veterans and Their Family MembersVeteran Service Officer Training


Douglas katason lead congressional liaison 303 370 7708

Douglas KatasonLead Congressional Liaison303-370-7708


Overview

The CHAMPVA Program

Resources

Eligibility

Application process

Benefits

Overview


Access to information

Cannot provide information contained in a claim or application, i.e. what it was for, the amount paid, etc.

Can provide only general status of an application or claim as to where it is in processing

Power of Attorney required to provide specific information regardless of any other appointment letter or relationship to beneficiary

Access to Information


Douglas katason lead congressional liaison 303 370 7708

CHAMPVA Beneficiaries


Champva eligibility

Family members, not for veterans

Not eligible for TRICARE, beneficiaries can not choose between the two.

Veteran must

be permanently and totally disabled

have died from a service connected condition

been P&T at the time of death

CHAMPVA-Eligibility


Champva eligibility1

Children

Through age 18, if in school fulltime, age 23

Current legislative change to increase the age to 26: has not been signed yet.

If permanently disabled and VARO determines is Helpless Child

CHAMPVA-Eligibility


Champva eligibility2

Spouses until divorce, NO EXCEPTIONS!

Widow(er): until remarriage

If remarriage ends (by death, divorce or annulment, beneficiary may be entitled to reinstatement

Survivor remarried age 55 and older keeps CHAMPVA

CHAMPVA-Eligibility


Champva eligibility3

If under age 65 and Medicare eligible, must be enrolled in Parts A and B

If over age 65 and Medicare eligible:

before June 5, 2001, must keep Part B if enrolled on June 5, 2001

on and after June 5, 2001, must enroll in Parts A and B

CHAMPVA- Eligibility


Application process

VARO notifies beneficiary of eligibility

No notification to HAC

Application required, information verified with VARO

May take a long time

Benefits backdated to date of qualifying event

Application Process


Application process1

Application must include:

Application (VA Form 10-10d)

OHI Certification Form (10-7959c)

Copy of Medicare card (if on Medicare)

Application Process


Application process2

Application may include copy (never an original) of:

Rating decision

Marriage license

Birth certificate/adoption papers

DD214 or Report of Separation

ALLOWS PROCESSING IN LESS THAN 30 DAYS-NO WAIT FOR VARO VERIFICATION

Application Process


Application process3

After eligibility is determined, verified against DEERS -- benie does NOT have to update DEERS (weekly process)

Cards, handbook, etc. mailed.

Application Process


Champva benefits

Major medical plan

Annual deductible $50/$100 max

Shares cost 75% -- user pays 25% unless care provided by VA

CITI

Meds by Mail

DME

Inpatient, outpatient, mental health, substance abuse, prescription medication (includes those on MEDICARE), hospice

CHAMPVA Benefits


Champva benefits1

CHAMPVA Benefits

  • No network of providers or provider contracts

  • Complete freedom of choice!

  • Benies do NOT need to see a VA doctor - CHAMPVA covers them when they see a private provider


Champva benefits2

CHAMPVA Benefits

  • Not Covered

    • Routine dental

    • Routine vision, unless disease

    • Chiropractic

    • Routine exams except school physicals

    • Custodial/Domiciliary Care (nursing home, long term care)


Champva and medicare

CHAMPVA And Medicare

  • For those with Medicare or over 65

  • Same program as for those not on Medicare or under 65

  • Used to be called “CFL “


Contact information

Phone Center

800-733-8387

Mon-Fri, 8:05 AM- 7:30 PM (Eastern)

Improvements

Preauthorization

888-820-1756

Same Hours

Contact Information


Contact information1

Web site: www.va.gov/hac

Extensive information

Email: [email protected]

Letter

CHAMPVA

PO Box 469063

Denver CO 80246-9063

Contact Information


Language availability

All CHAMPVA items

Spanish in stock

CHAMPVA Handbook Only

Other languages and Braille upon request

3-5 weeks to translate

Other Programs

On request

3-5 weeks to translate

Phone Center

Any language

Hearing impaired

Language Availability


Care giver

Provides CHAMPVA on a limited time basis for care givers of wounded warriors

Family members

Spouses

Same sex partners

Friends

Eligibility is set by the Veteran’s local VAMC

Training is involved

Care Giver


Foreign medical program

Application must include:

FMP Registration Form - VA Form 10-7959f-1

Rating decision

Mail the application to:

FMP Office

PO Box 469061 Denver,

CO 80246-9061 USA

Foreign Medical Program


Application process4

Will receive a letter from us listing conditions we will pay for

Veteran can have any % of disability including 0%

100% disability overseas does not entitle Veteran to full coverage, only listed conditions

Application Process


Application process5

Claims must be made within one year of service

Payments are made at the exchange rate on day of service

Different rules in Philippines and Canada

Philippines has a VA

Veterans can us Canadian VA

Application Process


Questions

Questions

?


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