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CHAMPVA for Life and Long Term Senior Care
CHAMPVA is a health insurance and care program provided by the VA for the families of veterans permanently disabled or killed in the line of duty who are not eligible for TRICARE. CHAMPVA for Life (CFL) is an extension of CHAMPVA benefits to those 65 years and older. CFL serves as the secondary payer to minimize out-of-pocket expenses by covering the Medicare’s coinsurance and deductibles. Like most health insurance, CHAMPVA for Life (CFL) is not a long term care solution, but it will cover some costs. Much like Medigap / Medicare Supplemental insurance, CFL picks up where Medicare leaves off. CFL will pay the co-insurance and deductibles but does not pay for the monthly Medicare Part B premium. Assisted Living Skilled Nursing In-Home Care & Adult Day Care CFL does not pay for either medical care or supervision in the home or in adult day care situations. Be Aware That: -CHAMPVA is only for the families of veterans. -There are other benefits for veterans including the VA Aid & Attendance Benefit and VD-HBCS program (Cash and Counseling for Veterans). CHAMPVA for Life is Also Known As: -Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) -CHAMPVA for Life (CFL) -Note some of the eligibility requirements refer to the veteran and others to their spouse. -Some individuals may appear to be eligible for both CHAMPVA for Life and TRICARE for Life, but this is not the case. If they are eligible for TRICARE, then they are automatically ineligible for CHAMPVA. Age Requirements The spouses of veterans must be at least 65 to be eligible for CHAMPVA for Life. Seniors turning 65 before June 5, 2001 require only Medicare Part A. Those turning 65 after that date require both Medicare A & B. Disabilities / Health Requirements The spouse of a veteran qualifies if the veteran meets one of the following conditions -Has a service-connected disability rating of 100%, meaning they are permanently and totally disabled or died with that rating. -Has died from a VA-rated service connected disability -Has died in the line of duty. Although (often these individuals are eligible for TRICARE and if so that would disqualify them for CHAMPVA). Family Status -A spouse will lose their eligibility for CHAMPVA for Life if they get divorced from the veteran. -A widow or widower that remarries will also lose their eligibility. However, should the re-marriage terminate, they then become eligible again. Financial Status Requirements Spouses of veterans with any level of financial resources and income are eligible for CHAMPVA for Life. Veteran Status Requirements Veterans cannot have been dishonorably discharged and they must meet one of the following conditions for their spouse to be eligible for CHAMPVA for Life: -Have a service-connected disability rating of 100%, meaning they are permanently and totally disabled or died with that rating -Have died from a VA-rated service connected disability -Have died in the line of duty. Although (often these individuals are eligible for TRICARE and if so that would disqualify their CHAMPVA eligibility) Geographic Requirements Geographic location is not a factor in determining eligibility for CHAMPVA for Life. Other Requirements Medicare Requirement – Veteran’s spouses turning 65 before June 5, 2001 must be enrolled in Medicare Part A. Those turning 65 after that date require both Medicare A & B to be eligible for CHAMPVA for Life. Types of Benefit Payout Benefits payments are made directly to the medical providers. Veterans at no point receive cash or checks from CHAMPV for Life. Restrictions on How Payout Can be Used Benefits are only from medical services and are paid directly to the providers. Benefits Amounts & Limits Of the relevant long term care options for seniors, CHAMPVA for Life only pays for limited skilled nursing care. The limits, combined with Medicare are as follows:
*We currently have conflicting information on whether this is still accurate. Time to Receive Benefits -If the individual is already a CHAMPVA beneficiary, then enrollment in CHAMPVA for Life is 4-6 weeks after CHAMPVA receives all documents. -If the individual is not a CHAMPVA beneficiary, then the processing time can vary from 1-6 months depending on the amount of information that must be confirmed with other federal agencies. This Source Can Help For In the area of long term care, CHAMPVA for Life only pays for limited skilled nursing care. There are no enrollment fees or monthly premiums for CFL. However, the spouses of veterans must purchase Medicare Part B and pay those monthly premiums to be eligible for CFL. In addition, they are responsible for co-pays. -If the individual is already a CHAMPVA beneficiary, then To enroll in CHAMPVA for Life, when they turn 65, seniors should provide CHAMPVA a copy of their Medicare card that shows their enrollment in Medicare Part A & B. They also are required to provide information about any other health insurance under which they are covered. Once these forms are processed, a new CHAMPVA card is issued with the extended expiration date. -If the individual is not a CHAMPVA beneficiary, then The senior must complete an application, a form detailing any other health insurance they have and provide a copy of their Medicare Part A & B card. Providing copies of optional documents such as marriage licenses and terminations or the veteran’s VBA disability rating can greatly accelerate the processing time. Click Here to Visit CHAMPVA’s WebsitePage Reviewed / Updated - Aug. 2012
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