CHAMPVA Supplement
Insurance Plan




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Learn More


About Our Plan

How the CHAMPVA Supplement Works

Termination/Exclusions

Rate Schedule

How To Enroll

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Links


TRICARE Official Site

DEERS Info






How the CHAMPVA Supplement
Insurance Plan Works


Covered Care Required
TRICARE CHAMPVA Pays
TRICARE CHAMPVA Supplement Plan Pays
Inpatient Services
Confinement(1) in civilian hospital or skilled nursing facility
DRG(2) rate, less the beneficiary cost share. The lesser of
1. $535 per day, times number of inpatient days
2. 25% of billed amount, or
3. the DRG rate
Inpatient Services
Non-DRG (2) based
75% of the Allowable Amount 25% of the Allowable Amount
Inpatient Physicians Services
Visits,surgeons,anesthesiologist, etc.
75% of the Allowable Amount 25% of the Allowable Amount
Outpatient Services
Offic visits, clinics, laboratory and pharmacy services, durable medical equipment (non-VA source)
75% of the Allowable Amount after the
CHAMPVA Annual Outpatient Deductible.
25% of the Allowable Amount


We will pay the Inpatient and Outpatient covered medical expenses once the Calendar Year plan deductible of $250 per person and $500 family maximum has been satisfied. Expenses incurred to satisfy the CHAMPVA Calendar Year Outpatient deductible cannot be used to satisfy the CHAMPVA Supplement Plan deductible.

(1) Confinement or confined means being an inpatient in a hospital (or skilled nursing facility) due to sickness or injury. And skilled nursing facility does not mean: a) a hospital; or b) a place for rest, custodial care, or the aged; or c) a place for the treatment of mental disease, drug addicts or alcoholics.

(2) Diagnosis-Related Groups (DRG): An agreement between most hospitals and CHAMPVA to accept a fixed rate for inpatient care regardless of the billed amount.












Click on the following links to learn more!
About Our Plan | How the CHAMPVA Supplement Works
Termination/Exclusions | Rate Schedule | How to Enroll | Return to Index