Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Federal, exists in every state

Health coverage through a qualifying veteran parent (CHAMPVA)

VA health coverage for spouses and children of veterans rated permanently and totally disabled, and certain survivors.

What it is

VA health coverage for spouses and children of veterans rated permanently and totally disabled, and certain survivors.

CHAMPVA helps pay covered care for the spouse and children of a veteran with a permanent and total service-connected rating, and for certain survivors. A person entitled to TRICARE cannot use it. VA decides eligibility on the rating and the child’s relationship and age.

Rules
  • Child age, relationship and other conditions apply; older students and children incapable of self-support have additional rules.
  • Covered services have cost sharing: generally a $50 individual / $100 family yearly outpatient deductible and 25% of CHAMPVA’s allowable amount, with a $3,000 family yearly catastrophic cap on covered care; noncovered and non-participating-provider charges can fall outside the cap.
What you get
  • Coverage of covered care for eligible veteran families, with cost sharing.
Detail
  • Advance authorization is required for some care.
If you decide to apply
  1. If a parent has a permanent and total service-connected VA rating, check VA's CHAMPVA eligibility page with the rating letter and confirm hospital acceptance.

VA CHAMPVA, 800-733-8387 · va.gov · Official page ↗

If it becomes relevant
  • Confirm hospital acceptance and coordination with other insurance before treatment.
Good to know

CHAMPVA and TRICARE are different programs for different families; a family is in one or the other.

Other details
  • The annual family cost-sharing cap applies to covered care only.
Official sources
Ask your social worker

“Does a parent’s veteran status make CHAMPVA relevant for our child?”

Why I’m asking: We want to be sure nothing is missed.

More background and detailed requirements

How this works

CHAMPVA helps pay covered care for the spouse and children of a veteran with a permanent and total service-connected rating, and for certain survivors. A person entitled to TRICARE cannot use it. VA decides eligibility on the rating and the child’s relationship and age.

  • Coverage of covered care for eligible veteran families, with cost sharing.
  1. If a parent has a permanent and total service-connected VA rating, check VA's CHAMPVA eligibility page with the rating letter and confirm hospital acceptance.

Rules

  • Child age, relationship and other conditions apply; older students and children incapable of self-support have additional rules.
  • Covered services have cost sharing: generally a $50 individual / $100 family yearly outpatient deductible and 25% of CHAMPVA’s allowable amount, with a $3,000 family yearly catastrophic cap on covered care; noncovered and non-participating-provider charges can fall outside the cap.

Detail

  • Advance authorization is required for some care.

If it becomes relevant

  • Confirm hospital acceptance and coordination with other insurance before treatment.

Other details

  • The annual family cost-sharing cap applies to covered care only.

Child age, relationship and other conditions apply; older students and children incapable of self-support have additional rules.

Covered services have cost sharing: generally a $50 individual / $100 family yearly outpatient deductible and 25% of CHAMPVA’s allowable amount, with a $3,000 family yearly catastrophic cap on covered care; noncovered and non-participating-provider charges can fall outside the cap.

Advance authorization is required for some care.

Confirm hospital acceptance and coordination with other insurance before treatment.

The annual family cost-sharing cap applies to covered care only.

Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Mail VA Form 10-10d, then give the hospital the CHAMPVA number and ask about approval before any transplant.

Your social worker

Confirms the hospital bills CHAMPVA and registers Medicaid behind it if the child has both.

The care team

Records and letters when the application asks for them.

Who decides
The VA's CHAMPVA office
Ask your social worker
“My child is covered through CHAMPVA. Can billing register it as the plan, and will the transplant team ask the CHAMPVA line about approval in advance?”

How to apply

First step: Call CHAMPVA at 800-733-8387 and mail VA Form 10-10d with the veteran's rating letter. Give the hospital the CHAMPVA number the day it arrives.

  1. Mail VA Form 10-10d with the veteran's rating letter and the child's birth certificate.
  2. Give the children's hospital the CHAMPVA number and any Medicaid card.
  3. Ask the CHAMPVA line whether a planned transplant needs approval in advance.

Where it starts: VA Form 10-10d by mail; questions on 800-733-8387

What to gather

  • The VA rating letter showing a permanent and total service-connected disability
  • The child's birth certificate and Social Security number
  • VA Form 10-10d
  • Any Medicaid card, so the hospital bills CHAMPVA first and Medicaid second

How long: The VA processes the paper application; ask the CHAMPVA line for the current time. Keep every hospital bill until the card arrives.

What a yes looks like

A CHAMPVA card and the child's number. Give both to the hospital and the pharmacy.

What a no looks like, and the next move

“Not eligible” names the reason: rating not permanent and total, TRICARE entitlement, or relationship. Ask the veteran's service officer about the rating; check Medicaid and the hospital's assistance meanwhile.

Watch out

  • A family entitled to TRICARE cannot use CHAMPVA. A retired sponsor's child stays on TRICARE; the VA rating alone does not switch the child over.
  • High-dose chemotherapy with a stem-cell transplant is on the list that needs approval in advance. Ordinary chemotherapy in most cases does not. Ask the CHAMPVA line before a transplant is scheduled.
  • The $3,000 family cap covers cost-sharing on covered care. It does not cap care CHAMPVA excludes, and an inpatient stay is priced by a separate formula.
  • Children generally must be unmarried and under 18. Approved schooling can extend coverage until before 23; incapacity for self-support beginning before 18 has a separate continuation route. Marriage ends child eligibility.
  • CHAMPVA pays before Medicaid. For a Medicaid-covered service at a participating provider, ask billing to apply Medicaid’s patient-payment limits before charging you the remaining CHAMPVA share. The inpatient per-day dollar figure remains unknown.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Civilian hospital and doctor care for the child, with a $50/$100 yearly outpatient deductible, a 25% share of the allowed amount, and a $3,000 family cap on that share per calendar year.

  • $50/year — Outpatient deductible per person per calendar year
  • $100/year — Outpatient deductible per family per calendar year
  • $25 (ordinary cost share; an inpatient stay priced by DRG uses a separate formula) — Family share of the CHAMPVA allowed amount
  • $3,000/year (covers cost-sharing on covered care, not every bill) — Family cap on cost-sharing per calendar year

Covers: Inpatient and outpatient hospital care · Physician care · Prescription drugs · Transplant services, with approval in advance

Legal protection: Care at authorized civilian (non-VA) hospitals · In most cases no approval is needed in advance · CHAMPVA pays after any other health plan, but before Medicaid, Indian Health Service, state crime-victim compensation and a CHAMPVA supplement plan

What it costs the family: The yearly outpatient deductible, the 25% share up to the $3,000 family cap, and any care CHAMPVA excludes.

The eligibility facts, as published

Veteran rating
permanent and total service-connected disability, or death from a service-connected condition
Tricare entitlement
excludes CHAMPVA
Medicare entitled child
must also meet the Medicare Part A and B conditions
Non va care
authorized non-VA providers; care must be medically necessary and not excluded
Child age
Unmarried and under 18; approved study until before 23; separate route for incapacity before 18.

Decisions this site cannot make: The veteran's VA rating · No TRICARE entitlement · The child's relationship to the veteran

Expect friction on: Paper application by mail · Approval in advance for transplant and some other services

The trap: Waiting for a VA approval before treatment. In most cases CHAMPVA needs no approval in advance; high-dose chemotherapy with a stem-cell transplant is on the list that does. Ask the CHAMPVA line before a transplant is scheduled.

What changes by state: Nothing. It is a federal VA program run from one office (800-733-8387).

Where I read this

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