VA Health Care Benefits for Family Members of Veterans

VA health insurance for family members of qualifying veterans include the Children of Women Vietnam Veterans Program (CWVV), Camp Lejeune Family Member Program (CLFMP), Spina Bifida Health Care Program (SB) and the Caregiver Program.

These programs provide qualifying family members or caretakers of veterans with free or reduced-cost health benefits and/or medical reimbursements. However, family members must meet several important eligibility requirements to qualify for these benefits. For instance, CWVV benefits are only available to certain biological children of female Vietnam Veterans.

Additionally, VA spouse medical benefits are available to qualifying spouses, widows, widowers and dependents of servicemembers. Known as CHAMPVA, this program is also available through the Department of Veterans Affairs (VA). While this program resembles TRICARE in several ways, the Department of Defense (DoD) oversees the TRICARE program rather than the VA. As such, these programs are not the same. To explore these programs in more detail and how to apply for VA health care benefits, program beneficiaries can review the sections below.

What are the different veteran family health insurance programs?

Several veterans’ family health insurance programs are available to qualifying servicemembers and their families through the U.S. Department of Veterans Affairs (VA). These programs include:

  • CHAMPVA health insurance. Also known as the Civilian Health and Medical Program of the Department of Veterans Affairs, this comprehensive health plan provides affordable health coverage to the spouses, widows and dependent children of qualifying servicemembers. Through the program, beneficiaries receive affordable coverage for most medically or psychologically-necessary services, as well as pharmaceutical benefits.
  • The Children of Women Vietnam Veterans (CWVV). While this VA family health care program is not a comprehensive plan, it does cover medically-necessary services for treating certain types of birth defects. However, beneficiaries must be the biological children of female Vietnam Veterans and they must have been born between February 28, 1961 and May 7, 1975. Through this fee-for-service program, beneficiaries receive reimbursements for medical expenses that relate to their birth defects. However, this program does not cover beneficiaries with spina bifida.
  • The Camp Lejeune Family Member Program (CLFMP). This type of health insurance for VA families is available to active duty servicemembers and the qualifying family members of veterans who served or resided at the U.S. Marine Corps Base Camp Lejeune in North Carolina between the period of August 1, 1953 and December 31, 1987. Since these veterans and their families may have been exposed to contaminated drinking water during this time, the CLFMP program provides qualifying active duty military members with medical coverage. Additionally, the family VA health care program reimburses eligible beneficiaries for any costs that relate to 15 different types of medical conditions or illnesses such as certain cancers or renal toxicity.
  • The Spina Bifida Health Care Program (SB). This family VA health care reimbursement program benefits the biological children of Korean and Vietnam Veterans, providing them with monetary medical allowances and vocational rehabilitation or training. However, biological children must have been diagnosed with a form of spina bifida, excluding spina bifida occulta.
  • The Caregiver Program. As part of this VA family health insurance program, certain qualifying caretakers of veterans receive access to support groups, counseling, pastoral care, and other services such as home health care and respite services. Caretakers may also receive durable medical equipment and sensory aides for the veterans in their care. Additionally, transportation is available to some veterans who need assistance in getting to and from their medical appointments.

Note: CLFMP health insurance for family members is available to those with one or more of the following conditions: cancers of the bladder, breast, esophagus, kidney, and lung; female infertility; miscarriage; multiple myeloma; scleroderma; renal toxicity; neurobehavioral effects; Non-Hodgkin’s lymphoma; leukemia; hepatic steatosis; and myelodysplastic syndromes.

Who meets CHAMPVA eligibility requirements and how can you apply?

To be eligible for the CHAMPVA program, beneficiaries must be the spouses, widows, widowers or dependents of qualifying veterans. Additionally, beneficiaries may not qualify for TRICARE and they must meet one of the following conditions:

  • They must be the spouse or child of a veteran with a permanent service-related disability.
  • They must be the surviving spouse or child of a veteran who died of a service-related disability.
  • They must be the surviving spouse or child of a deceased veteran who at the time of death was deemed totally and permanently disabled due to a service-connected condition.
  • They must be the surviving spouse or child of a veteran who died while serving on activity duty or while serving in an inactive training period.

To obtain CHAMPVA health insurance coverage as a veteran, however, beneficiaries may not be eligible for TRICARE. Veterans cannot choose between these two programs, as servicemembers must obtain coverage through TRICARE if they are eligible to do so.

Related Article: VA Health Care Costs and Coverage

To participate in this VA health insurance plan for family members, applicants must complete an Application for Benefits (VA Form 10-10d) and a Certification of Other Health Insurance (VA Form 10-7959c). Additionally, Medicare-eligible applicants must submit a copy of their Medicare card. If CHAMPVA applicants are 65 years of age or older and do not qualify for Medicare, they must also submit documentation from the Social Security Administration (SSA) as proof of their ineligibility for Medicare under another beneficiary’s Social Security Number (SSN).

To apply for CHAMPVA medical insurance, applicants may fax their materials to 303-331-7809 or they may mail them to the following address:

VHA Office of Community Care

CHAMPVA Eligibility

PO Box 469028

Denver CO 80246-9028

 

Applying for Other Types of Veteran Family Health Insurance Programs

Other VA family health care programs include the CWVV, CLFMP, SB and Caregiver Program. To obtain these types of medical benefits as the spouse or child of a veteran, applicants must submit the following forms:

  • An Application for Benefits for Certain Children of Vietnam Veterans with Disabilities (VA Form 21-0304), if they wish to apply for the CWVV program
  • A Camp Lejeune Family Member Program Application (VA Form 10-10068), if they wish to apply for CLFMP
  • An Application for Comprehensive Assistance for Family Caregivers Program (VA Form 10-10CG), if they wish to apply for benefits as a caregiver

To obtain veterans family health insurance reimbursements as a beneficiary with spina bifida (SB), however, applicants must contact the Denver VA Regional Office at 303-914-2900, as doing so begins the application process.

Related Article: VA Financial Benefits for Survivors

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