Provider contact information contains the addresses and phone numbers for the various VHA Office of Community Care health care benefit programs. For PC3/Choice providers with concerns, please first contact Health Net and TriWest directly.
Providers may send questions and feedback to [email protected]
The contact information contains important benefit information that is of interest to you. We recommend you carefully read the handbook prior to using benefits.
The VA does not maintain a provider listing. Most Medicare and TRICARE providers will also see beneficiaries (but be sure you ask the provider). If you are having difficulty finding a provider, we recommend you visit the Medicare website and use the “Search Tools” at the bottom of that page to locate a Medicare provider.
If you choose to see a provider who does not accept CHAMPVA, the SUPPLEMENT INSURANCE will pay or reimburse the cost share. Remember that cost shares are based on the allowable amount.
The program offers a robust pharmacy benefit, paying 75% of the allowable charge at any pharmacy for prescription medication. The Meds By Mail program offers prescription medication delivered to your home. The best part of Meds By Mail is that there is NO cost share or co-pay. CHAMPVA also offers a medication by mail program called MEDS BY MAIL.
Pharmacies that are a part of the SXC Health Solutions, Inc. (SXC) network, agree to collect your cost share and send a claim via SXC to CHAMPVA for the remaining amount. However, not all pharmacies are a part of the SXC pharmacy network. In those cases, you may have to pay the entire amount and submit a claim yourself. A good way to find a pharmacy that participates in the SXC network, is to visit their website at https://vahac.rxportal.sxc.com.
An eligible sponsor may be entitled to receive medical care through the VA health care system based on his or her own veteran status. If the eligible sponsor is the spouse of another eligible sponsor, both may now be eligible for CHAMPVA benefits. In each case where the eligible spouse requires medical attention, he or she may choose the VA health care system or coverage under CHAMPVA for his/her health care needs. If you have been previously denied benefits and you believe you would now be qualified, please submit an application following the guidelines as listed on the “How to apply” section.
Eligibility can be impacted by changes such as marriage, divorce from the sponsor, or eligibility for Medicare or TRICARE. Changes in status should be reported immediately to:
CHAMPVA, ATTN: Eligibility Unit
PO Box 469028
Denver, CO 80246-9028
If you provide all of the required and optional documents, and if your application is complete, then it takes approximately six weeks after we get your package until you get your CHAMPVA identification card and related materials.
If you provide only the required documents, and not the optional documents, processing can take two to eight months since we have to confirm information with other federal agencies.
Once we get your application, we will review it to be sure it is complete and that all the required forms are included. If your application is not complete, we will return it to you with further instructions. For additional information, please refer to Fact Sheet 01-03: Instructions for CHAMPVA Applicants.
You can speed the processing of your application if you also send copies (do not send originals):
Online: Click Here
Mail:
National Personnel Records Center
Military Personnel Records
1 Archives Drive
St. Louis, MO 63138
Fax: 314-801-9195
Instructions about who can request Official Military Personnel Files and the information required can be viewed on the National Archives Veterans’ Service Records page at https://www.archives.gov/veterans/military-service-records.
Before sending your application, please ensure the application is signed and dated. Also, if applying for a spouse, please include the date of marriage on the application.
Mail:
VHA Office of Community Care
CHAMPVA Eligibility
PO Box 469028
Denver, CO 80246-9028
Fax: 303-331-7809
The Plan is currently not available in CO, ME, NH, NM, NY, OR, PR, UT, WA.
Calling the number above will direct you to a Licensed Sales Agent.
