*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: January 1, 2012 |
|
15.30 - TRICARE and CHAMPVA |
Archived: June 1, 2016 (Previous Versions) |
TRICARE and TRICARE for Life are types of health care coverage provided to certain military personnel and their families. These programs were formerly the Civilian Health and Medical Program of Uniformed Service (CHAMPUS).
CHAMPVA is a Department of Veterans Affairs program.
TRICARE is a health care program for active and retired military personnel and their dependents, survivors and certain former spouses.
l The U.S. government pays the cost of TRICARE coverage.
l There is usually an annual deductible and co-payments for some services.
TRICARE has many programs, but the main programs are:
l TRICARE Standard. This is a fee-for-service option (the original CHAMPUS program).
l TRICARE Prime. This is a managed care option.
l TRICARE Extra. This is a preferred provider option that allows enrollees to seek care at discounted prices from providers in the TRICARE network.
Eligibility requirements, benefits and cost-sharing requirements vary by each TRICARE plan. For more information, see the Military Health System’s TRICARE Web site.
TRICARE for Life is a Medicare supplement entitlement program for Medicare-eligible TRICARE beneficiaries.
l People must be enrolled in Medicare Part A and Part B to remain TRICARE for Life eligible.
l This program has no enrollment fees or premiums (other than the Medicare Part B premium).
l It includes creditable drug coverage for Medicare Part D.
l Update the TPL Subsystem with TRICARE for Life policy information for clients who are eligible for federally funded health care programs.
l For more information regarding TRICARE for Life, see the Military Health System’s TRICARE Web site.
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries.
People eligible for TRICARE are not eligible for CHAMPVA. In addition, they must be:
l the spouse or child of a veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office, or
l the surviving spouse or child of a veteran who died from a VA-rated service connected disability, or
l the surviving spouse or child of a veteran who was, at the time of death, rated permanently and totally disabled from a service connected disability, or
l the surviving spouse or child of a military member who died in the line of duty.
For more information on CHAMPVA see the Department of Veterans Affairs CHAMPVA Web site.