Supplement plans are available to (1) Military Retirees and their families, (2) spouses/children of Active Duty service persons, (3) National Guard and Reserve members and their families, (4) CHAMPVA spouses and children of disabled veterans.
Persons who are eligible for Medicare are not usually eligible for the supplement plan. For this reason, supplement coverage is generally limited to persons under age 65. (Once eligible for Medicare, Medicare pays primary and TRICARE for Life pays secondary. A supplement is no longer needed.)
However, a senior may still qualify for the supplement at or beyond age 65 if he/she lives outside the United States and its territories. Such individuals must be eligible for Medicare Part A and enrolled in Medicare Part B. (Medicare does not cover medical expenses incurred outside the United States and its territories.)
Additionally, a senior may still qualify for the supplement at or beyond age 65 if he/she is ineligible for Medicare and submits a copy of the Social Security Disallowance of Benefits, Notice of Award, or any official letter/document from Social Security as proof.
CHAMPVA supplement should not be sold to non-spouse/child persons who receive CHAMPVA benefits as a qualifying “caregiver.”
Traditionally, CHAMPVA is a medical benefits program for spouses and children of veterans who are totally
and permanently disabled due to a service-related illness or injury. The veteran can utilize VA facilities and
physicians and receive medical care free of charge. CHAMPVA takes care of the spouse/kids. They, too, suffer
financially due to the veteran's disability. CHAMPVA provides benefits to them with minimal out-of-pocket
expenses. If they choose, they can purchase our CHAMPVA Supplement plan to pick up the majority of those
out-of-pocket expenses.
However, in some situations, another person (not a spouse or dep child) can also qualify for CHAMPVA
benefits if he/she is the primary, unpaid caregiver of the veteran. The caregiver may be any person (usually a
loved one) who takes care of the veteran, does not get paid for it, and does not have any other health
insurance (Medicaid, Medicare, or any group/individual plan). Eligibility for the caregiver benefit is carefully
monitored and it is crucial that the person does not have any other coverage … INCLUDING CHAMPVA
SUPPLEMENT.
One of our supplement insureds is a CHAMPVA caregiver. She did not know that buying our supplement could
make her ineligible for the caregiver benefits. When she found out, she sent us a letter from CHAMPVA as
proof, and we refunded her premiums (minus any claims that had been paid).
If you speak to someone who is receiving CHAMPVA benefits as a "caregiver," please know that the person
should NOT purchase a supplement with us. If the person already has a supplement with us, we can most
likely refund the premium (minus any claim checks that have been issued).
This will probably not be something that happens very often, but it's good to have the information at hand.
Children must be under age 26 to enroll. For enrollment, there are no exceptions to the age rules. Disabled children may not enroll if they are over the age limit.
After enrolling, child coverage ends at age 26. Disabled children who are already covered at age 26 will be permitted to continue. See this section for details.