CHAMPVA Supplemental Insurance Plan | Rates 2017
Economical Premiums To Fit Your Budget

The CHAMPVA deductible is applied to the first medical or pharmacy claims processed in 2017 until the deductible is met.

  • Annual CHAMPVA Deductible is $50 per beneficiary or a maximum of $100 per family per year.
  • Annual Supplement Deductible is $250 per beneficiary or a maximum of $500 per family per year.
Premiums illustrated are Per Person.
Age of Spouse, Widow/erMonthlyQuarterlySemi-AnnualAnnual
Under 40$32.33$97.00$194.00$388.00
40 - 44$35.67$107.00$214.00$438.00
45 - 49$41.00$123.00$246.00$492.00
50 - 54$52.67$158.00$316.00$632.00
55 - 59$62.33$187.00$374.00$748.00
60 - 64$75.00$225.00$450.00$900.00
65+$94.67$284.00$568.00$1,136.00
Each Child$25.00$75.00$150.00$300.00

It’s So Easy To Enroll in the CHAMPVA SUPPLEMENT Enrollment Form 

CHAMPVA SUPPLEMENTAL INSURANCE

Important Notice

This coverage is available to GEA members and their dependents only. If you are not a member of GEA, it is easy to become one. A membership application is included with the CHAMPVA SUPPLEMENT Enrollment Form

 

Pre-Existing Conditions Limitation

Any injury or sickness whether diagnosed or undiagnosed, for which a covered person received medical care or treatment within the 6 month period preceding the effective date of his or her insurance will not be covered until the coverage has been in effect for 6 months. However, new conditions will be covered immediately.

 

The Pre-existing condition limitation may be waived under the following conditions:

For individuals who were previously enrolled in a non-TRICARE Supplement Employer Group Plan and loses that coverage due to involuntary termination. Such individuals must enroll in the Supplement Plan within 31 days following the termination date of the prior insurance plan. Application for coverage under the Supplement Plan should include a copy of the Certificate of Creditable Coverage for the prior group insurance plan.

 

For inquiries, call CHAMPVA Supplement Insurance office toll-free at: (888) 654-3129

 

Before you begin enrollment, review CHAMPVA SUPPLEMENT Benefits Summary and Rates.

 

IMPORTANT NOTICE:

The CHAMPVA Supplement Plan works in all 50 States, but not sold in ME, MT, NH, NV, OR, WA.

APPLY NOW: Application Download

Click on the application and brochure below:

Print Enrollment Form

Brochure CHAMPVA Supplement

CHAMPVA Supplement Plan Details
CHAMPVA Handbook

The CHAMPVA Handbook contains important benefit information that is of interest to you. You are highly encouraged to carefully read the handbook prior to using CHAMPVA benefits.

CHAMPVA | MEDS BY MAIL

The CHAMPVA program offers a robust pharmacy benefit, paying 100% 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 Accept CHAMPVA

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 to CHAMPVA 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.