The CHAMPVA Supplemental Insurance Plan May Provide You With The Protection You May Need When A Serious Covered Accident Or Sickness Occurs.
CHAMPVA Insurance Features
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health benefits program in which the Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with eligible beneficiaries.
In general the CHAMPVA program covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive program material that specifically addresses covered and non-covered services and supplies in the form of a CHAMPVA handbook.
GEA CHAMPVA Supplemental Insurance Plan:
CHAMPVA when used with the Supplement
Pays 100% of Doctors’ Visits and Hospital Co-Pays*
* After the CHAMPVA Deductible and CHAMPVA Supplement Insurance Plan Deductible have been met.
How the CHAMPVA Supplement works with CHAMPVA
The CHAMPVA Supplemental Insurance Plan, when combined with your CHAMPVA benefits, is designed to provide you with the protection you need when you need it. The plan will pay your cost share for both covered inpatient and outpatient medical expenses after you satisfy the calendar year plan deductible of $250 per person, $500 family maximum. Take a moment now to read the details inside. Then enroll today to give your family the additional protection of the GEA CHAMPVA Supplement Insurance Plan that complements your CHAMPVA benefits.
Eligible Spouse: “Spouse” means your spouse who is under age 65 and a CHAMPVA benefits recipient, but not a spouse from whom you are legally separated or divorced. “Spouse” also means widow(er) if he or she is a member of the Participating Organization.
Spouses over age 65 are also eligible if documentation from the Social Security Administration certifying their non-entitlement to Medicare Part A benefits is submitted with their enrollment form.
Eligible dependent and unmarried children under age 18 (23 if a full-time college student) may also enroll.
Supplement Rates and GEA Membership
Rates illustrated are Per Person. Includes first year discount of 11%. Premiums increase as a person moves from one 5-year age bracket to another (40, 45, 50, 55, 60). The company reserves the right to change premiums on a group wide basis to maintain the financial solvency of the plan. 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
The CHAMPVA $50 individual/$100 family outpatient deductible are not covered by the CHAMPVA Supplement Plan. The CHAMPVA Supplement plan has an annual year Plan deductible of $250 per person and $500 family maximum. We will pay the Inpatient and Outpatient covered medical expenses once the Calendar Year plan deductible of $250 per person and $500 family maximum has been satisfied. Expenses incurred to satisfy the CHAMPVA Calendar Year Outpatient deductible cannot be used to satisfy the CHAMPVA Supplement Plan deductible.
Pre-Existing Conditions Limitation
All new sickness or injury covered from day one, and the Supplement has a 6-month pre-existing period. 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 their 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 more information regarding the Waiver of Pre-Existing give us a call.
How claims are filed with the Supplement EOB
All claims are filed first with CHAMPVA. After CHAMPVA has processed your claim, they will send you an Explanation of Benefit Statement (EOB). You will need to file a claim with the Supplement Plan only if the provider has not agreed to file one on your behalf. To file a supplement claim, simply write your certificate (member ID) number on the EOB and also, write “Pay Provider” if you would like the benefits paid directly to the provider, otherwise the benefits will be paid to you. Claims may be mailed to: GEA Administrator, 6110 Parkland Blvd., Cleveland, OH 44124 FAX: 800-311-3124
GOVERNMENT EMPLOYEES ASSOCIATION (GEA)
The thousands of government employees who belong to the association give GEA a strong voice to advocate for issues that impact current and former government employees. This strong voice enables GEA to foster support for those issues that matter to government employees and their families, and also offer valuable member benefits at an affordable cost, including TRICARE Supplement and CHAMPVA Supplement. You must be a GEA member to enroll in the TRICARE Supplement and CHAMPVA Supplement plan. The GEA membership form is included with Enrollment Form and can be added to your premium option.
Veterans Maxz Insurance Group℠
This website is designed for all service members regardless of Rank, Service or Duty Status and our 100% Service Related Disabled Veterans and their eligible Beneficiaries . Our mission is to provide professional service to you in gratitude for the courageous and professional manner you have defended our County and Liberty.
Over the next few pages, you can review the CHAMPVA Supplemental Insurance Plan to the Department of Veterans Affairs Health Administration Center for family members of disabled Veterans (who are CHAMPVA eligible). You will find information regarding Vision, Dental and Medicare Supplemental Insurance for eligible Veterans their Beneficiaries