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Champva s Form: What You Should Know

You can't use this form for self-pay or CHAM PVA.

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Video instructions and help with filling out and completing Champva Forms

Instructions and Help about Champva Forms

Hi, I'm Dr. Bill Cushing, and today I'd like to introduce you to TRICARE. TRICARE is an insurance plan that you may encounter in your practice, and you may have to bill for it. TRICARE is the Department of Defense's health insurance plan for military personnel and their families. TRICARE was formerly known as the Civilian Health and Medical Program of the Uniformed Services or CHAMPUS. All military hospitals and clinics are part of TRICARE, and civilian facilities and private physicians also contract with TRICARE to provide services to TRICARE beneficiaries. Members of the Army, Navy, Marines, Air Force, Coast Guard, Public Health Service, and the National Oceanic and Atmospheric Administration are eligible for TRICARE. Eligibility is determined by each military branch, and the status of eligibility can be found by inquiring into the Defense Enrollment Eligibility Reporting System or DEERS (EE RS). TRICARE offers its beneficiaries a number of plans to choose from. TRICARE Standard is a fee-for-service program that covers medical services provided by private physicians or at a military treatment facility. An annual deductible is required, and families of active-duty personnel pay 20% of outpatient services, while retirees and their families pay 25%. Treatment by a provider who does not accept assignment exposes the beneficiary to charges up to 115% of the allowable charges. There is an annual catastrophic cap of $1,000 for active-duty families and $3,000 for all other beneficiaries. Another program is TRICARE Prime. This is a managed care option, and active-duty service members must enroll in one of the TRICARE Prime options. There are a few options available, including TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, and TRICARE Global Remote. In all these programs, a primary care manager is assigned to a beneficiary to coordinate and manage their care. Non-active-duty families must pay an annual...