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Champva cpc Form: What You Should Know

CHAM PVA is NOT part of VA health care coverage. Veterans should refer to the following VA information for more information: Veterans Benefits for Health Care Coverage Through a Veteran Health Plans Program page 14 (PDF) Benefits for CHAM PVA — Veterans Affairs The CHAM PVA 10-10d Benefits provides a health care plan covering outpatient visits. It is your responsibility to ensure that all of your required services are covered. Please provide all the required documentation regarding CHAM PVA benefits. The information about CHAM PVA benefits is provided by Veterans Affairs. CHAM PVA — VA Healthcare Coverage Veterans Affairs provides care for veterans that are receiving services through the Veterans Health Administration. Your benefits include: • Inpatient care and outpatient services (e.g., physical therapy, chiropractic and podiatry) • Well-child health and other benefits related to a veteran's mental and physical health The VA will provide you with an appointment ticket that allows reimbursement for your service-connected expenses before you arrive at the facility. It is your responsibility to provide the required information as directed by VA. VA requires you to complete, sign, date and return any required application for CHAM PVA benefits. If no information is contained within the application, you must submit a completed VA Form 10-7959a and all the required documentation to verify your application. If you decide to enroll at any point in time, you will be responsible for all charges related to health care services at the facilities you enroll at. A VA health plan for veterans is a benefit provided by Veterans Affairs. Your benefits may vary depending on your particular circumstances. You may have benefits at a facility in which you have enrolled and are receiving care only. You may have benefits at a facility in which you are eligible, but not receiving care. Furthermore, you may have benefits at a home-based facility, as well as in a VA medical center. Your benefits may also vary with some plans, such as the Blue Cross/Blue Shield (BCBS/BSP). In this case, BCBS/BSP may pay for the first two years of your medical treatment but will not pay any subsequent costs after this period. However, you will continue to pay all charges while in the BCS/BSP system. VA will monitor your situation to determine if you are entitled to payment from a different plan.

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