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Learn About VA Health Care for Family Members

Information You Can Find in Our Guide:

Our free guide will help you understand the steps you have to take and how to obtain the benefits you are looking for.

Learn About VA Health Care for Family Members

Veteran health insurance for family members is available from the United States Department of Veteran Affairs (VA) but only to certain qualifying individuals experiencing certain issues. VA child and VA spouse medical benefits can help lower a veteran’s family’s health care costs. Veteran family health insurance may be obtained by the veteran’s spouse, surviving spouse, dependent child or family caregiver if he or she meets the requirements for participation in any of the programs detailed below.

The most common type of VA health insurance for family members is TRICARE. Managed by the Department of Defense’s Defense Health Agency, TRICARE comprehensive health care insurance plans may be available to specific veteran family members. Review the following sections to learn about other health care programs veteran family members and caregivers may be able to receive.

Information You Can Find in Our Guide:

Our free guide will help you understand the steps you have to take and how to obtain the benefits you are looking for.

About the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

VA health insurance for family members of veterans who do not qualify for TRICARE may be available through CHAMPVA, the Civilian Health and Medical Program of the Department of Veterans Affairs. CHAMPVA health insurance coverage is actually a cost-sharing program that helps qualifying current and surviving spouses and children of certain disabled or deceased veterans cover the cost of health care services and supplies.

CHAMPVA covers medically necessary services and supplies that have been ordered by an authorized medical care provider. CHAMPVA health insurance covers many of the same types of services and procedures that other health care plans provide, including surgery, durable medical equipment and a wide variety of inpatient and outpatient services. Pharmacy services are also a benefit. CHAMPVA health insurance includes a deductible that must be met and a percentage that must be paid before reaching the annual catastrophic cap.

CHAMPVA eligibility requirements include not qualifying for participation in TRICARE. Other eligibility requirements for this are linked to the veteran’s circumstances surrounding their disability or death.

Information on the Program of Comprehensive Assistance to Family Caregivers of Post-9/11 Veterans (PCAFC)

VA spouse medical benefits include The Program of Comprehensive Assistance to Family Caregivers of Post-9/11 Veterans (PCAFC). This VA family health care program was designed to help spouses, children and other family members caring for veterans with disabilities obtained in the line of duty on or after September 11, 2001. Qualification for PCAFC benefits is based on the veteran’s health status. The veteran must have one from a list of qualifying injuries or disabilities, and the issue must have happened during or been made worse by active duty service.

To be eligible for PCAFC VA health insurance for family caregivers, the veteran’s level of care must be more intensive than what is normally expected from a spouse, child, parent or friend. These VA child or VA spouse medical benefits include a monthly payment, caregiver training, respite care and other things that help make the caregiving process easier. Applicants for PCAFC must complete the official PCAFC form and submit it along with supporting documentation in person or by mail.

Learn About the Camp Lejeune Family Member Program

This veteran family health insurance program is designed to assist veterans and veteran family members who were stationed at Marine Corps Base Camp Lejeune or Marine Corps Air Station (MCAS) New River in North Carolina for a minimum number of days between August 1953 and December 1987. These individuals may qualify for VA family health care through the program because they likely had contact with contaminated drinking water from two on-base wells that were found to contain several toxic chemicals.

This VA health insurance for family members of veterans is meant to help those diagnosed with a range of serious diseases linked to consuming the contaminated water. The Camp Lejeune Family Member Program assists by helping to pay the costs of being treated for sicknesses caused by this exposure. To be eligible for these veteran family health insurance benefits, applicants must provide a physician’s documentation of one of 15 serious illnesses linked to chemical exposure. These diseases include various forms of cancer, female infertility issues and a range of kidney, lung and skin disorders.

Find Out About the Spina Bifida Health Care Benefits Program (SBHCBP)

Veteran family health insurance is available to biological children of certain Korea and Vietnam veterans who have been diagnosed with spina bifida. The Spina Bifida Health Care Benefits Program (SBHCBP) is a VA family health care program that assists those suffering from lower limb paralysis, back pain, mental handicaps or other symptoms caused by this spinal cord birth defect.

Qualified VA family health care applicants for SBHCBP can receive various health care benefits financed by the Department of Veterans Affairs. As with all veteran family health insurance programs, applicants must complete the appropriate VA form and submit it in person or by mail to the correct authority.

About the Children of Women Vietnam Veterans Health Care Benefits Program (CWVV)

Another type of VA health insurance for family members benefits the biological children of woman Vietnam War veterans who were born with certain birth defects. These grown children may qualify to receive veteran family health insurance benefits to help pay for medical expenses related to these debilitating conditions. Unlike some programs, the Children of Women Vietnam Veterans Health Care Benefits Program is not a comprehensive medical insurance plan. It only assists with services directly related to a covered birth defect and conditions linked to the defect. In addition, CWVV applicants’ mothers must have served in Vietnam during a specific time period.

Get Information on Pharmacy Benefits

Qualifying veteran family health insurance recipients who receive CHAMPVA, SBHCBP or CWVV can also request pharmacy benefits through the VA. Recipients of VA child or VA spouse medical benefits for prescription drugs may order them through the VA’s official mail pharmacy program or at their local pharmacy. CWVV, SBHCBP or CHAMPVA health insurance recipients who also qualify for pharmacy benefits must follow specific policies regarding other prescription drug health insurance coverage. In most cases, these medications must be linked to the covered disability.

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