CHAMPVA and Medicare: who pays first (who is primary?)

Educational information only, not medical, legal, or insurance advice. Confirm with CHAMPVA and your provider. Last verified against VA.gov: October 11, 2026 (VA CHAMPVA care page updated Aug 12, 2026). Changelog

The CHAMPVA Guidebook says: “When you have Medicare and CHAMPVA, Medicare will be your primary insurance.” CHAMPVA pays after your other health insurance, and if you have more than one plan, such as Medicare and a Medicare supplement, CHAMPVA pays after both. The federal rule says the same thing: CHAMPVA is the last payer (38 CFR 17.276).

The four exceptions

The Guidebook and VA’s provider page list exactly four kinds of coverage that CHAMPVA pays before: Medicaid, Indian Health Service, a State Victims of Crime Compensation program, and a CHAMPVA supplemental policy. A CHAMPVA supplement (bought to cover your CHAMPVA cost share) is different from a Medicare supplement: CHAMPVA pays before a CHAMPVA supplement but after a Medicare supplement.

You need Medicare Parts A and B

If you’re eligible for Medicare, you must have Part A and Part B to get or keep CHAMPVA. The Guidebook warns: if you cancel Part B, your CHAMPVA ends the same day. Part D isn’t required, and you can’t use Meds by Mail if you’re enrolled in Part D. A few people who turned 65 before June 5, 2001 follow different rules (38 CFR 17.271). More: Turning 65 with CHAMPVA.

Medicare Advantage counts

VA says a Medicare Advantage plan (Part C) meets the Part A and B requirement. Your Medicare Advantage plan pays first, then CHAMPVA may cover costs you still owe. More: Medicare Advantage and CHAMPVA.

How CHAMPVA pays after Medicare (crossover)

• Your provider bills Medicare first.
• The Guidebook says Medicare electronically forwards the claim to CHAMPVA after it processes it, so in most cases you don’t file anything yourself.
• CHAMPVA then pays up to its allowable amount. The Guidebook says that in most cases when you have other health insurance and CHAMPVA, you pay nothing.
• If you have a Medigap plan, CHAMPVA processes the rest after it gets the Medigap plan’s EOB, and you may have to file a claim with the Medicare EOB yourself.

What to send if you file the claim yourself

If your provider can’t file for you, send CHAMPVA:

1. VA Form 10-7959a (CHAMPVA claim form), one per family member
2. The provider’s itemized bill
3. The EOB from Medicare and from any other insurance that paid first

Deadline: 1 year from the date of service (1 year from discharge for a hospital stay). Step by step: Filing a claim.

Keep CHAMPVA updated: VA Form 10-7959c

When you get Medicare or any other insurance, or it changes, send CHAMPVA:

• A completed VA Form 10-7959c (Other Health Insurance Certification)
• A copy of the front and back of your Medicare or insurance card (and your Part D card if you have one)

You can do this online or by mail. The Guidebook says CHAMPVA will then issue a new ID card. Not updating can delay your claims. More: Medicare and other insurance.

Questions: call CHAMPVA at 800-733-8387 (TTY 711), Monday–Friday, 8:00 a.m.–7:30 p.m. ET.