CHAMPVA claim deadlines, reimbursement, and how to read your EOB

Q: What is the CHAMPVA timely filing limit?

File within 1 year of the date of service. For a hospital stay, file within 1 year of the discharge date. If you were granted retroactive CHAMPVA eligibility, you have 180 days after your first CHAMPVA ID card is issued to file claims for care on or after your effective date. Late claims are denied.

Q: How do I get reimbursed for care I paid for?

Enroll in direct deposit through VA's Financial Services Center portal, then file VA Form 10-7959a online or by mail with an itemized bill and proof you paid. If you have other insurance, file with it first and include its EOB. VA says claims take about 90 days.

Q: What does a CHAMPVA EOB show?

The amount billed, the amount CHAMPVA allowed, the amount not covered, CHAMPVA's payment, any other insurance payment, your deductible and catastrophic cap totals so far, dates of service, the provider, and remarks.

Educational information only, not medical, legal, or insurance advice. Confirm with CHAMPVA and your provider. Last verified against VA.gov: October 16, 2026 (VA claim page updated Jul 15, 2026). Changelog

Short answer: file within 1 year of the date of care (or of hospital discharge). After VA processes a claim, you get an Explanation of Benefits (EOB) showing what CHAMPVA allowed and paid and what you owe. If you disagree, you can ask for a decision review.

What is the CHAMPVA timely filing limit?

Situation	Deadline
Outpatient care, prescriptions, supplies	1 year after the date of service
Inpatient (hospital) care	1 year after the discharge date
Retroactive CHAMPVA eligibility	180 days after your first CHAMPVA ID card is issued, for care on or after your effective date (shown on the lower left of your card)
VA asks you for more information	Respond within 1 year of the date on the EOB or letter

Sources: VA’s claim page, the Guidebook, and 38 CFR 17.276. The Guidebook says claims filed after the deadline are denied, and if you disagree with a timely filing denial, you must file an appeal. Under 38 CFR 17.276, a request for an exception must be in writing and explain why the claim was late, with supporting documents.

How do I get reimbursed for care I paid for?

Usually your provider files and VA pays them directly. You file yourself when you paid out of pocket, for example at a provider who doesn’t accept CHAMPVA or an out-of-network pharmacy.

Enroll in direct deposit. VA says you must, through the Financial Services Center’s Customer Engagement Portal, to get paid.
If you have other insurance, file with it first and keep its EOB (VA says you can usually get it 30–90 days after care).
Gather documents: an itemized bill and proof you paid. See our document checklist and step-by-step guide.
File VA Form 10-7959a online through VA.gov, or mail it to VHA Office of Integrated Veteran Care, CHAMPVA Claims, PO Box 500, Spring City, PA 19475. Use a separate form for each family member, and sign it (Guidebook).
Wait about 90 days (VA). VA pays you back for the part it covers, based on the allowable amount. See what you pay.

What does a CHAMPVA EOB show?

The Guidebook says your EOB includes:

EOB item	What it means
Amount billed	What the provider charged
Amount allowed	What CHAMPVA approves for the service (the allowable amount)
Amount not covered	Charges CHAMPVA didn’t cover. Check the Remarks
CHAMPVA payment	What CHAMPVA paid
Other insurance paid	What your other plan paid first
Deductible accrual	How much of your individual and family deductible you’ve met this year
Catastrophic cap accrual	How much you’ve paid toward the $3,000 yearly family cap
Dates of service, provider, date mailed	Which visit this EOB is for
Remarks	Notes, including what’s missing if VA needs more information

Who gets it: when a provider files, the EOB goes to you and the provider. When you file, it goes only to you. Care through Meds by Mail or CITI doesn’t produce an EOB (Guidebook).

Check it for errors and fraud: the Guidebook asks you to review each EOB and report any service billed that you didn’t receive.

If VA needs more information

VA sends an EOB or letter listing what’s missing. Respond within 1 year: online, choose “A resubmission for an existing claim” and upload the documents, or mail a copy of the EOB or letter with the documents to the PO Box 500 address. You can also ask VA to get records from your provider, which may take longer (VA). Common fixes: Denied claim?

How do I ask VA to review a decision?

If you disagree with a decision, VA’s claim page says you can request a decision review. Mail the request with a copy of the decision or EOB to VHA Office of Integrated Veteran Care, CHAMPVA Appeals, PO Box 600, Spring City, PA 19475.

The Guidebook lists three options, though not all are available in every case:

Option	What it is	Form
Supplemental Claim	A new review with new and relevant evidence	VA Form 20-0995
Higher-Level Review	A new look at the same evidence, no new evidence	VA Form 20-0996
Board Appeal	Appeal to the Board of Veterans’ Appeals	VA Form 10182

To ask for a review, the Guidebook says the decision must have been made within the last year, the claim can’t be under review already, and it can’t have been returned for missing information, missing preauthorization, or as a duplicate. A denied preauthorization has its own review: write within 1 year of VA’s notice explaining why it’s wrong, with a copy of the denial.

Older (“legacy”) claims: 38 CFR 17.277 covers reconsideration of legacy claims: a written request within 1 year of the decision stating why it’s wrong, then a further written review request within 90 days if you still disagree.

Free help: an accredited VSO. The Guidebook notes VSOs can’t charge fees.