CHAMPVA for spouses and children of 100% P&T veterans: cost and benefits
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 page updated Aug 7, 2026). Changelog
The P&T requirement
The spouse or dependent child of a veteran rated permanently and totally (P&T) disabled from a service-connected disability can qualify for CHAMPVA, as long as they are not eligible for TRICARE. VA defines P&T as a disability rated 100% and not expected to improve. A 100% rating that isn’t permanent doesn’t qualify. Check the veteran’s rating decision or benefit summary letter for the P&T wording.
Survivors also qualify if the veteran died from a service-connected disability or was rated P&T at death. Details: Eligibility.
What it costs
From the CHAMPVA Guidebook and 38 CFR 17.274:
| Cost | Amount |
|---|---|
| Outpatient deductible | $50 per person, $100 per family per calendar year |
| Your cost share (CHAMPVA primary) | 25% of the CHAMPVA allowable amount |
| Yearly out-of-pocket cap | $3,000 per family per calendar year |
| Meds by Mail prescriptions | Nothing |
| Preventive care (such as an annual physical) | Nothing |
| If you have other insurance (CHAMPVA secondary) | Usually nothing |
The Guidebook says you never pay the deductible to CHAMPVA up front; it’s credited as claims are processed.
What’s covered
CHAMPVA is a cost-sharing program for medically necessary care: doctor visits, hospital stays, prescriptions, mental health care, and more. Some things aren’t covered, like routine dental and eye care. See What CHAMPVA doesn’t cover.
Medicare at 65 (or earlier)
If you’re eligible for Medicare, you must have Part A and Part B to keep CHAMPVA. A Medicare Advantage plan also meets this requirement. See Turning 65 with CHAMPVA.
How to apply
Apply online, by mail, or by fax with VA Form 10-10d and supporting documents. Fax: 303-331-7809. Step by step: How to apply and the 10-10d walkthrough.
Questions: call CHAMPVA at 800-733-8387 (TTY 711), Monday–Friday, 8:00 a.m.–7:30 p.m. ET.