CHAMPVA Chattanooga TN: 2026 Eligibility & Coverage Guide

What Is CHAMPVA in Chattanooga, TN?

CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) is a federal health benefits program for spouses, dependents, and survivors of veterans rated permanently and totally disabled (100% P&T) from a service-connected disability or who died from a service-connected condition. Chattanooga-area beneficiaries can use CHAMPVA at any Medicare-accepting provider, including Erlanger Health System and CHI Memorial, and may receive care at the Chattanooga VA Clinic under the CITI program.

Quick Facts

CHAMPVA Eligibility Requirements

You may qualify for CHAMPVA if you do not qualify for TRICARE and at least one of the following is true:

• You are the spouse or dependent child of a veteran rated permanently and totally disabled (100% P&T) from a service-connected disability.

• You are the surviving spouse or dependent child of a veteran who died from a service-connected disability.

• You are the surviving spouse or dependent child of a veteran who was rated permanently and totally disabled at the time of death.

A “permanent and total disability” means a disability the VA has rated as 100% disabling and is not expected to improve.

Key rule: You cannot have CHAMPVA if you qualify for TRICARE. The two programs do not stack. TRICARE is administered by the Department of Defense for active-duty service members, retirees, and their families regardless of disability status. CHAMPVA is a VA program specifically for families of 100% P&T veterans who have no TRICARE eligibility.

Who Qualifies: Specific Groups

Surviving Spouse Rules

If you remarry on or after your 55th birthday, you keep your CHAMPVA benefits. If you remarry before age 55, your benefits end on the date of remarriage. If that remarriage later ends, you may qualify for CHAMPVA again beginning the first day of the month after the remarriage ends.

Dependent Children Age 18–23

If enrolled in high school, college, or another educational institution, a dependent child can keep CHAMPVA between ages 18 and 23. Benefits end when the child is no longer enrolled in school or turns 23, whichever comes first. Marriage before age 23 also ends eligibility. If the child is permanently unable to support themselves due to a disability that occurred before age 18, they can keep CHAMPVA after age 18 as a “helpless child.”

Newborn Dependent Children

The VA cannot pay medical claims for a qualifying newborn until the child is enrolled in CHAMPVA. Parents should apply as soon as possible after birth. Before applying, you must: (1) get a Social Security number for the child, and (2) add the child as a dependent of the veteran sponsor by contacting the nearest VA regional office.

What CHAMPVA Covers

CHAMPVA covers most medically necessary health care services and supplies. Covered services include:

• Hospital stays and inpatient care

• Outpatient medical services

• Mental health treatment

• Emergency care

• Prescription medications

• Skilled nursing care

• Ambulance services

• Durable medical equipment (DME) up to $2,000

• Home health care including skilled nursing, physical therapy, occupational therapy, speech therapy, and home health aide services

2026 Changes: GLP-1 Medication Coverage

CHAMPVA now covers prescription GLP-1 medications only when prescribed for FDA-approved reasons:

CHAMPVA does not cover prescription GLP-1 medications for weight loss.

CHAMPVA Costs and Cost Sharing in 2026

CHAMPVA is a cost-sharing program. After the annual deductible, CHAMPVA pays 75% of the allowable amount, and the beneficiary pays 25%. There is a $3,000 catastrophic cap per household per calendar year.

How the Catastrophic Cap Works

Once your household reaches $3,000 in out-of-pocket costs for covered services in a calendar year, CHAMPVA pays 100% of additional covered services for the rest of the year. This cap applies per household, not per individual.

Meds by Mail: Zero-Cost Prescriptions

CHAMPVA beneficiaries who do not have other prescription coverage can use Meds by Mail for non-urgent maintenance medications. There is no enrollment fee, no deductible, and no cost share. Medications are mailed directly to your home. To use Meds by Mail, ask your provider to send prescriptions electronically to Meds by Mail CHAMPVA through their ePrescribing system.

OptumRx Pharmacy Network

CHAMPVA has a contract with OptumRx for pharmacy services. Beneficiaries can fill prescriptions at any OptumRx network pharmacy by presenting their OptumRx prescription card. If a pharmacy is outside the network, you pay the full cost upfront and file a claim for reimbursement of 75% of the CHAMPVA allowable amount.

The CITI Program: Using VA Facilities in Chattanooga

The CHAMPVA Inhouse Treatment Initiative (CITI) is a voluntary program that allows CHAMPVA beneficiaries to receive care at participating VA medical facilities on a space-available basis. Chattanooga-area CHAMPVA beneficiaries may be able to receive care at the Chattanooga VA Clinic, located at 6401 Shallowford Road, Chattanooga, TN 37421, phone 423-893-6500.

CITI Program Benefits:

• No deductible

• No cost sharing for covered services received at VA facilities

• Access to inpatient, outpatient, pharmacy, DME, and mental health services

• Care is delivered based on availability of space

Eligibility for CITI: Beneficiaries who do not have Medicare or an HMO as their primary insurance may be eligible. The majority of VA facilities are CITI participants. No extra enrollment is necessary — simply determine if your local VA facility participates.

Chattanooga-Area VA Facilities

The Pointe Centre VA Clinic was designated a VA Close to Me cancer care site in 2026, expanding oncology and infusion therapy services closer to home for Chattanooga-area veterans and their families.

How to Apply for CHAMPVA in Chattanooga

The application process for CHAMPVA is the same regardless of location. Chattanooga-area applicants submit their applications to the VHA Office of Integrated Veteran Care in Denver, Colorado.

Required Documents

• VA Form 10-10d: Application for CHAMPVA Benefits (up to three beneficiaries per form)

• VA Form 10-7959c: CHAMPVA Other Health Insurance Certification (one per beneficiary, if you have other insurance)

• Veteran’s DD-214 (Certificate of Release or Discharge from Active Duty)

• VA disability rating documentation (showing 100% P&T or service-connected death)

• Social Security numbers for all applicants

• Marriage certificate (for spouses)

• Birth certificates (for dependent children)

Step-by-Step Application Process

1. Gather your documents. Collect the veteran’s DD-214, VA rating decision showing 100% P&T or service-connected death, marriage certificate, and birth certificates.

2. Complete VA Form 10-10d. One form covers up to three beneficiaries. Download the PDF from VA.gov or use the online tool.

3. Complete VA Form 10-7959c for each beneficiary who has other health insurance (including Medicare).

4. Mail or fax your application. Send to:

   • VHA Office of Integrated Veteran Care

   • CHAMPVA Eligibility

   • P.O. Box 469028

   • Denver, CO 80246-9028

   • Fax: 303-331-7801

5. Wait for confirmation. Processing typically takes 30–60 days. You will receive a CHAMPVA Identification Card and welcome packet.

6. Begin using benefits. Provide your CHAMPVA card to providers. If using CITI at the Chattanooga VA Clinic, inform registration staff of your CHAMPVA status.

Online Application

VA Form 10-10d is available as a downloadable PDF, and the VA now offers an online application tool. Applying online can reduce processing time and eliminate mail delays.

CHAMPVA and Medicare: How They Work Together

CHAMPVA is the secondary payer for beneficiaries with Medicare coverage. If you have Medicare Part A and Part B, Medicare pays first and CHAMPVA covers most of the remaining cost. In most cases, dual Medicare/CHAMPVA beneficiaries pay nothing out of pocket.

Key rules:

• If you turn 65 on or after June 5, 2001, you must be enrolled in Medicare Parts A and B to be eligible for CHAMPVA.

• Enrollment in Medicare Part D is not required to remain eligible for CHAMPVA.

• Individuals aged 65 or older who are not entitled to Medicare Part A retain CHAMPVA eligibility.

CHAMPVA vs. TRICARE: Key Differences

If you are eligible for TRICARE, you are not eligible for CHAMPVA. If you are eligible for CHAMPVA, you are not eligible for TRICARE. The two programs do not stack.

Tennessee State Benefits for CHAMPVA Families

Tennessee offers state-level benefits that complement CHAMPVA for eligible veteran families. These are administered by the Tennessee Department of Veterans Services and other state agencies.

Tennessee Property Tax Relief for Disabled Veterans

Tennessee provides property tax relief for veterans with a 100% service-connected disability. The maximum market value on which tax relief is calculated is $175,000. Eligible veterans must own and use the property as their primary residence. Applications are filed through the County Trustee’s office.

Tennessee Vehicle Registration Exemption

Permanently and totally disabled veterans may qualify for an exemption from all registration taxes and fees for one vehicle. This benefit took effect January 1, 2026.

Tennessee Hunting and Fishing License

The one-time $10 fee for a permanent sports combination hunting and fishing license (DAV) has been eliminated for eligible disabled veterans. Qualifying veterans can now obtain the license at no cost.

Tennessee Homeownership for Heroes

The Tennessee Housing Development Agency offers Great Choice Loans with reduced interest rates and down payment assistance up to 5% or $15,000 for eligible veterans. This program can be combined with a VA loan for home purchases.

Common Mistakes CHAMPVA Applicants Make

Applying for CHAMPVA when eligible for TRICARE. CHAMPVA and TRICARE are mutually exclusive. If you qualify for TRICARE, you cannot receive CHAMPVA.

Waiting too long to enroll a newborn. The VA cannot pay claims for a newborn until the child is enrolled. Apply as soon as you have the child’s Social Security number and dependent status added to the veteran’s record.

Failing to submit VA Form 10-7959c. If you have other health insurance, including Medicare, you must complete this form for each beneficiary. Missing it delays your application.

Not checking CITI participation. Not all VA facilities participate in the CITI program. Call the Chattanooga VA Clinic at 423-893-6500 to confirm CITI availability before scheduling.

Assuming CHAMPVA covers everything at 100%. CHAMPVA pays 75% of allowable charges after the deductible. Beneficiaries are responsible for the remaining 25% until the $3,000 catastrophic cap is met.

Missing the one-year claim filing deadline. All CHAMPVA claims must be filed within one year of the date of service. For inpatient care, the claim must be filed within one year of the discharge date. Claims submitted after the deadline are denied.

CHAMPVA Appeals Process

If a CHAMPVA claim is denied, beneficiaries can request an appeal or reconsideration. The appeal must be submitted within one year from the initial determination date. Appeals should include the denied claim number, the reason for the appeal, and any supporting documentation from the provider. Send appeals to the VHA Office of Integrated Veteran Care in Denver, Colorado.

Latest Rule Changes for 2026

GLP-1 medication coverage restrictions. CHAMPVA now covers GLP-1 medications only for FDA-approved reasons: type 2 diabetes, moderate to severe obstructive sleep apnea, and MASH/MACE prevention. Weight loss prescriptions are not covered.

1095-B form changes. Starting in 2026, the VA will no longer automatically mail the 1095-B tax form. Beneficiaries can download it from the VA website or request a copy.

Deductible reset. The annual deductible requirement began again on January 1, 2026. The deductible is $50 per beneficiary or $100 per family. It applies to the first medical or pharmacy claims processed in 2026 until met.

Tennessee vehicle registration exemption. Effective January 1, 2026, permanently and totally disabled veterans are exempt from all registration taxes and fees for one vehicle.

Common Questions

What is CHAMPVA and who qualifies in Chattanooga?
CHAMPVA is a VA health benefits program for spouses, dependents, and survivors of veterans rated 100% permanently and totally disabled or who died from a service-connected condition. Chattanooga-area beneficiaries must not qualify for TRICARE. Apply with VA Form 10-10d.

How do I apply for CHAMPVA in Chattanooga?
Download VA Form 10-10d from VA.gov, complete it, and mail it to the VHA Office of Integrated Veteran Care, P.O. Box 469028, Denver, CO 80246-9028. Include the veteran’s DD-214, VA rating decision, marriage certificate, and birth certificates. Processing takes 30–60 days.

Can I use CHAMPVA at the Chattanooga VA Clinic?
Yes, if the Chattanooga VA Clinic participates in the CITI program. Call 423-893-6500 to confirm. Under CITI, CHAMPVA beneficiaries receive care on a space-available basis with no deductible or cost sharing.

What does CHAMPVA cost in 2026?
CHAMPVA has a $50 annual deductible per person ($100 family maximum), a 25% cost share after the deductible, and a $3,000 catastrophic cap per household per calendar year. There are no monthly premiums.

Is CHAMPVA the same as TRICARE?
No. CHAMPVA is administered by the VA for families of 100% P&T veterans. TRICARE is administered by the Department of Defense for active-duty, retirees, and their families. You cannot have both.

Can a surviving spouse keep CHAMPVA after remarrying?
If you remarry on or after your 55th birthday, you keep CHAMPVA benefits. If you remarry before age 55, benefits end on the date of remarriage. If that remarriage ends, you may qualify again.

How long can a dependent child stay on CHAMPVA?
Dependent children can stay on CHAMPVA until age 18, or until age 23 if enrolled in school. If permanently disabled before age 18, they can keep CHAMPVA indefinitely as a “helpless child.”

Does CHAMPVA cover prescriptions?
Yes. CHAMPVA covers prescriptions through the OptumRx network and Meds by Mail. Meds by Mail offers maintenance medications at no cost — no deductible, no cost share, and no enrollment fee.

What is the CITI program?
The CHAMPVA Inhouse Treatment Initiative allows CHAMPVA beneficiaries to receive care at participating VA medical facilities on a space-available basis. Care under CITI is exempt from deductible and cost sharing.

Can I have CHAMPVA and Medicare at the same time?
Yes. CHAMPVA is the secondary payer for beneficiaries with Medicare. If you turn 65 on or after June 5, 2001, you must enroll in Medicare Parts A and B to remain eligible for CHAMPVA.

Key Takeaways

• CHAMPVA provides comprehensive health coverage for spouses, dependents, and survivors of veterans rated 100% permanently and totally disabled or who died from a service-connected condition.

• CHAMPVA and TRICARE are mutually exclusive — you cannot have both.

• The 2026 CHAMPVA deductible is $50 per person ($100 family maximum), with a 25% cost share after the deductible and a $3,000 household catastrophic cap.

• Chattanooga-area beneficiaries may receive care at the Chattanooga VA Clinic (6401 Shallowford Road) under the CITI program, with no deductible or cost sharing.

• Apply using VA Form 10-10d and VA Form 10-7959c (if you have other insurance). Processing takes 30–60 days.

• Meds by Mail provides maintenance prescriptions at zero cost with no deductible or enrollment fee.

• Surviving spouses who remarry at age 55 or older keep CHAMPVA benefits; those who remarry before 55 lose benefits until the remarriage ends.

• Tennessee offers property tax relief, vehicle registration exemptions, and homeownership assistance that can complement CHAMPVA.

• CHAMPVA covers GLP-1 medications only for FDA-approved reasons (type 2 diabetes, sleep apnea, MASH/MACE) — not for weight loss.

• The CHAMPVA help line is 1-800-733-8387.

Official Resources

• VA CHAMPVA Benefits: VA.gov — CHAMPVA

• CHAMPVA Care and Providers: VA.gov — CHAMPVA Care

• VA Form 10-10d: VA.gov — VA Form 10-10d

• Meds by Mail: VA.gov — Meds by Mail

• Chattanooga VA Clinic: 6401 Shallowford Road, Chattanooga, TN 37421 | 423-893-6500

• Pointe Centre 2 VA Clinic: 1208 Pointe Centre Drive, Suite 110, Chattanooga, TN 37421

• VA Tennessee Valley Healthcare System: VA.gov — TVHS

• Tennessee Department of Veterans Services: tn.gov/veteran

• CHAMPVA Help Line: 1-800-733-8387