Overton Brooks VA Medical Center

Questions and answers concerning the CHAMPVA Program changes

 

Note: Some of the answers below refer to sections and pages within the CHAMPVA Handbook. If you do not have a copy of the Handbook, an on-line version is available as a .PDF file. You will need to have the Adobe Reader installed on your computer to view it.
View The CHAMPVA Handbook On-Line

Question Icon Do all VA Medical Centers participate in the CITI program.

No. The decision to participate in the CITI Program is made by the Medical Center Director.

Question Icon Why doesn’t every VA Medical Center participate in the CITI Program.

Not all VA’s have identified they have excess capacity; the CITI Program is designed to provide CHAMPVA beneficiaries access to care in the VA facility AFTER the VA has met the needs of the veteran population (excess capacity, if there is any).  In some areas, veterans utilize the full capacity of the local medical center.

Question Icon Do any of the VA’s in Louisiana provide CHAMPVA services.

No, Alexandria has never participated in CHAMPVA’s CITI Program.  New Orleans discontinued their services effective April, 2006. 

Question Icon How can I find a provider, within the community, who will accept CHAMPVA.

The Health Administration Center (HAC), administrators of the CHAMPVA Program, does not provide a list of CHAMPVA providers. Many providers who accept Medicare and Tricare also accept CHAMPVA. Review your telephone book for a listing of doctors in your community. Call and ask if they accept CHAMPVA, or you may find providers on your computer.  * Visit The TriCare web site. This web site provides the means for obtaining Tricare providers by identifying the type of provider you need, using your zip code and travel radius/miles you’re willing to drive for health care.
Recommendations from friends and/or family members for a health care provider is also an option. 

Question Icon What about pharmacy benefits. Where can I get my medicine.

CHAMPVA offers a drug program called Meds by Mail. This program is for CHAMPVA beneficiaries who have no other health insurance (OHI). Meds by Mail provides you with free medications for chronic medical problems that require ongoing or daily maintenance doses. There is no cost to you. Acute medical problem medications must be purchased at local pharmacies as it takes 21 days to fill a prescription from Meds by Mail.

If purchasing your medications in the local community, you will want to select a Pharmacy that is part of the Medical Matrix network. View The CHAMPVA Fact Sheet 01-24, Pharmacy Benefits in .PDF format.
Always verify that the pharmacy you use accepts CHAMPVA. If not, you will have to pay full price for the medication and file a claim to CHAMPVA for reimbursement. CHAMPVA patients with other health insurance (OHI) that provides pharmacy coverage, are not eligible for Meds by Mail.

Question Icon How much out of pocket money will I be required to pay in the local community for health care services.

There are two parts to your costs.  First, for outpatient care, there is an annual deductible.  Second, most medical services and supplies have a cost share (co-payment).  See “Your Costs” in your CHAMPVA Handbook for payment information. (Section Four, page 42).

Professional Services, Durable Medical Equipment (DME), Non-VA source, Outpatient visits and Pharmacy Services all require a deductible and you pay 25% of allowable charges after the deductible is met.  CHAMPVA will pay the remaining 75% for covered services.  (See Section Four, page 44 – Cost Summary Chart for more information).

Question Icon How will my new community provider get my health care information (medical record - health care treatment) from the Overton Brooks VA Medical Center.

A Release of Information (ROI) form will be mailed to you with the initial letter of notification that we will not be providing CHAMPVA services effective May 31, 2007.  You can complete the ROI form and return it to the Business Office (Health Information Management Section) requesting that a copy of your most recent appointments, medications, tests, etc. be mailed to you or your provider. 

Question Icon Who do I call if have questions regarding CHAMPVA.

Assistance or any questions you have regarding CHAMPVA may be obtained by calling the Overton Brooks VA Medical Center CHAMPVA Office at 318-221-8411 or 1-800-863-7441 (Jim Lockett), Ext. 6932 or (Jo Ann Phillips), Ext 6315. 

The Health Administration Center (HAC) mailed new CHAMPVA Handbooks to all active beneficiaries fall of 2006.  These handbooks provide information regarding eligibility, obtaining medical care, benefits, your costs, other health insurance, claim filing instructions and help and information.  It is very important that you acquaint yourself with your Handbook.  You can contact the HAC at 1-800-733-8387 or Visit The HAC Web Site