Champva form for prescription 2025

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We cover generic prescription medications and certain brand-name prescription medications through Meds by Mail. We dont cover certain types of controlled substances, including many opioid pain medications. To find out if your medication is available, call us at 866-229-7389 or 888-385-0235 (TTY: 711).
If youre the spouse or child of a Veteran with disabilities, or the surviving spouse or child of a Veteran who has died, use VA Form 10-10d to apply for health insurance through CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs).
Every CHAMPVA beneficiary eligible to participate in the network of OptumRx pharmacies will receive a pharmacy ID card from OptumRx (see sample). Please contact OptumRx at 888-546-5502 if you do not receive a card.
There are a few drawbacks when it comes to CHAMPVA such as: Eligibility qualifications may be confusing, including the notion that if an individual is eligible for TRICARE, they are not eligible for CHAMPVA. It can take many months for CHAMPVA applications to be processed and put into effect.
The fastest way to request a new prescription is through your provider. You can also request a prescription by mail. New prescriptions may take up to 21 days for processing and delivery.

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Use VA Form 21-526EZ when you want to apply for VA disability compensation (pay) and related benefits.
Pharmacies that are a part of the OptumRx network will send claims electronically to VHA OCC for payment. For CHAMPVA beneficiaries who do not have other health insurance (OHI), you will pay a 25% cost share/ co-pay for your medication (after the annual outpatient deductible has been met).

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