Changes to CHAMPVA
By CWO4 Lewis Tolleson, USCG-Ret., Director; Lt. Col. William A. Pierce, USA-Ret.; and Capt. Bud Schneeweis, USCG-Ret. Benefits Information

Can you tell me more about the recent changes to CHAMPVA?

Surviving spouses who lost access to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) by remarrying before Feb. 4, 2003, now can be reinstated if they remarried after age 55 and if they apply for reinstatement by Feb. 4, 2004. A surviving spouse who remarried after age 55 and lost access to TRICARE benefits now may be eligible for CHAMPVA coverage. 

To be eligible for CHAMPVA, an individual must be the family member of a veteran who has a permanent and total service-connected disability, who died of a service-connected condition, or who was totally disabled from a service-connected condition at the time of death. 

In general, CHAMPVA covers most health care services and supplies that are medically and psychologically necessary. CHAMPVA is separate from TRICARE and has a different beneficiary population. The benefits are similar, but the programs are administered separately with significant differences in claim filing procedures and preauthorization requirements.

Medicare Notices

What is the new electronic Medicare Summary Notice? 

The electronic Medicare Summary Notice (e-MSN) is a way to obtain duplicate copies of your MSNs. These duplicates can be viewed and printed from your computer 24 hours a day, seven days a week just by accessing the Palmetto GBA Web site, www.palmettogba.com. Currently, e-MSN does not replace the paper MSN mailed when a claim is processed. e-MSN is a pilot program that is optional, and at this time it is limited to individuals whose claims are processed by Palmetto GBA. The Centers for Medicare & Medicaid Services is evaluating the benefits before e-msn is made more widely available.

To find out if you are eligible to participate, visit Palmetto GBA’s Web site to review the list of states included in the pilot. 

HIPAA Takes Effect 

What is the Health Insurance Portability and Accountability Act? 

HIPAA is a federal law that became effective April 14, 2003. It was enacted to combat waste, fraud, and abuse; improve portability of health insurance coverage during events such as changing or losing jobs, pregnancy, moving, or divorce; and simplify administration of health care. 

HIPAA requires doctors, hospitals, health plans, and others to protect their patients’ medical information. It gives patients the right to restrict certain uses of protected health information such as physical and mental conditions, age, ethnicity, and other personal statistics. HIPAA affects everyone who receives medical care — it is not specific to TRICARE.

The next time you go to the doctor you will be asked to sign a form acknowledging that you received notification of your rights under HIPAA. Your signature does not affect the care you receive, and you have the right to refuse to sign. 

How has HIPAA changed the delivery of health care? 

Patients now have the right to a higher level of control over personal information. You may request a copy of your medical records, and you may request a list of those to whom your records have been disclosed. You also can ask that the doctor’s office call you on a specific phone line and not leave a message if you do not answer, that appointment reminders be sent in envelopes instead of on postcards, and that a hospital not discuss your medical condition with certain people.

Call your doctor’s office if you have questions about HIPAA. If you have questions specific to TRICARE, call the Department of Defense at (888) DOD-HIPPA (363-4472).