The short answer
No. CHAMPVA excludes services or supplies prescribed or provided by a member of your immediate family, or by anyone living in your household or the Veteran's household. That's true even if they're a licensed nurse, doctor, or therapist. Family can still help with care, but CHAMPVA won't pay for it.
What's the rule?
38 CFR 17.272(a)(15) excludes services or supplies prescribed or provided by:
- a member of the beneficiary's immediate family, or
- anyone living in the beneficiary's or the Veteran's household.
The CHAMPVA Guidebook lists the same exclusion for extended care.
It doesn't stop family from helping. It just means CHAMPVA won't pay for it.
Does it matter if they're licensed?
No. The regulation has no exception for licensed professionals. If your sister is a nurse or your spouse is a therapist, CHAMPVA won't pay for care they provide to you.
Does it apply to people who aren't related?
Yes. The household part covers anyone who lives with you or with the Veteran, related or not.
Does it apply to prescriptions too?
Yes. The rule says "prescribed or provided." If a family member writes the order, even if someone else does the care, the exclusion can apply.
Some examples
| Situation | Does the rule apply? |
|---|---|
| Your mother, a licensed nurse, gives you skilled care | Yes |
| An unrelated nurse who rents a room in your home treats you | Yes |
| Someone who lives with the Veteran, but not you, provides care | It can |
| A family member writes the order and someone else does the care | It can |
| An unrelated home health nurse who doesn't live with you or the Veteran | No, but other rules still apply |
Is home health care excluded?
No. Home health from an unrelated professional can be covered when it meets CHAMPVA's rules. The exclusion is about who provides the care, not where. More here: CHAMPVA home health care.
Before counting on payment
If this might apply, write down:
- who prescribed or ordered the service,
- who provides it,
- their relationship to the patient, and
- whether they live with the patient or the Veteran.
If the arrangement is unusual, like a relative who works for an agency that would bill CHAMPVA, ask CHAMPVA at 800-733-8387 before care starts.
Is there help for family caregivers?
Not through CHAMPVA payments for care. But if you care for a Veteran, VA's caregiver program may provide a stipend and other support, and some Primary Family Caregivers can get CHAMPVA for their own health care. More here: CHAMPVA for Primary Family Caregivers.