The short answer
Getting Medicare before 65 doesn't end CHAMPVA. But if you're entitled to Medicare Part A, you must also enroll in Part B to keep CHAMPVA. If you cancel Part B, CHAMPVA ends the same day. Medicare Advantage counts. Then Medicare pays first and CHAMPVA second. Send VA your Medicare card and Form 10-7959c.
What's the rule?
38 U.S.C. 1781(d) and 38 CFR 17.271 say someone under 65 who's entitled to Part A must be enrolled in Part B to keep CHAMPVA. With both, CHAMPVA becomes secondary.
| Your Medicare status | What it means |
|---|---|
| Not entitled to Part A | The Part B rule doesn't apply |
| Part A and Part B | You keep CHAMPVA. Medicare pays first. |
| Part A but not Part B | You don't meet CHAMPVA's Medicare rule |
| Medicare Advantage | Counts as A and B. The plan pays first. |
The key date is when your Part A entitlement starts, not your age.
Why would you get Medicare before 65?
Usually through Social Security disability, end-stage kidney disease, or ALS. Medicare's before-65 page explains the timing for each.
Don't cancel Part B
The CHAMPVA Guidebook says if you cancel Part B, CHAMPVA ends the same day. For you, Part B isn't optional extra coverage. It's what keeps CHAMPVA.
CHAMPVA doesn't pay your Part B premium.
The June 5, 2001 grandfather rule only covers people who were already 65 then. It can't apply to anyone under 65 today.
How do claims work?
- The provider bills Medicare first.
- Medicare processes it and usually forwards it to CHAMPVA.
- CHAMPVA pays what's left under its rules. VA's CHAMPVA care page says it may cover some or all of the Part B deductible.
- Check both EOBs.
If you have job-based insurance too, it doesn't remove the Part B requirement. Ask Medicare and your plan which pays first. More here: CHAMPVA and Medicare.
What do you send VA?
VA Form 10-7959c and a copy of the front and back of your Medicare card.
- Check your Part A and Part B start dates on your card or award letter.
- Make sure Part B starts when Part A does.
- Send VA the form and card.
- Give providers both cards.
- Watch your first few EOBs.
If the start dates don't match, call Medicare or Social Security and CHAMPVA right away.
Other things that change
- Part D isn't required. More here: CHAMPVA and Part D.
- CITI care at VA facilities ends. VA says beneficiaries eligible for Medicare can't use CITI. Find a new provider before Medicare starts. More here: CHAMPVA CITI.
- Medicare Advantage rules apply if you pick one, like networks and referrals.