The short answer
Yes, CHAMPVA works while you travel. There's no medical network, so you can see any provider who's qualified and willing to bill CHAMPVA. Prescriptions are easiest at an OptumRx network pharmacy. In an emergency, get care first and sort out paperwork after. Keep receipts in case you need to file the claim yourself.
Does CHAMPVA work outside my home state?
Yes. 38 CFR 17.270 covers care in all 50 states, D.C., U.S. territories, and abroad. And because CHAMPVA has no medical network, there's no out-of-network penalty for seeing a doctor in another state.
The usual rules still apply: the care has to be covered, medically necessary, and from a qualified provider.
For care outside the U.S., see Using CHAMPVA outside the United States.
What should you pack?
- Your CHAMPVA ID card
- Your OptumRx prescription card
- Medicare and any other insurance cards
- Enough medication, or a plan to refill on the road
- A way to keep receipts, like photos on your phone
If you'll need planned care while away, call ahead.
How do you find a doctor on the road?
The CHAMPVA Guidebook suggests starting with Medicare or TRICARE provider lists, since offices that bill those are often set up for CHAMPVA. Then ask:
- "Will you see a CHAMPVA patient?"
- "Do you accept CHAMPVA assignment?"
- "Will you bill CHAMPVA for me under payer ID 84146?"
If they don't accept assignment, you may have to pay upfront and could owe more than CHAMPVA's allowable amount. More here: How to find a provider that takes CHAMPVA.
What about an emergency?
Get care. Traveling doesn't add any approval step, and the preauthorization rule for inpatient mental health and substance use care in 38 CFR 17.273 applies only to non-emergencies.
Once things settle, give the hospital your CHAMPVA and other insurance information, and keep the paperwork. Planned follow-up care after an emergency may still need preauthorization if it's on the list. More here: Which CHAMPVA services need preauthorization?
How do prescriptions work away from home?
Unlike medical care, prescriptions do use a network.
- OptumRx network pharmacies: VA's CHAMPVA care page says you can fill urgent and regular prescriptions at OptumRx network pharmacies, which include most local pharmacies. Show your card.
- Other pharmacies: You can use one, but you'll usually pay the full price and file for reimbursement. Ask for a detailed receipt with the drug name, strength, quantity, price, date, prescriber, and 11-digit NDC number.
- Meds by Mail: If you use it, the Guidebook says it can ship maintenance medications to a temporary address, like a winter home. It's not for urgent fills.
More here: CHAMPVA prescription coverage.
What if you have to file the claim yourself?
If you paid a provider or pharmacy directly, file a claim online or by mail. VA's claim page asks for:
- an itemized bill,
- proof you paid, and
- your other insurance's EOB, if you have other coverage.
CHAMPVA pays you by direct deposit only, so set it up before you need it. More here: CHAMPVA direct deposit.
File within 1 year of the care, or 1 year from discharge for a hospital stay.
Common travel mistakes
- Thinking there's a CHAMPVA network to stay inside. There isn't, for medical care.
- Assuming "we take CHAMPVA" means they accept assignment.
- Leaving the OptumRx card at home.
- Paying cash at a pharmacy without a detailed receipt.
- Forgetting to tell the provider about your other insurance.