TRICARE vs. CHAMPVA: Key Differences Explained
TRICARE is the healthcare program for active duty service members, retirees, and their families managed by the Defense Health Agency. CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) covers dependents of veterans who are permanently and totally disabled from service-connected conditions, or dependents of veterans who died from service-connected disabilities.
Eligibility
TRICARE
Active duty, Guard/Reserve, retirees, and their families. Must be registered in DEERS.
CHAMPVA
Spouse/children of a veteran rated 100% permanently and totally disabled, or survivors of veterans who died from service-connected disabilities. Cannot be eligible for TRICARE.
Feature Comparison
| Feature | TRICARE | CHAMPVA |
|---|---|---|
| Administering Agency | Defense Health Agency (DHA) | Department of Veterans Affairs (VA) |
| Network Providers | Yes — Humana Military, TriWest networks | No formal network — any Medicare-accepting provider |
| Referrals Required | Only for Prime | No |
| Prescription Coverage | Yes — military pharmacy, mail order, retail | Yes — Meds by Mail and retail |
| Dental Coverage | Separate plan (TRICARE Dental Program) | Not included |
| Mental Health | Covered | Covered |
Cost Comparison
| Cost | TRICARE | CHAMPVA |
|---|---|---|
| Annual Enrollment Fee | $0 (ADFMs) to $776.64 (retiree family) | $0 |
| Annual Deductible | $0 (Prime) to $300 (Select family) | $50/individual |
| Outpatient Visit | $0 (Prime) to $28+ (Select) | 25% of allowable charges |
| Inpatient Care | $0 (Prime ADFMs) | 25% of allowable + per-day amount |
| Catastrophic Cap | $1,000–$3,500 | $3,000 |
Pros & Cons
TRICARE
Pros
- Larger provider network
- Multiple plan options
- Military pharmacy access
- Dental available
- Lower costs for active duty families
Cons
- Must be registered in DEERS
- Prime requires referrals
- Geographic restrictions for Prime
CHAMPVA
Pros
- No enrollment fee
- No referrals ever
- Low deductible
- Can see any Medicare-accepting provider
Cons
- No formal provider network
- No dental coverage
- Must not be TRICARE eligible
- No military pharmacy access
Best For
TRICARE
Active duty, Guard/Reserve members and their families, plus military retirees. Anyone registered in DEERS.
CHAMPVA
Dependents of 100% disabled veterans and survivors of service-connected deaths who are not TRICARE-eligible.