If you count on CHAMPVA and Medicare is now on the horizon, you may be worried about losing coverage you have leaned on for years. Take a breath: the two programs are built to work together, and you do not have to choose between them. But there is one rule you cannot afford to miss. Once you are eligible for Medicare, you must keep both Part A and Part B, or you can lose CHAMPVA entirely. This guide walks you through how CHAMPVA and Medicare coordinate, who pays first, what you owe, and the exact proof the VA needs, so nothing catches you off guard.

First, what CHAMPVA is, and what it is not

CHAMPVA, the Civilian Health and Medical Program of the Department of Veterans Affairs, is a health benefits program for eligible spouses, dependent children, and survivors of veterans who are rated permanently and totally disabled from a service-connected condition, or who died from a service-connected condition. Certain other categories of family members may also qualify.

Two distinctions matter, because they are easy to confuse and the rules are not the same for each. CHAMPVA is administered by the VA, but it is separate from the VA health care the veteran receives for themselves, and it is separate from TRICARE. If your situation involves the veteran's own VA coverage, Medicare and VA benefits is the guide that speaks to that. This guide is about your CHAMPVA coverage and how it lines up with your Medicare.

Why you must keep both Part A and Part B

If you have depended on CHAMPVA to see a doctor or fill a prescription, the fear of a coverage gap is real, and it deserves a clear answer. Here is the rule to hold onto above all others: if you are eligible for Medicare, for any reason and at any age, you must have both Medicare Part A and Part B to get or keep CHAMPVA. This applies whether you reach Medicare through age or through disability before 65. A Medicare Advantage plan (Part C) also meets the requirement, because it includes Parts A and B.

The reason this matters so much is the consequence of getting it wrong. Because CHAMPVA requires Part B once you are Medicare-eligible, dropping Part B, or never enrolling in it, can cause you to lose CHAMPVA. People sometimes consider skipping Part B to avoid its monthly premium, not realizing that the choice can quietly cost them their CHAMPVA benefits too. If that has already happened to you, re-enrolling in Part A and Part B restores your eligibility, but Part B has fixed enrollment windows, so the timing matters. Medicare enrollment periods covers when you can sign up so you can close the gap and keep CHAMPVA.

There is one narrow exception. Under the "CHAMPVA for Life" provisions, a beneficiary who had already reached age 65 as of June 5, 2001 but was not enrolled in Part B on that date can keep CHAMPVA without Part B. Anyone who turned 65 on or after June 5, 2001, which is essentially everyone approaching Medicare today, is bound by the standard rule and needs both parts.

Medicare pays first, CHAMPVA pays second

When you have both, the order of payment is set: Medicare is the primary payer, and CHAMPVA is the secondary payer. Medicare pays for your care first. Then, for services that CHAMPVA covers, CHAMPVA may cover costs you still owe, such as your Medicare deductibles and coinsurance.

In practice, this makes CHAMPVA function much like supplemental coverage sitting on top of Medicare. This secondary-payer arrangement is the same kind of coordination Medicare uses with other coverage you might have; if you want the broader picture of how Medicare decides who pays first, see coordination of benefits. The takeaway for you is simple: Medicare goes first, and CHAMPVA can help with what is left over on covered services.

Question How it works with CHAMPVA and Medicare
Do I need Part A and Part B? Yes. Once you are Medicare-eligible, for any reason at any age, you must have both Part A and Part B to keep CHAMPVA.
Who pays first? Medicare pays first. CHAMPVA is the secondary payer.
What does CHAMPVA cover after Medicare? For CHAMPVA-covered services, costs you still owe, such as Medicare deductibles and coinsurance.
Who pays the Part B premium? You do. CHAMPVA does not pay your Medicare Part B premium ($202.90/month in 2026).
Do I need Part D? No. CHAMPVA drug coverage is creditable, so Part D is optional and carries no penalty if you decline it.
What proof do I need at 65? Proof of your Medicare coverage. If you are not eligible for premium-free Medicare, a notice of disallowance from the Social Security Administration.

CHAMPVA does not pay your Part B premium

It is worth being plain about this, because the cost can catch families off guard at an already stressful time. CHAMPVA does not pay your Medicare Part B premium. You are responsible for paying that monthly premium yourself, just as any other person on Medicare would. In 2026, the standard Part B premium is $202.90 a month, up from $185.00 in 2025, and higher earners pay more through an income-related surcharge.

That is the trade at the heart of keeping both coverages: Part B is required to keep CHAMPVA, and you carry the Part B premium yourself. It is a real monthly cost, and if it strains your budget, a Medicare Savings Program may help pay the premium for those who qualify. CHAMPVA's own help comes on the back end, after Medicare has paid, in the form of covering deductibles and coinsurance you would otherwise owe on covered services.

Do you need Medicare Part D with CHAMPVA?

This is the question many CHAMPVA beneficiaries lose sleep over, and the answer is reassuring: you do not need to enroll in Medicare Part D to get or keep CHAMPVA. CHAMPVA includes prescription drug coverage that qualifies as creditable prescription drug coverage, which means it provides at least as much prescription coverage as Medicare Part D. So if you decline Part D, you will not owe a Part D late-enrollment penalty, as long as you do not go 63 or more days in a row without creditable coverage.

If you ever need to prove your CHAMPVA drug coverage is creditable, for example if a Part D plan asks, you can contact CHAMPVA and request a letter of creditable coverage. Keep that letter with your important papers, so you have it if you ever do decide to add a Part D plan later.

How to keep CHAMPVA when you turn 65

Turning 65 should not mean losing coverage you rely on, and it will not, as long as you show the VA the right document. The VA simply needs to confirm your Medicare status. Here is how to keep your CHAMPVA benefits in place.

1
Step 1

Confirm your Medicare status a few months before your 65th birthday

Check whether you qualify for premium-free Medicare Part A, which most people earn through 40 quarters (about 10 years) of Medicare-covered work, their own or a spouse's. If you are not sure, the Social Security Administration can tell you.

2
Step 2

Gather your proof

If you are eligible for premium-free Medicare, your proof is documentation of your Medicare coverage, such as a copy of your red-white-and-blue Medicare card or an enrollment letter from Social Security. If you are not eligible for premium-free Medicare, request a notice of disallowance from the Social Security Administration, the letter showing you do not qualify.

3
Step 3

Send your proof to CHAMPVA

Submit the document to the VA Office of Community Care so your CHAMPVA benefits continue without interruption. If you are unsure where to send it or what counts, call CHAMPVA before your birthday rather than after, so there is no gap.

Where to get help

You do not have to sort this out alone. These are the offices that handle CHAMPVA and Medicare questions directly.

CHAMPVA (VA Office of Community Care) Enrollment, covered services, the Part A and Part B requirement, and requesting a letter of creditable coverage. 1-800-733-8387 va.gov CHAMPVA
Social Security Administration Medicare Part A and Part B enrollment, premium-free eligibility, and issuing a notice of disallowance if you do not qualify for premium-free Medicare. 1-800-772-1213 ssa.gov
Medicare Questions about what Medicare covers, Part B premiums, and how Medicare coordinates as the primary payer. 1-800-633-4227 medicare.gov

Frequently Asked Questions

Do I need Medicare Part B to keep CHAMPVA?

Yes. Once you are eligible for Medicare, for any reason and at any age, you must have both Medicare Part A and Part B to get or keep CHAMPVA. Dropping Part B, or never enrolling in it, can cause you to lose your CHAMPVA benefits, so keeping Part B is not optional once you are Medicare-eligible. A Medicare Advantage plan (Part C) also satisfies the requirement, since it includes Parts A and B.

Who pays first, Medicare or CHAMPVA?

Medicare pays first. CHAMPVA is the secondary payer, so after Medicare pays, CHAMPVA may cover costs you still owe, such as Medicare deductibles and coinsurance, for CHAMPVA-covered services. This makes CHAMPVA work much like supplemental coverage on top of Medicare.

Does CHAMPVA pay my Medicare Part B premium?

No. CHAMPVA does not pay your Medicare Part B premium. In 2026 the standard Part B premium is $202.90 a month, and you pay it yourself. CHAMPVA's role is to help with the deductibles and coinsurance you still owe after Medicare pays, on services CHAMPVA covers.

Do I need Medicare Part D if I have CHAMPVA?

No. CHAMPVA prescription drug coverage counts as creditable coverage, meaning it is at least as good as Medicare Part D, so you can decline Part D without owing a late-enrollment penalty, as long as you do not go 63 or more days in a row without creditable coverage. If you need proof, contact CHAMPVA and ask for a letter of creditable coverage.

What proof do I need to give the VA at 65?

When you turn 65, you must give the VA proof of your Medicare coverage to keep CHAMPVA, such as a copy of your Medicare card or a Social Security enrollment letter. If you are not eligible for premium-free Medicare at 65, you instead provide a notice of disallowance from the Social Security Administration, showing that you do not qualify for premium-free Medicare. You can request that notice by calling Social Security at 1-800-772-1213.

What happens if I already lost CHAMPVA by missing Part B?

If your CHAMPVA ended because you were not enrolled in Part B, re-enrolling in both Part A and Part B restores your eligibility. Part B has set enrollment windows, so contact the Social Security Administration to find your next enrollment period, and contact CHAMPVA once your Medicare is active to reinstate your benefits.

Learn More

MedicareWhat is Medicare? Parts A, B, C, and D explainedWhat is Medicare? A plain guide to Parts A, B, C, and D, who qualifies, 2026 costs, when to enroll, and what it doesn't cover, with help-paying options. MedicareMedicare enrollment periods and when to sign upWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs. MedicareMedicare and VA benefits for veteransHow VA benefits and Medicare work together: why veterans should take Part B at 65 to avoid a lifelong penalty, and delay Part D with VA drug coverage. MedicareHow Medicare coordination of benefits worksMedicare coordination of benefits: who pays first with employer coverage, retiree plans, or COBRA, plus the COBRA trap that triggers a lifelong penalty. MedicareMedicare late-enrollment penalties, and how to avoid themWorried you missed a Medicare deadline? Here is how the Part A, B, and D late enrollment penalties are calculated, how long each lasts, and how to avoid them. MedicareTRICARE For Life and MedicareTRICARE For Life wraps around Medicare for military retirees at 65. Learn why Part B is required, who pays first, and whether you need Part D or Medigap.

If you are a CHAMPVA beneficiary approaching Medicare and want help keeping your coverage in place, find personalized guidance at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.