What documentation does CHAMPVA require when a spouse turns 65 to prove Medicare enrollment?
Executive summary
When a CHAMPVA spouse beneficiary turns 65, the Department of Veterans Affairs requires documentary proof of Medicare status to continue CHAMPVA coverage: typically a copy of the Medicare card (front and back) plus a completed CHAMPVA Other Health Insurance Certification (VA Form 10-7959c); if the person is not entitled to Medicare, a Social Security “notice of disallowance” is required instead [1] [2] [3]. Eligibility rules tied to the beneficiary’s birthdate (notably the June 5, 2001 cutoff) determine whether both Medicare Part A and Part B must be shown [4] [5].
1. What CHAMPVA asks for the moment a spouse turns 65
CHAMPVA’s official enrollment and verification paperwork directs beneficiaries to submit a completed CHAMPVA-Other Health Insurance Certification (VA Form 10-7959c) along with a copy of the front and back of the beneficiary’s Medicare card to prove Medicare enrollment and coordinate benefits [1]. Air Force benefits guidance repeats that applicants and existing beneficiaries who already have Medicare should include a copy of the Medicare card with their VA forms [2]. The VA’s application packet and instructions stress that these are the primary supporting documents for continuing CHAMPVA coverage once Medicare eligibility is in play [1].
2. If Medicare isn’t available: the SSA “notice of disallowance”
For spouses who turn 65 but are not entitled to Medicare Part A (for example, because they never worked enough quarters to qualify for premium‑free Part A), the VA requires formal Social Security Administration documentation showing they are not entitled to Medicare benefits under any Social Security number — the common form of that proof is a “notice of disallowance” from SSA [3] [2]. Several VA pages explicitly state that beneficiaries who are not eligible for Medicare must furnish SSA documentation confirming non‑entitlement to preserve or establish CHAMPVA eligibility [3] [2].
3. Which parts must be shown: the Part A/Part B rule and the 2001 cut‑off
CHAMPVA requires Medicare Part A and Part B enrollment in most cases when an eligible person has Medicare; this requirement is made explicit for persons who turn 65 on or after June 5, 2001, who must be enrolled in both Parts A and B to remain eligible for CHAMPVA [4] [5]. VA guidance and secondary sources reiterate that if a beneficiary already has both Parts A and B they must retain both, and that limited historical exceptions exist for those whose 65th birthday preceded the June 5, 2001 statutory change [4] [5].
4. Practical documentary examples and alternative evidence
The clearest, routinely accepted evidence is a copy of the Medicare card (showing Part A and Part B effective dates where applicable) and the VA Form 10‑7959c certification; other cited sources add that Social Security Administration enrollment confirmation or SSA documentation can serve as supplemental proof when card images are insufficient or when Part A entitlement is absent [1] [2] [6]. Independent guides and veterans’ service organizations echo that SSA documentation may be required in specific situations, particularly for under‑age beneficiaries or those with atypical entitlement scenarios [6].
5. Where reporting differs and why it matters
Most official VA materials are consistent on the paperwork: Medicare card copies plus the OHI certification or, alternatively, SSA notices for non‑entitlement [1] [3]. Third‑party summaries and some veterans’ advocacy pages sometimes emphasize the Part A/Part B rule without specifying the exact forms to send, which can confuse beneficiaries about whether SSA letters are acceptable — the VA sources make clear they are, in the non‑entitlement scenario [2] [3]. It is also important to note that CHAMPVA is always secondary to Medicare and that Medicare‑covered services at VA facilities do not get Medicare payment, an operational point that explains why the VA needs clear Medicare documentation [7].