CHAMPVA Family Cap Tracker
How close is your family to the $3,000 catastrophic cap, and what will the next visit cost? Enter what you have paid so far this year, and optionally the next visit, and see exactly what is left.
Use the deductible and cost share totals from your CHAMPVA statements for this calendar year. Nothing you type here leaves your browser.
An estimate for general information, based on CHAMPVA rules as published by the VA. It is not a statement from CHAMPVA, and it does not change what CHAMPVA actually pays. Always check your Explanation of Benefits.
Common questions
What counts toward the $3,000 cap?
Your deductible and your 25 percent cost share for covered services, added up across the whole family for the calendar year. Premiums do not count, non-covered services do not count, and any amount a provider charged above the CHAMPVA allowable does not count, because that amount is a write-off, not your payment.
Where do I find how much I have paid so far?
Add up the deductible and cost share lines on your CHAMPVA Explanation of Benefits statements for this year. Do not use the amount the provider billed, and do not include amounts CHAMPVA or another insurer paid. If a statement is still being processed, leave it out until it is final.
What happens when I reach the cap in the middle of a visit?
You pay only up to the cap. If a visit would take you past $3,000, you pay the part that reaches $3,000 and CHAMPVA pays 100 percent of the allowable for the rest of that visit, and for covered services for the rest of the year. This tracker splits that visit for you.
Does the cap reset?
Yes, every calendar year. On January 1 the deductible and the cap start over, even if you reached the cap the year before.
Is anything I type into this tool sent anywhere?
No. The math runs entirely in your browser. Nothing is uploaded, stored, or sent to us or anyone else.
What if I have Medicare or other insurance too?
That insurance pays first, and CHAMPVA then pays what is left up to the allowable, with normally no cost share for you. In that case your deductible and cost share may stay low, and this tracker will simply show how far you are from the cap on the CHAMPVA share you actually paid.