Fill out VA 10-10D (Application for CHAMPVA Benefits) online
VA Form 10-10D is used to apply for CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), a health insurance program that provides coverage for eligible family members of veterans who have been rated permanently and totally disabled due to a service-connected condition, or who died from a service-connected disability.
How to fill out VA 10-10D (Application for CHAMPVA Benefits)
Enter the sponsor veteran information
Provide the veteran sponsor's full name, Social Security Number, VA file number, date of birth, and date of death (if applicable). Include the VA rating decision letter reference.
Enter the applicant information
For each applicant (spouse and/or children), provide their full name, Social Security Number, date of birth, sex, relationship to the veteran, and current address.
Report other health insurance
Indicate whether each applicant has other health insurance (including Medicare). If yes, complete and attach VA Form 10-7959C with a copy of the insurance card.
Attach supporting documents and sign
Include copies of the VA rating decision, marriage certificate (for spouses), birth certificates (for children), and any other required documentation. Sign and date the application.
About VA 10-10D (Application for CHAMPVA Benefits)
Who needs this form
Spouses and children of veterans with permanent and total service-connected disabilities, or surviving spouses and children of veterans who died from service-connected conditions. Applicants must not be eligible for TRICARE.
Where to submit
Mail to VHA Office of Integrated Veteran Care, CHAMPVA Eligibility, Box 137, Spring City, PA 19475. Can also be submitted online at va.gov. For questions, call the CHAMPVA Help Line at 800-733-8387.
Source and content freshness
- Filing deadlines may shift for weekends and holidays. Verify due dates with official instructions.
Common mistakes to avoid
- Not including required supporting documents (marriage certificate, birth certificates, VA rating decision)
- Applying when eligible for TRICARE (TRICARE-eligible individuals cannot receive CHAMPVA)
- Not reporting other health insurance coverage (must be reported on VA Form 10-7959C)
- Missing signatures on the application
Frequently asked questions
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What is the difference between CHAMPVA and TRICARE?
CHAMPVA and TRICARE are both government health insurance programs for military families, but they serve different populations. TRICARE covers active duty service members and their families, as well as retirees. CHAMPVA covers family members of veterans with permanent and total service-connected disabilities who are NOT eligible for TRICARE. If you're eligible for TRICARE, you cannot receive CHAMPVA benefits.
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