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VA Form 10-7959a, CHAMPVA Claim Form, is used to adjudicate claims for CHAMPVA benefits in accordance with 38 U. or house member—like health care, disablement, education, and more.
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    To apply for CHAMPVA benefits, you must submit the following documents: Application for CHAMPVA Benefits, VA Form 10-10d; Other Health Insurance (OHI) Certification, VA Form 10-7959c ; For individuals who are eligible for Medicare for any reason, you will need a copy of your Medicare card.

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    May 11, 2023 · class=" fc-falcon">VA Forms; Forms & Publications.