How to Apply

Application Process

If you provide all the required and optional documents, and if your application is complete, then it normally takes 6 weeks after we get your package until you get your CHAMPVA card and related materials.

If you provide only the required documents and not the optional documents, processing can take 2-8 months since we have to confirm information with other federal agencies.

Once we get your application, we will review it to be sure its complete and that all the required forms are included. If your application is not complete, we will return it to you with further instructions.

• Fact Sheet 02-01 Instructions for Applicants

Required Documents

To apply for CHAMPVA benefits, you must submit the following documents:

• Application for CHAMPVA Benefits form
  • Blank Application or
  • Fillable Application
• Other Health Insurance (OHI) Certification form
  • VA Form 10-7959c or
  • Forma 10-7959c Certificacion CHAMPVA de Otros Seguros de Salud (OSS)
• Marriage / Divorce Information Letter
  • CHAMPVA Marriage Status Application Attachment
• For individuals who are eligible for Medicare (normally those age 65 and older), we also need a copy of your Medicare card.
• If you are age 65 or older and are not entitled to Medicare, you must send documentation from the Social Security Administration, which confirms that you are not entitled to Medicare benefits under anyone's Social Security number.

Optional Documents

You can speed the processing of your application if you also send copies (do not send originals)

• Veteran and spouse marriage license
• Birth certificate/adoption papers for children
• The page from the VBA rating decision that shows the veteran is permanently and totally disabled (or death rating for a survivor)
• If you are a remarried widow/widower and are once again single, provide a copy of the legal documentation that terminated the remarriage. The legal documentation of termination of a remarriage may be a divorce decree, death certificate or annulment decree.
• Veteran's DD214 (Certificate of Release or Discharge from Active Duty) or if the veteran was a WWII or Korea veteran, the Report of Separation. The VA does not have copies of this form, you must obtain it from your veterans military service. If you do not have this form readily available, we recommend that you not spend time requesting one from the military, send your application package in without it and we will obtain it for you.
• School certification of full-time enrollment for children ages 18-23
  (see Fact Sheet 01-02)

Send your complete package to:

CHAMPVA-Eligibility
PO Box 469028
Denver, CO 80246-9028