The short answer
Fill out and sign the current VA Form 10-10d, add the documents that apply, and mail it to VHA Office of Community Care, CHAMPVA Eligibility, PO Box 137, Spring City, PA 19475. To fax, use the CHAMPVA Eligibility fax number printed on the current form. Include both sides of any card, and keep a full copy.
What form do you use?
VA Form 10-10d, the Application for CHAMPVA Benefits. Download it from VA.gov each time instead of using an old saved copy.
The form has room for three applicants. For more, fill out another complete Form 10-10d, sign it, and send it together.
Primary Family Caregivers don't use this form. VA enrolls them automatically once they're approved for its caregiver program and qualify.
What do you include?
For every applicant: the signed and dated Form 10-10d.
If an applicant has other insurance or Medicare:
- VA Form 10-7959c, the Other Health Insurance Certification, for that person,
- copies of the front and back of each insurance or Medicare card, including Part D, and
- for someone 65 or older who isn't entitled to Medicare, a Social Security Notice of Disallowance.
Relationship documents, depending on who's applying: marriage certificate, birth certificate, adoption papers, stepchild marriage proof, school certification, or a child's VA rating letter. VA's CHAMPVA page has the full list, and so does our CHAMPVA application checklist.
Send copies, not originals.
Where do you mail it?
VA's CHAMPVA page lists:
VHA Office of Community Care
CHAMPVA Eligibility
PO Box 137
Spring City, PA 19475
The form itself may say "VHA Office of Integrated Veteran Care" instead. It's the same PO box.
Use a mailing option with tracking that delivers to PO boxes, and keep the tracking number.
Where do you fax it?
Use the CHAMPVA Eligibility fax number printed on the current Form 10-10d. The April 2025 version lists 303-331-7809.
CHAMPVA uses different fax numbers for claims and other work, so don't use a number from another form. Send each side of a two-sided document as its own page, and save the fax confirmation.
Why does "both sides" matter so much?
VA's after-you-apply page says its scanner reads only one side of each document. If the back of an insurance card isn't copied as its own page, VA may not see it, and that can lead to a letter asking for it.
Before you send it
- The form is the current version, signed, and dated.
- Every applicant with other coverage has Form 10-7959c and card copies.
- Relationship documents are included where they apply.
- Both sides of every two-sided document are copied.
- You've kept a full copy of everything.
What happens next?
You usually don't need to do anything unless VA writes to ask for more. If it does, add the document to your existing application. Don't start over. To check on it, call CHAMPVA at 800-733-8387. More here: What happens after you apply for CHAMPVA.
If you'd rather do it electronically, see How to apply for CHAMPVA online.