How to Apply for CHAMPVA by Mail or Fax

Quick answer

To apply for CHAMPVA by mail or fax, complete the current Application for CHAMPVA Benefits (VA Form 10-10d), sign it, and include the supporting documents that apply to each applicant.

For mail, VA's current CHAMPVA benefits page directs applications and supporting documents to:

VHA Office of Community Care
CHAMPVA Eligibility
PO Box 137
Spring City, PA 19475

For fax, the current April 2025 VA Form 10-10d lists 303-331-7809 on the form itself for CHAMPVA Eligibility. Because VA uses other CHAMPVA fax numbers for other workflows, use the application-specific number printed on the current Form 10-10d and re-check the form before sending.

If you would rather submit electronically, see How to Apply for CHAMPVA Online.

First, make sure Form 10-10d is the right application

VA Form 10-10d is the paper application for spouses, children, and surviving spouses or children who may qualify for CHAMPVA. The current form revision is April 2025.

There is an important exception: a qualifying Primary Family Caregiver under VA's Program of Comprehensive Assistance for Family Caregivers does not file a separate Form 10-10d. VA says it enrolls the caregiver automatically after determining that the caregiver qualifies for CHAMPVA.

For a newborn child, VA also requires two steps before the CHAMPVA application: obtain the child's Social Security number, then add the child as a dependent of the Veteran sponsor.

If you are unsure whether the applicant fits a CHAMPVA eligibility category, review Who Qualifies for CHAMPVA? before sending the packet.

Step 1: Download the current Form 10-10d

Use VA's official Form 10-10d page rather than an old saved copy from another website.

The current form has space for three applicants. If you need more space, the form instructions say to complete another Form 10-10d in its entirety, sign it, and submit it with the packet.

Complete the sponsor and applicant information carefully and sign and date the certification section. Missing information can delay VA's eligibility determination.

Step 2: Gather the supporting documents that apply

Not every applicant needs the same attachments. VA's current CHAMPVA benefits page separates documents that are required in certain situations from documents that are optional but may help VA process the application faster.

If an applicant has Medicare or other health insurance

The current Form 10-10d says that each applicant who reports Medicare or other health insurance must submit VA Form 10-7959c, CHAMPVA Other Health Insurance (OHI) Certification.

VA also requires copies of the applicable insurance information:

• the front and back of the health insurance or Medicare card;
• the front and back of a Medicare Part D card if the applicant has Part D; and
• if the applicant is age 65 or older and is not entitled to Medicare, a Social Security Administration Notice of Disallowance showing Medicare ineligibility.

Use VA's current Form 10-7959c page for the paper OHI form.

If the applicant is a spouse or surviving spouse

VA says a copy of a marriage certificate, certificate of civil union, or common-law marriage affidavit is optional but can help it process the application faster.

If a surviving spouse remarried before age 55 and that later marriage ended, VA lists a divorce decree, annulment decree, or death certificate as supporting evidence that can help document the change.

If the applicant is a dependent child

VA says a birth certificate can help it process a child's application faster. Additional documents are required in some circumstances:

• Adopted child: adoption papers.
• Stepchild: proof of the marriage between the Veteran sponsor and the child's other parent.
• Student age 18 to 23: a school certification letter showing enrollment.
• Child who became permanently unable to support themselves before age 18: a VA disability rating letter can help establish that status.

The exact evidence depends on the applicant's facts, so compare your packet with the supporting-document section on VA's current CHAMPVA page before sending it.

Step 3: Build a complete paper packet

Before mailing or faxing, check the packet as one unit:

1. The current Form 10-10d is complete, signed, and dated.
2. Every applicant who reports Medicare or other health insurance has the required Form 10-7959c and card copies.
3. Relationship, adoption, stepchild, school, Medicare, or other supporting records are included when they apply.
4. Both sides of any two-sided card or document are copied.

VA's current after-you-apply instructions warn that its scanner can scan only one side of each document. If a document is double-sided, include a copy of each side even when you mail the packet.

Keep a complete copy of everything you send. Supporting records should generally be copies unless VA specifically asks for an original.

Step 4: If you mail the application

Mail the completed Form 10-10d and supporting documents to:

VHA Office of Community Care
CHAMPVA Eligibility
PO Box 137
Spring City, PA 19475

The Form 10-10d itself uses the organizational name "VHA Office of Integrated Veteran Care" for CHAMPVA Eligibility but lists the same PO Box 137 in Spring City. The current VA.gov application page uses "VHA Office of Community Care." The destination box and city are the same.

For your own records, consider using a mailing method that provides tracking and is compatible with a P.O. Box. Save the tracking number with a copy of the packet. Tracking shows delivery activity from the carrier; it does not prove that VA has completed intake or adjudication.

Step 5: If you fax the application

Fax the completed Form 10-10d and supporting documents to 303-331-7809, the number printed on the current April 2025 Form 10-10d for CHAMPVA Eligibility.

For a multi-page fax:

• make sure every page is legible;
• include both sides of any double-sided record as separate pages;
• note the total number of pages you are sending; and
• save the fax transmission confirmation.

A successful fax transmission is useful evidence that your machine or fax service transmitted the packet. It is not the same as VA confirming that the application has been indexed or approved.

Do not substitute a general CHAMPVA, claims, or preauthorization fax number for the number printed on the current application form.

Step 6: Know what happens after you send it

VA's current after-you-apply guidance says you generally do not need to do anything while the application is pending unless VA sends a letter asking for more information.

If VA asks for a missing document, you can add the information to the existing application online, by mail, or by fax. You do not need to start the whole application over just because VA requested additional evidence.

VA also says changes to personal information, health insurance, or school status should generally be added to the existing pending application. A new application is appropriate when you are adding a dependent or when you previously applied while ineligible and later became eligible.

For a status question, the current Form 10-10d lists the CHAMPVA Customer Service Center at 800-733-8387. Have enough information available to identify the application, but do not send sensitive personal information through an unsecured channel.

Practical proof-of-submission checklist

Keep these items together until enrollment is complete:

• a copy of every completed and signed form;
• a copy of every supporting document;
• the date you mailed or faxed the packet;
• the mail tracking number or fax confirmation;
• any letter VA sends requesting more information; and
• copies of anything you later submit in response.

This record can help you identify what was sent and when if VA later says information is missing. It does not replace VA's own application record.

Common mistakes to avoid

• Using an old Form 10-10d or an outdated fax number saved from another source.
• Sending Form 10-10d without Form 10-7959c when an applicant reports Medicare or other health insurance.
• Copying only one side of an insurance card or other two-sided document.
• Forgetting the signature or date on the certification.
• Sending an eligibility application to a general claims or correspondence destination instead of the CHAMPVA Eligibility destination.
• Mailing or faxing the only copy of an important personal record.
• Submitting a brand-new application merely to correct a pending application's contact, insurance, or school information.

For current CHAMPVA phone numbers, addresses, forms, and other operational contacts, see CHAMPVA Contacts, Mailing Addresses, and Official Forms.