VA Form 10-7959A CHAMPVA Claim Form

VA Form 10-7959A, known as the CHAMPVA Claim Form, is a document used in the United States by the Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA). It is used by eligible dependents or survivors of certain veterans to claim reimbursement for medical services or supplies. These claims may include those for prescription medications, medical supplies, doctor's appointments, and other related healthcare services. The form must detail the service provided, the date, and charges incurred to facilitate an accurate payout.

The VA Form 10-7959A, commonly known as the CHAMPVA Claim Form, is filed by beneficiaries of the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). These beneficiaries are primarily the spouses or children of disabled, retired, or deceased veterans who are not eligible for TRICARE, the military's health insurance program. The form is used to claim reimbursement for healthcare services received from non-VA providers.

FAQ

Q: What is VA Form 10-7959A CHAMPVA Claim Form?
A: VA Form 10-7959A, also known as the CHAMPVA Claim Form, is a document filed by beneficiaries of the Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA) to claim for reimbursement of medical expenses.

Q: Who is eligible to use VA Form 10-7959A?
A: The VA Form 10-7959A is eligible to be used by the spouse or child of a disabled, deceased, or retired Veteran who meet specific criteria as set by the Department of Veterans Affairs.

Q: How can I file a claim using VA Form 10-7959A?
A: To file a claim using VA Form 10-7959A, you need to fill in the necessary information in the form including your personal details and the specifics of your medical expenses. Once completed, mail the form along with your supporting documents to the VA Health Administration Center.

Q: Is there a deadline to submit VA Form 10-7959A?
A: Yes, there is a deadline for submitting VA Form 10-7959A. Claims must be filed with the VA Health Administration Center in Denver no later than one year after the date that care was provided.

Q: What documents are required to support the VA Form 10-7959A?
A: Supporting documents for VA Form 10-7959A typically include your itemized bills for services or supplies provided, copies of any other health insurance Explanation of Benefits (EOB) if you have any, and any required medical documentation for the treatment or service.