Submit this form annually or whenever your income, dependents, or insurance changes

Reporting lower income may qualify you for reduced copays or free care

You do NOT need to reapply for healthcare — this just updates your existing enrollment

Veterans Affairsmoderate

VA Health Benefits Update

VA 10-10EZR · VA

Health Benefits Update Form for veterans already enrolled in VA health care who need to update personal, insurance, financial, or military service information.

Form Details

Total fields: 60
Auto-fillable: 40 (67%)
Time without BeneFill: 30 minutes
Time with BeneFill: 8 minutes
Time saved: 22 minutes
Filled by: patient
Frequency: annual

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Where to Submit This Form

🌐

VA.gov (recommended)

https://www.va.gov/health-care/update-health-information-form-10-10ezr/

Update your health benefits information online.

📬

Mail to VA Health Eligibility Center

Health Eligibility Center 2957 Clairmont Road NE, Suite 200 Atlanta, GA 30329-1647

🏢

In person at any VA Medical Center enrollment office

https://www.va.gov/find-locations/?facilityType=health

Processing Time

1-2 weeks for your records to be updated.

What Happens Next

VA will update your enrollment information. Changes to income may affect your Priority Group, copay rates, and eligibility for travel reimbursement.

Tips for This Form

✓ Submit this form annually or whenever your income, dependents, or insurance changes
✓ Reporting lower income may qualify you for reduced copays or free care
✓ You do NOT need to reapply for healthcare — this just updates your existing enrollment

More Veterans Affairs Forms

VA Healthcare Enrollment

VA 10-10EZ · VA

Application for VA health benefits. Requires military service history, current insurance, income/assets, and toxic exposure history.

VA Disability Compensation Application

VA 21-526EZ · VA

Application for disability compensation and related benefits for service-connected conditions. Requires linking conditions to military service.

Intent to File a Claim

VA 21-0966 · VA

Preserves the effective date for a VA benefits claim while gathering evidence. Provides 1 year to submit the formal claim.

Authorization to Release Information to VA

VA 21-4142 · VA

Authorization and consent allowing VA to obtain private medical records from non-VA providers for disability claim adjudication.

General Release for Medical Provider Information

VA 21-4142a · VA

Companion form to 21-4142 allowing specific medical professionals to release records to VA for claim processing.

Statement in Support of PTSD Claim

VA 21-0781 · VA

Statement detailing stressor events related to a PTSD disability compensation claim. Describes incidents during military service.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the VA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.