You MUST report any other health insurance to CHAMPVA — failure to do so can delay claims

If you gain or lose other coverage, submit an updated form immediately

CHAMPVA pays after your primary insurance processes the claim

Veterans Affairseasy

CHAMPVA Other Health Insurance Certification

VA 10-7959c · VA

CHAMPVA Other Health Insurance certification to report changes in other health insurance coverage. Must include copy of insurance card.

Form Details

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Where to Submit This Form

📬

Mail to CHAMPVA

VHA Office of Community Care CHAMPVA PO Box 469028 Denver, CO 80246-9028

📠

Fax to CHAMPVA

Fax: 303-331-7809

Required Attachments

📎 Copy of the other health insurance (OHI) card (front and back)
📎 Documentation of coverage dates and type of plan

Processing Time

2-4 weeks for CHAMPVA to update your file with OHI information.

What Happens Next

CHAMPVA will update your records. Future claims will be coordinated with your other health insurance, and CHAMPVA will serve as secondary payer.

Tips for This Form

✓ You MUST report any other health insurance to CHAMPVA — failure to do so can delay claims
✓ If you gain or lose other coverage, submit an updated form immediately
✓ CHAMPVA pays after your primary insurance processes the claim

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