CHAMPVA Other Health Insurance Certification
Declare other health insurance with a CHAMPVA application or report coverage changes after enrollment.
10-7959C
Healthcare
What this form does
Declare other health insurance with a CHAMPVA application or report coverage changes after enrollment.
Tells CHAMPVA about other non-VA health insurance so benefits can be coordinated correctly.
Official VA title: CHAMPVA—Other Health Insurance (OHI) Certification
VA revision March 18, 2025 · Links verified against VA.gov August 6, 2026
Use it when: When you are applying for CHAMPVA and have other health insurance to declare, or when you are already enrolled and need to report a coverage or beneficiary change. If you are already enrolled, VA says to wait for the enrollment packet before submitting this form.
Preparation route
How to use 10-7959C
Every preparation step stays open so you can scan the whole job before starting.
Do now · 01
Before you start
Use this form when: When you are applying for CHAMPVA and have other health insurance to declare, or when you are already enrolled and need to report a coverage or beneficiary change. If you are already enrolled, VA says to wait for the enrollment packet before submitting this form.
Gather · 02
Gather your documents
Helpful when available
- Other health insurance card or policy details — Have the insurer, policyholder, member, group, and coverage information available.
Waypoint · 03
Complete the form
- CHAMPVA beneficiary information
- Other insurance company and plan information
- Policyholder and covered-beneficiary details
- Coverage effective and termination dates, when applicable
Waypoint · 04
Avoid common mistakes
- Using this as a reimbursement claim — CHAMPVA claims use Form 10-7959A
- Submitting a post-enrollment change before receiving the CHAMPVA enrollment packet
- Leaving out coverage dates or affected beneficiaries
Go next · 05
Submit the form
Available methods
- Online
- Mail to
- VHA Office of Integrated Veteran Care, CHAMPVA Eligibility, PO Box 137, Spring City, PA 19475
- Submission note
- If you applied for CHAMPVA online, use VA’s online tool. If you applied by mail, download the current PDF and follow its mailing instructions.
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