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VA Form 10-10EZ

Healthcare Enrollment

Enroll in VA healthcare. This is your application.

10-10EZ

Healthcare

What this form does

Enroll in VA healthcare. This is your application.

Applies for VA health care benefits. Specific services and cost-sharing depend on eligibility and priority group.

Official VA title: Instructions and Enrollment Application for Health Benefits

VA revision February 1, 2025 · Links verified against VA.gov August 10, 2026

Use it when: When applying for VA health care for the first time. Eligibility depends on service, discharge, and other factors that VA reviews.

Preparation route

How to use 10-10EZ

Every preparation step stays open so you can scan the whole job before starting.

  1. Do now · 01

    Before you start

    Estimated time
    20-30 minutes

    Use this form when: When applying for VA health care for the first time. Eligibility depends on service, discharge, and other factors that VA reviews.

  2. Gather · 02

    Gather your documents

    Helpful when available

    • DD-214 — VA may be able to verify service. A copy can help if service information is missing or VA asks for it.
    • Most recent tax return or income information — VA does not require financial information from every applicant. The application explains when it may affect eligibility, priority group, or costs.
    • Insurance cards (private, Medicare, Medicaid) — If you have other health insurance.
  3. Waypoint · 03

    Complete the form

    • Military service history
    • Financial information (income, deductible expenses)
    • Insurance information (private insurance, Medicare, Medicaid)
    • Next of kin and emergency contact
  4. Waypoint · 04

    Avoid common mistakes

    • Not applying because you think you won't qualify — apply and let the VA decide
    • Not reporting all income sources accurately
    • Forgetting to list current private insurance
    • Not knowing you can use VA healthcare even with private insurance
  5. Go next · 05

    Submit the form

    Available methods

    • Online
    • Phone
    • Mail
    • In person
    Mail to
    Health Eligibility Center, PO Box 5207, Janesville, WI 53547-5207
    Submission note
    Apply online, call VA health benefits at 877-222-8387, mail the official form, or apply at a VA medical center or clinic.

Field note

You can use VA healthcare alongside private insurance. Even if you have great private coverage, enrolling gives you access to VA mental health, prescriptions, and specialty care.

Continue the route

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  1. Do now
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