VHA 10-7959c Author: Department of Veteran Affairs Subject: CHAMPVA Other Health Insurance \(OHI\) Certification Form. This form is also used to report any changes in your other insurance status. Keywords

Jan 15, 2025 · Get VA Form 10-7959C, CHAMPVA Other Health Insurance (OHI) Certification. Use this VA form as part of your CHAMPVA 10-10d benefit application if you have other health insurance, or to report changes in your other health insurance, such as new beneficiaries or coverage changes.

Jan 24, 2025 · Get VA Form 10-7959c to download A copy of the front and back of your health insurance card or Medicare card Note: If you have Medicare Part D for prescription coverage, you’ll also need to submit a copy of the front and back of your Medicare Part D card.

This form is also used to report any changes in your other health insurance status. Updates can be sent by FAX or call by phone. PLEASE READ INSTRUCTIONS AND INFORMATION ON THE REVERSE SIDE BEFORE COMPLETING THIS FORM

Forma 10-7959c, Certificacion CHAMPVA de Otros Seguros de Salud (OSS) For individuals who are eligible for Medicare, for any reason, the VA also need a copy of your Medicare card. If you are age 65 or older and are not entitled to Medicare, you must send documentation from the Social Security Administration that confirms you are not entitled to ...

Other Health Insurance (OHI) Certification, VA Form 10-7959c (Certificacion CHAMPVA de Otros Seguros de Salud (OSS), Forma VA 10 7959c) For individuals who are eligible for Medicare for any reason, we need a copy of your Medicare card.

You must complete a VA Form 10-7959c for each person in Section II that indicates they have Medicare or any other health insurance before we will be able to complete your application. Please do NOT exceed the

You need to submit both an Application for CHAMPVA Benefits (VA Form 10-10d), and VA Form 10-7959c, and your Medicare card. For those who don’t qualify for Medicare, you have to prove that you don’t qualify under anyone’s SSN by providing the appropriate documents from the SSA.

The latest form for CHAMPVA Benefits - Application, Claim, Other Health Insurance, Potential Liability & Misc Expenses expires 2021-03-31 and can be found here. Latest Forms, Documents, and Supporting Material

VA FORM 10-7959c, SEP 2020 Indemnity: Plans that pay a flat fee or daily rate to supplement lost income while hospitalized are called Indemnity Plans.