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VA Form 10-320

Form name:Veteran Reimbursement Claim Form
Form revision date: September 2024
Related to: Health care

When to use this form

Use this form to request reimbursement for these expenses:

  • Out-of-pocket emergency prescription expenses from a pharmacy that’s not in VA’s network, and 
  • Out-of-pocket expenses for unauthorized emergency care at non-VA facilities

Downloadable PDF

Helpful links

  • Find out how to update your direct deposit information online for disability compensation, pension, or education benefits.

  • Find out how to change your address and other information in your VA.gov profile for disability compensation, claims and appeals, VA health care, and other benefits.

  • Submit an online request to get your DD214 or other military service records through the milConnect website.

  • Learn how to access your VA records, benefit letters, and documents online.

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