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VA Form 10-493b

Form name:CHAMPVA Benefits Election Affirmation
Form revision date: January 2016
Related to: Family member and caregiver benefits, Health care

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Related forms and instructions

VA Form 10-10d

Form name: Application for CHAMPVA Benefits (VA Form 10-10d)

If you’re the spouse, dependent, or survivor of a Veteran who meets certain requirements, use VA Form 10-10d to apply for healthcare benefits through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

VA Form 10-493

Form name: TRICARE Affirmation

VA Form 10-493a

Form name: TRICARE For Life Affirmation-Spanish

Helpful links related to VA Form 10-493b

  • Learn how eligible spouses and children of Veterans can get health insurance through CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs).

  • Find out about VA benefits for spouses, dependents, survivors, and family caregivers.

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