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Update Your Health Benefits Information (VA Form 10-10EZR)

Use the Health Benefits Update Form (VA Form 10-10EZR) to update your personal, financial, and insurance information after you’re enrolled in VA health care.

How do I use this form to update my information?

Fill out, sign, and date a copy of the form.
Download VA Form 10-10EZR.

Send the completed form and any supporting documents to:

VA Health Eligibility Center
2957 Clairmont Road, Suite 200
Atlanta, GA 30329

What information can I update with this form?

You can update your:

  • Personal information (like your marital status or self-identified gender identity)
  • Contact information (like your phone number, email, or mailing address)
  • Insurance information (including current coverage through private insurance, Medicare, or Medicaid)
  • Dependent information (about a spouse or dependent child)
  • Financial information (like your income and deductible expenses from the previous year)

Can I use this form to see if I’m eligible for more benefits based on my financial situation?

Yes. You can use this form to update information about your income and deductible expenses.

We’ll use this information to determine if you’re eligible for:

  • Cost-free medical services for non-service-connected conditions
  • Beneficiary travel to reimburse you for the cost of traveling to a VA facility to receive care
  • A waiver of the beneficiary travel deductible requirement

Can I use this form to apply for VA health care?

No. You can use this form only to update your information if you’re already enrolled in VA health care.
Find out how to apply for VA health care.

Why does this form ask about my other insurance?

We ask for this information because we have to bill your private health insurance provider for any care, supplies, or medicine we provide to treat your non-service-connected conditions (illnesses or injuries that aren’t related to your military service).

We don’t bill Medicare or Medicaid, but we may bill Medicare supplemental health insurance for covered services.

If you have other health insurance coverage, it doesn’t affect the VA health care benefits you can get. And telling us about your other insurance may help to offset your costs.
Learn more about VA health care and other insurance.

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