VA Form 10-10EZR
Health Benefits Update Form
You are already enrolled in VA health care and need to update your address, report a change in insurance, report a change in income (for copay recalculation), or add/remove dependents.
- Who fills it
- veteran
- Journey phase
- Keeping Your Award Current
- Estimated time
- 15-30 minutes.
- When to file
- Whenever relevant information changes. Annual income update can lower copays if income decreased. Address update prevents missed appointments.
Official VA form page: https://www.va.gov/find-forms/about-form-10-10ezr/
Gather before you start
- ▸Your VA patient ID or SSN
- ▸Updated address, phone, email if changed
- ▸New insurance card(s) if insurance changed
- ▸Prior year income information if requesting copay recalculation
Attach with the form
- ▸Insurance card copies if insurance changed
Section I - Veteran Identification
Blocks 1-5Name, SSN, DOB, VA patient IDPII
Your VA enrollment record identifiers. Include your VA patient ID from any VA medical center letter or MyHealtheVet account if known.
(legal name, SSN, VA patient ID)
Common mistakes
- ×Filing 10-10EZR when you are not yet enrolled - if you have never enrolled, file 10-10EZ instead.
Section II - Information Being Updated
Block 6What information are you updating?
Check all that apply: (1) Address/phone/email; (2) Health insurance (add, remove, change); (3) Income (may reduce copays); (4) Dependent changes. For each checked item, complete the corresponding section.
Check all sections that have changed
Common mistakes
- ×Updating address only through the post office without telling VA - mail forwarding is not reliable for VA appointment notices.
Section III - Income Update (if applicable)
Blocks 7-18Prior year income if requesting copay recalculation
If your income decreased from last year, reporting the lower income can reduce your VA health care copays or move you to a higher priority group. Report gross income for yourself, your spouse, and any dependents. Also report unreimbursed medical expenses which further reduce countable income.
(last year gross income for you and household)
Common mistakes
- ×Not knowing income updates are retroactive to January 1 of the current year - filing early in the year maximizes the copay reduction.
- ×Forgetting that unreimbursed medical expenses reduce countable income further.
Authority
- 38 CFR 17.36 - PG 1–8 enrollment categories under 38 CFR 17.36.
Section IV - Signature
Blocks 19-20Veteran signature and datePII
Sign and date. Updates typically process within 1-2 weeks.
(signature/date)
Common mistakes
- ×Not updating income even when it decreased significantly - this can mean paying unnecessary copays.
Statutory and regulatory authority
- 38 CFR 17.36 - PG 1–8 enrollment categories under 38 CFR 17.36.
- 38 USC 1710 - Core VA health care eligibility.