![]() ![]() If you sign with an “X,” 2 people you know must witness your signature.If you’re using a power of attorney, you’ll need to submit a copy of the Power of Attorney form along with your application.You or someone acting as your power of attorney must sign and date the form. Option 2: Apply by mailįill out an Application for Health Benefits (VA Form 10-10EZ). You can also apply in any of these 4 ways Option 1: Apply by phoneĬall our toll-free hotline at 87, Monday through Friday, 8:00 a.m. But if you’re not eligible based on other factors, we’ll need this information to decide on your application. Note: You don't have to tell us about your income and expenses when you apply. These include certain health care and education costs. Your deductible expenses for the past year.Gross household income is your income before taxes and any other deductions. This includes income from a job and any other sources. Gross household income from the previous calendar year for you, your spouse, and your dependents.Insurance card information for all insurance companies that cover you, including any coverage provided through a spouse or significant other. This includes Medicare, private insurance, or insurance from your employer.Your military discharge papers (DD214 or other separation documents).Social Security numbers for you, your spouse, and your qualified dependents.Gather the information listed below that you’ll need to fill out an Application for Health Benefits (VA Form 10-10EZ).Find out if you’re eligible for VA health care benefits.How do I prepare before I start my application? ![]()
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