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1. www.va.gov › vaforms › medicalVHA 10-7959c - VA.gov Home | Veterans Affairs

   www.va.gov › vaforms › medical

   VHA 10-7959c. OMB Control Number: 2900-0219 Estimated Burden: 10 minutes Expiration Date: 10/31/2024. Department of Veterans Affairs. CHAMPVA Other Health Insurance (OHI) Certification.

2. www.va.gov › find-forms › about-form-10-7959cAbout VA Form 10-7959C | Veterans Affairs

   www.va.gov › find-forms › about-form-10-7959c

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   19 wrz 2023 · Get VA Form 10-7959C, CHAMPVA Other Health Insurance (OHI) Certification. Use this VA form as part of your CHAMPVA 10-10d benefit application if you have other health insurance, or to report changes in your other health insurance, such as new beneficiaries or coverage changes.

3. www.templateroller.com › group › 31429VA Form 10-7959c Download Fillable PDF or Fill Online CHAMPVA...

   www.templateroller.com › group › 31429

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   1 lut 2017 · Download Fillable Va Form 10-7959c In Pdf - The Latest Version Applicable For 2024. Fill Out The Champva Other Health Insurance (ohi) Certification Online And Print It Out For Free.

4. www.va.gov › family-and-caregiver-benefits › health-and-disabilityCHAMPVA Benefits | Veterans Affairs

   www.va.gov › family-and-caregiver-benefits › health-and-disability

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   Application for CHAMPVA Benefits (VA Form 10-10d), and. Other Health Insurance Certification (VA Form 10-7959c), and. Documents related to your Medicare status: If you qualify for Medicare for any reason, you’ll need to submit a copy of your Medicare card.

5. www.uslegalforms.com › form-library › 495910-va-10-7959c-2020VA 10-7959c 2020-2024 - Fill and Sign Printable Template Online

   www.uslegalforms.com › form-library › 495910-va-10-7959c-2020

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   Complete VA 10-7959c 2020-2024 online with US Legal Forms. Easily fill out PDF blank, edit, and sign them. Save or instantly send your ready documents.

6. pdfliner.com › va-form-10-7959cVA Form 10 7959C: Printable VA Application 10 7959C — PDFliner

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   Also known as CHAMPVA Other Health Insurance (OHI) Certification, VA Form 10-7959C is a document used to certify and report health insurance coverage for beneficiaries of the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

7. www.clientservicesnetwork.com › csnmccss › DocumentsCHAMPVA Other Health Insurance (OHI) Certification

   www.clientservicesnetwork.com › csnmccss › Documents

   PLEASE READ INSTRUCTIONS AND INFORMATION ON THE REVERSE SIDE BEFORE COMPLETING THIS FORM SECTION II: MEDICARE BENEFICIARIES: ATTACH A COPY OF YOUR MEDICARE CARD CHAMPVA Other Health Insurance (OHI) Certification OMB Number 2900-0219 Estimated burden: 10 minutes 10-7959c Page 1