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10-7959c. CHAMPVA OTHER HEALTH INSURANCE (OHI) CERTIFICATION NOTES, DEFINITIONS, AND INSTRUCTIONS. INSTRUCTIONS. Failure to complete all applicable sections on the front can result in a delay or denial of benefits. Use this form to report any changes in your other health insurance.
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.
9 wrz 2021 · Use this form to report any changes in your other health insurance. -- New beneficiaries - we need OHI information from the date your CHAMPVA eligibility became effective. -- Re-certification - update OHI information every time a change is made to your OHI coverage.
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Find all of your CHAMPVA insurance resources here. Learn how to apply for CHAMPVA benefits. All required & optional documents are found here.
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.
If applicants indicate in Section II that they have Medicare or other health insurance, each applicant must submit VA Form 10-7959c, CHAMPVA Other Health Insurance (OHI) Certification. If additional space is needed, complete another VA Form 10-10d in its entirety, sign and submit.
