All veterans are encouraged
to enroll in the Veterans Affairs Health Care system. If you
would like to make an application for Health Care Benefits,
please fill out a 10-10EZ Application for Health Care Benefits
(online
application).
You may also print the form and mail it to us at:
Patient Access Center (17A1)
One Veterans Drive
Minneapolis, MN 55417
Please include the following with your mailed application: A copy of both sides of your current insurance
card, including Medicare or Medicaid A copy of your DD214 "Armed Forces Report
of Transfer or Discharge" If you are a Purple Heart recipient, include a
copy of your award letter (not your certificate) if "Purple Heart" is
not noted on your DD214 Please carefully read the instructions for Section V- Financial Disclosure. Although disclosure is completely voluntary, your detailed financial information will help us to more accurately determine for which of the eight Priority Groups you qualify. Currently new applicants qualifying for Priority Group 8 cannot be enrolled for VA health care benefits. If you choose not to provide financial information, you may be placed in Priority Group 8 and denied enrollment because all potentially qualifying information is not available
(more
information on enrollment priority groups).
