| INITIAL SECTION OF LETTER |
Each year VA requires most nonservice-connected veterans and 0% service-
copayments for your medical care and medications and your priority for
enrollment in the VA health care system.
o Failure to complete the means test by the anniversary date will cause
your priority for enrollment in the VA health care system to lapse.
What Do You Need To Do?
o Complete, sign and return a new VA Form 10-10EZR, Health Benefits
Renewal Form, including the financial section. You may obtain this
form by contacting our Business Office or by downloading the form from
our website at: http://www.domain.ext/vaforms/search_action.asp. Return
connected veterans to complete a financial assessment (means test). Our
the completed and signed form to the Business Office at the address
above before your means test anniversary date.
o When you report to your next health care appointment, bring your health
insurance card so we may update your health insurance information.
o Notify us if you feel you received this letter in error.
What If You Have Questions?
records show that your annual means test is due.
As of this date we have not received the updated financial income
information we requested in a previous letter.
What Does This Mean To You?
o An updated means test is needed to determine your ability to pay
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