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VA Form 10-10EC Printable, Fillable in PDF – To determine the estimated amount of your monthly copayment obligations for extended care services provided to you by VA, either directly by VA or paid for by VA. There is no copayment for the first 21 days of extended care services that VA provides to you in any 12 month period. You must report any changes that might affect the copayment amount to your local VA medical facility within 10 calendar days of the change.
Where Can I Get Help Filling Out The Form?
Contact the Social Work staff at your local VA medical facility for assistance on understanding the information and financial data needed to complete VA Form 10-10EC.