VA Form 10-320 is the Veteran Reimbursement Claim Form. It is used to claim eligible out-of-pocket emergency prescription expenses at pharmacies outside the VA network and out-of-pocket expenses for unauthorized emergency care at non-VA facilities. The form separates claimant details, itemized evidence and a signed explanation of why VA care was not used. This guide explains the documented audience, completion steps, supporting evidence, cautions and questions based on the official document and relevant agency instructions. Use the PDF resource to review and prepare the document; filing is governed by the agency’s rules.
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What is 10-320?
VA Form 10-320 is the Veteran Reimbursement Claim Form. It is used to claim eligible out-of-pocket emergency prescription expenses at pharmacies outside the VA network and out-of-pocket expenses for unauthorized emergency care at non-VA facilities. The form separates claimant details, itemized evidence and a signed explanation of why VA care was not used.
Who needs to file 10-320?
The form addresses veterans requesting reimbursement for the two expense categories identified in VA’s instructions. Reimbursement also depends on clinical and administrative criteria stated by VA and is not guaranteed merely by submitting the form.
When to file 10-320
Use the form when requesting reimbursement for the covered emergency prescription or unauthorized emergency-care expenses. The June 2026 PDF excerpt does not specify a universal submission deadline; consult the applicable VA Community Care claim guidance.
Documents you need
- For emergency pharmacy reimbursement: a valid paid receipt showing the amount, medication name, dose/strength and quantity, prescribing provider and dispensing date, and pharmacy name and location.
- For unauthorized emergency medical care: an itemized billing statement with charges and service dates, proof of payment, description of illness/injury, and primary-insurance explanation of benefits if applicable.
- Medical documentation as requested by VA; the form warns that insufficient records may cause the claim to be returned for more information.
How to fill out 10-320
Check the expense category
Confirm whether your request concerns an emergency prescription bought outside the VA network or unauthorized emergency medical care outside VA.
Complete claimant information
Enter the claimant name, ICN or SSN, date of birth, known referral/authorization number, and address in section A.
Document pharmacy costs when applicable
For prescription reimbursement, assemble the receipt with each item specifically listed in section B.
Document emergency medical costs when applicable
For unauthorized emergency care, add the itemized statement, payment proof, illness/injury description and any applicable insurer EOB.
Confirm clinical records
Review whether VA has the medical documentation required to evaluate the claim.
Explain the circumstances
In section C explain why the services were not obtained through VA.
Sign and date
Complete the signature and date beneath the declaration in section C.
Use the VA claims instructions
Consult VA Community Care’s File a Claim page for the proper filing destination and any further conditions.
How to submit 10-320
Follow VA Community Care’s File a Claim guidance for where to submit the completed form. The VA PDF explicitly warns not to send the completed form to the OMB paperwork-burden comment email address. The form includes a signed explanation of why services were not obtained through VA.
Common mistakes to avoid
- Do not use the OMB burden-comment email address as a claims filing destination.
- Do not submit an emergency pharmacy claim without a paid receipt and the medication details listed in section B.
- Do not omit the signed explanation of why services were not obtained through VA, which is section C.
- Do not treat a primary insurer explanation of benefits as universally required: the form says if applicable.
Frequently asked questions
What costs are addressed by VA Form 10-320?
The VA instructions identify emergency prescriptions from out-of-network pharmacies and certain out-of-pocket unauthorized emergency-care expenses at non-VA facilities.
What must a pharmacy reimbursement receipt show?
Amount paid, medication name, dosage/strength, quantity, prescriber, dispensing date and pharmacy location/name.
Is an EOB required for every emergency-care claim?
No. The form says the primary insurance Explanation of Benefits is needed if applicable.
Does the form require a signed explanation?
Yes. Section C asks why services were not obtained through VA and requires a signature and date.
Where should I send the claim?
Use VA Community Care’s official File a Claim instructions; the paperwork-comment email printed on the form is not the claims address.
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