The following information about this VA form comes from the VA forms database, and any changes are updated here nightly. Contact the form administration for further information.
Form number
21P-8416
Row ID
1295
Form title
Medical Expense Report (Fillable)
Issue date
Revision date
Form administration
Number of pages
6
Deleted
False
Form name
Medical Expense Report
Form Language
English
Related to
Benefits
VA disability compensation
VA benefits for spouses, dependents, survivors, and family caregivers
VA health care
VA pension benefits
When to use

Use VA Form 21p-8416 to report medical or dental expenses that you have paid for yourself or for a family member living in your household. These must be expenses you weren’t reimbursed for and don’t expect to be reimbursed for.