OMB control number
Continued Health Care Benefit Program (CHCBP) Application
OMB 0720-0066 · DOD/DODOASHA.
OMB 0720-0066
The information collected on the Department of Defense (DD) Form 2837, Continued Health Care Benefit Program (CHCBP) Application, is needed to determine a former military beneficiary’s eligibility to purchase CHCBP coverage, which is optional continuation coverage after the former member or former beneficiary loses entitlement to military health benefits coverage under Title 10 United States Code (10 USC), Chapter 55. Provision of the information requested on the DD Form 2837 is required to obtain or retain benefits, or eligibility for CHCBP coverage cannot be determined and must be denied.
The latest form for Continued Health Care Benefit Program (CHCBP) Application expires 2026-10-31 and is listed under ICR 202305-0720-002.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form DD Form 2837 Continued Health Care Benefit Program (CHCBP) Application | Form |
 0720-0066_SSA_08.31.2023.docx | Supporting Statement A |
| 0720-0066_SSNJ_6.15.2023.pdf | Supplementary Document |
 Continued Health Care Benefit Program (CHCBP) Application |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202305-0720-002 | Extension without change of a currently approved collection | 2023-08-31 | Approved without change | |
| 202008-0720-001 | Reinstatement with change of a previously approved collection | 2020-08-06 | Approved without change |