When care isn’t available through VA, nearby or in a timely manner, community care may be an option.
If your VA facility doesn’t offer a specific service, and if you can’t get an appointment in a timely manner, you may be eligible for community care.
As a Veteran, you have more choices than ever when it comes to your health care. Your appointment can be in-person at a VA medical center, or you might choose to meet with your VA provider through a video appointment or over the phone. You may also be eligible for care with community provider.
Overview of community care
With community care, eligible Veterans have access to a network of more than a million community providers across all 50 states and U.S. territories. Community care supplements the VA health care system so Veterans can receive care through community providers when VA can’t provide the care you need, when or where you need it.
Here are two examples where you could be eligible for community care: (1) When VA doesn’t provide a specific type of care or (2) when you have to drive too far or wait too long to get care with a VA provider.
In most cases, you must receive VA approval before receiving care from a community provider. Check with VA staff, such as your the local Referral Coordination Team, to understand all of your potential options including community care.
How to determine eligibility for community care
You may be eligible for community care if you meet any of the following six criteria:
- You require a specific service your VA health facility does not provide
- You live in a state or territory that doesn’t have a full-service VA health care facility
- You previously qualified under the 40-mile distance requirement and remained qualified on June 6, 2018, and you still live in a location that would make you eligible under these requirements
- VA can’t provide the care you need within our access standards for drive and wait times
- You and your VA provider agree that getting care from an in-network community provider is in your best medical interest
- VA can’t provide the service needed in a way that meets our quality standards
Setting up an appointment and finding a community provider
First, check with a member of your VA care team to find out if you’re eligible for community care.
After community care eligibility is confirmed, there are two options to schedule an appointment with a community provider:
- Coordinate with a VA staff member to schedule an appointment for you, or
- Schedule an appointment with the provider directly by using VA Online Scheduling to request an appointment.
► Learn more about VA Online Scheduling.
Reinforcing VA’s commitment to care
VA continues to expand the ways you can access care, either directly from VA or through VA’s network of community providers. This includes in-person care at one of nearly 1,300 VA medical facilities (primary, specialty, urgent, emergency), 24/7 access via VA’s clinical contact centers, video appointments from a nearby VA clinic, or using a Veteran’s personal smart phone, tablet or PC for virtual access to VA’s medical experts across the country.
“We are providing more care to Veterans than ever with significant progress in modernizing access to care, and that starts with the right people, processes and technology,” said Dr. Miguel LaPuz, assistant under secretary for Health for Integrated Veteran Care. “Our mission is to ensure timely access to world class health care regardless of location or the way you choose to get care—in-person, over the phone or video appointments, at VA or in the community. We know we still have much work to do. We are always looking for ways to make improvements. Our priority is to provide the soonest and best care for Veterans.”