VA Community Care Guide 2026

1. What Is VA Community Care?

VA Community Care allows eligible veterans to receive healthcare from providers outside the VA system — paid for by the VA. This includes private doctors, specialists, hospitals, urgent care clinics, and mental health providers in your local community.

The program was established by the VA MISSION Act of 2018 (Maintaining Internal Systems and Strengthening Integrated Outside Networks), which replaced the older Veterans Choice Program. It took full effect on June 6, 2019, and has been expanded several times since.

The goal is simple: if the VA cannot provide the care you need in a timely or convenient manner, you can get it from an approved community provider and the VA pays the bill.

2. When You Qualify for Community Care

You may be eligible to receive care from a community provider if any of the following six criteria apply:

Drive Time / Distance Standards

• Primary care, mental health, non-institutional extended care: Average drive time exceeds 30 minutes to the nearest VA facility
• Specialty care: Average drive time exceeds 60 minutes to the nearest VA facility offering that specialty

Wait Time Standards

• Primary care, mental health: Appointment not available within 20 days of the clinically indicated date or the date of request (whichever is later)
• Specialty care: Appointment not available within 28 days

Other Qualifying Criteria

• Service not available: The VA does not offer the specific service you need at any VA facility
• Best medical interest: Your VA provider determines community care is in your best medical interest (documented in your medical record)
• VA service standards not met: The VA medical facility does not meet quality standards for the needed care
• State without a full-service VA medical facility: You live in a state (Alaska, Hawaii, New Hampshire) without a full VA medical center

3. How to Get a Community Care Referral

You cannot simply walk into a community provider and expect the VA to pay. Here is the process:

4. The Urgent Care Benefit

One of the most valuable parts of the MISSION Act is the urgent care benefit, which allows eligible veterans to visit approved urgent care clinics without a referral.

Key Details

• Visits per year: 3 visits per calendar year at in-network urgent care providers
• No referral needed: You do not need prior VA authorization for urgent care visits
• Copay: You may owe a copay for the third visit (first two visits have no copay for most veterans). Copay amount depends on your VA priority group.
• In-network only: Must be an in-network urgent care provider within the VA Community Care Network. Check the VA Facility Locator at va.gov/find-locations to find approved providers.
• What is covered: Minor injuries, illnesses, sprains, infections, rashes, flu symptoms, minor burns — conditions that need prompt but not emergency attention
• Prescriptions: If the urgent care provider prescribes medication, you can fill it at a VA pharmacy (no copay for most veterans) or a community pharmacy (may have a copay)

5. How Billing Works

When community care works correctly, billing is straightforward: the VA pays the community provider, and you pay nothing (or a small copay based on your priority group). Here is how it should work:

• VA pays the provider directly: Community providers bill the VA through the Community Care Network (managed by third-party administrators Optum and TriWest)
• You should not get a bill: For authorized community care, the provider should bill the VA, not you
• Copays may apply: Some veterans in higher priority groups may owe copays for certain services, similar to copays at VA facilities
• Other insurance: If you have private insurance, the VA may coordinate benefits, but community care is still covered by the VA

What to Do If You Get a Bill from a Community Provider

This happens more often than it should. If a community provider sends you a bill for VA-authorized care:

1. Do not pay it immediately. Confirm you had a valid VA authorization for the visit.
2. Call the VA Community Care office at your local VA medical center. Give them the provider name, date of service, and authorization number.
3. Contact the provider's billing department. Tell them this was VA-authorized community care and provide your authorization number. Ask them to bill the VA directly.
4. If the provider refuses to rebill: Call the VA at 1-877-881-7618 (Community Care billing assistance). They can help resolve billing disputes.
5. File a complaint: If you continue to get bills, contact the VA Patient Advocate at your local VA medical center.

6. Dental Care Through Community Care

Dental care is one of the most requested — and most limited — VA benefits. Here is what is available through community care:

Who Qualifies for VA Dental Care

• 100% service-connected disability rating: Full dental benefits, including through community care
• Former POWs: Full dental benefits
• Service-connected dental condition: Treatment for the specific service-connected dental condition
• Veterans in a VA vocational rehabilitation program (VR&E): Dental care if needed for employment
• Homeless veterans in certain programs: Dental care through domiciliary or residential programs
• One-time dental benefit: Veterans who separated after January 2003 can apply for a one-time dental benefit within 180 days of separation

7. Mental Health Through Community Care

Mental health care is a priority area for VA Community Care. If you need mental health services and the VA cannot provide them within access standards, you may receive community care for:

• Individual therapy: Cognitive Behavioral Therapy (CBT), Prolonged Exposure (PE), EMDR, and other evidence-based treatments
• Psychiatric medication management: Evaluation and prescribing by community psychiatrists
• PTSD treatment: Specialized trauma-focused therapy from community mental health providers
• Substance abuse treatment: Outpatient and intensive outpatient programs
• Marriage and family counseling: When related to military service or transition
• Group therapy: Community-based group programs

Vet Centers: No Referral Needed

Vet Centers are community-based counseling centers operated by the VA that provide free readjustment counseling, PTSD treatment, military sexual trauma counseling, bereavement counseling, and family counseling. There are over 300 Vet Centers nationwide. You do not need a VA referral — just walk in or call. Visit vetcenter.va.gov to find the nearest location.

8. Key Contacts & Resources