The Veteran's Choice Program (VCP)

The Veterans Community Care Program

What is the Veterans Community Care program?

Replacing the Veterans’ Choice Program, the Veterans Community Care program allows eligible veterans to get medical assistance through in-network providers that are not a part of the Veterans Medical Center (VAMC). This program was created under the VA Mission Act of 2018.

Who is eligible for the Veterans’ Community Care program?

A referral to the Veterans Community Care (VCC) program can only be provided by the VAMC. The VAMC will determine if the person is eligible for the program through the following criteria:

  • It is in the best interest of the veteran to seek assistance in the VCC Network (VCCN);
  • The veteran does not live near a VAMC;
  • The VAMC does not offer the medical care required by the veteran;
  • The veteran cannot receive care within a reasonable period of time (standard appointment times are within 20-28 days) or within a reasonable drive time (primary care – 30 minutes, specialists – 60 minutes);
  • After a VA evaluation, it is found that the veteran is not receiving the best care possible at the VAMC.

Do I get to select my doctor in the Veterans Community Care Network?

If the veteran has received authorization to see a medical professional in the VCCN, the TriWest Healthcare Alliance will review the veteran’s medical records and select a provider that best fits their needs. 

Are urgent care visits covered by my military benefits?

Under the VCC, veterans are able to visit urgent care or walk-in clinics without prior authorization when:

  • They are eligible for urgent care benefits,
  • The provider is a part of the VCCN, and
  • The non-emergent medical service is an approved service under VCC.
    • Examples: minor injuries, skin rashes, cold/flu symptoms, painful urination, ear infection, broken bone that requires a cast or splint

If there are follow up services required after an urgent care visit, those services most often take place at the VAMC, unless approved by the VA.

Can I see a dentist using the Veterans Community Care Network?

No. The Veterans’ Community Care program only covers the following medical services:

  • Primary care
  • Inpatient specialist
  • Outpatient specialist
  • Behavioral health
  • Newborn care for female veterans (limited services)

The following are not covered services:

  • Dental
  • Chronic dialysis treatments
  • Home health aides
  • Nursing home care
  • Long-term acute care hospitals (LTAC)
  • Pension and compensation exams

Am I able to go to a non-VA pharmacy to pick up my prescriptions?

Unless the VA is unable to fill the prescription right away, the veteran will still need to pick up their medication at a VA pharmacy.

If the VA is unable to fill a prescription within 14 days, the veteran may request that they have the prescription filled at a non-VA pharmacy for those 14 days. The veteran would have to pay the out-of-pocket cost and submit for a reimbursement with the VA. To be reimbursed the veteran will have to provide a copy of the prescription and receipt of purchase.

Can I be grandfathered into the Veterans’ Choice Program?

To be grandfathered into the Veterans’ Choice Program, the veteran must meet the following requirements:

  • Prior to June 6, 2018 the veteran has lived a minimum of 40 miles away from the nearest VAMC or VA clinic,
  • The veteran continues to live at this residence, and
  • The veteran lives in one of these states – Alaska, Montana, North Dakota, South Dakota, or Wyoming.

Approval would have to be granted by the VA prior to seeing a private care provider.

 

Resources

VA Mission Act of 2018 - https://www.congress.gov/bill/115th-congress/senate-bill/2372/text

Community Care - https://www.va.gov/communitycare/

VA Care in the Community - https://www.benefits.gov/benefit/322

  

 

This website has been prepared for general information purposes only. The information on this website is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Also, the law may vary from state-to-state or county-to-county, so that some information in this website may not be correct for your situation. Finally, the information contained on this website is not guaranteed to be up to date. Therefore, the information contained in this website cannot replace the advice of competent legal counsel licensed in your jurisdiction.

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