With the implementation of the MISSION Act, eligible Veterans have more convenient choices for getting timely, high-quality health care. Veterans eligible for community care can choose to receive care from a VA medical facility or a community provider in VA’s network.
This article answers some common questions about making community care appointments.
1. When will I be referred to a community provider?
Eligibility for community care depends on specific eligibility criteria, and your care team can help you understand your options if you are eligible. In most situations you can choose to receive your care in VA. If you are eligible and do choose to receive care in the community, you must receive approval from VA before receiving care to avoid being billed for the care. Emergency care and the community urgent care benefit are exceptions; you do not need prior approval for these types of care, though you may have a co-payment for receiving such care.
2. How do I find a community provider near me?
You can either choose your preferred community provider or a VA staff member can help you select one. The selected community provider must be part of VA’s network of community providers and must be an eligible provider. VA’s network includes (1) providers that participate in regional community care networks that are managed for VA by third-party administrators under contract with VA, as well as (2) other community providers with whom VA contracts directly for certain services. A VA staff member will be able to confirm if you can go to a specific community provider.
To find an in-network community provider near you, use the VA Facility Locator. Before an appointment is scheduled, make sure to confirm that you are authorized to receive this care and have received a referral from VA to see the community provider.
If your preferred provider is not in VA’s network, VA may be able to add the provider to its network, or you can choose to schedule with a network provider that offers the same care.
3. How do I schedule a community care appointment?
Once an eligible community provider has been selected, VA will send you and the community provider a referral. VA will also send any pertinent medical documentation to the community provider to ensure proper care coordination between your VA care team and the community provider.
There are several options for scheduling an appointment, depending on the type of care you need. Your VA medical facility will work with you to identify the scheduling options available to you.
You may be able to:
- Directly schedule an appointment and inform a VA staff member about the appointment.
- Request an appointment by logging into My HealtheVet and using the VA Online Scheduling application for certain types of routine services.
- Ask a VA staff member to schedule the appointment.
- Ask a VA third-party administrator (TPA) to schedule the appointment.
4. It’s been five days since I was approved to see a community provider, and no one has contacted me to schedule my appointment. What do I do?
If you are experiencing delays in scheduling your community care appointment, please contact your VA medical facility for assistance.
5. My appointment was cancelled. How do I reschedule?
You may reschedule an appointment with your community provider when scheduling issues arise or contact your VA medical facility community care office for assistance.
Click here for more information on making community care appointments.
