THE VETERANS' PRESS: Many veterans are eligible for receiving community care and still be covered by VA health care

Community Care

Veterans may be eligible for care through a provider in their local community depending on their health care needs or circumstances, and if they meet specific eligibility criteria. Even if a veteran is eligible for community care, they generally still have the option to receive care from a VA medical facility.

In most cases, veterans must receive approval from VA before receiving care from a community provider to avoid being billed for the care. VA staff members generally make all eligibility determinations for community care.

Eligibility

A veteran’s eligibility for community care depends on his/her individual health care needs or circumstances. Please note the following about eligibility for community care:

• Veterans must receive approval from VA prior to obtaining care from a community provider, in most circumstances.

• Veterans must either be enrolled in VA health care or be eligible for VA care without needing to enroll to be eligible for community care.

• Eligibility for community care will continue to be dependent upon a veteran’s individual health care needs or circumstances.

• VA staff members generally make all eligibility determinations.

There are six criteria that can qualify a veteran to receive community care. Veterans only need to meet one of these to be eligible.

1) Veteran needs a service not available at a VA medical facility

2) Veteran lives in a U.S. state or territory without a full-service VA medical facility

3) Veteran qualifies under the “Grandfather” provision related to distance eligibility for VCP

4) VA cannot provide care within certain designated access standards

5) It is in the veteran’s best medical interest

6) A VA Service Line Does Not Meet Certain Quality Standards

Ask your VA health care team or your assigned VA doctor.

For more information: https://www.va.gov/COMMUNITYCARE/index.asp