Urgent Care - Community Care
Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

Community Care

Menu
Menu

Quick Links

Veterans Crisis Line Badge
My healthevet badge
EBenefits Badge
 

Urgent Care

VA offers an urgent care benefit that provides eligible Veterans with greater choice and access to timely, high-quality care. Urgent care providers treat injuries and illnesses that require immediate attention, but are not life-threatening. The benefit supplements care Veterans may also have access to at a VA medical facility.

When using the urgent care benefit, Veterans must go to an urgent care provider in VA’s network. Upon arriving, Veterans must state they are using their VA urgent care benefit.

The urgent care provider will verify the Veteran’s eligibility before providing care. If a Veteran arrives at an urgent care network location and has any difficulty receiving care, they can call 866‑620‑2071 to receive assistance.

To find an urgent care location in VA’s contracted network, Veterans can use the VA Urgent Care Locator.

Veterans may be billed by VA separately for a copayment when using the urgent care benefit, depending on their assigned priority group and the number of times they use the urgent care benefit in a calendar year.
Important: VA can only pay for urgent care if the provider is part of VA’s contracted network. Veterans who go to an out-of-network urgent care provider, may be required to pay the full cost of care.

Process Overview

1. Find Provider  

Eligible Veteran finds and travels to in-network urgent care provider.

2. Confirm Eligibility 

Veteran states he or she is using VA benefit and urgent care provider confirms Veteran eligibility.

3. Receive Care  

Veteran receives urgent care and medication is prescribed, if needed.

4. Billing

Urgent care provider
bills VA's Third Party Administrator (TPA) and VA may bill the Veteran the applicable copayment.


Eligibility

To be eligible for urgent care, Veterans must:

  • Be enrolled in the VA health care system AND
  • Have received care through VA from either a VA or community provider within the past 24 months

To check eligibility, Veterans can contact their local VA medical facility by phone or in person. Veterans do not need to get prior authorization from VA to visit an urgent care provider in VA’s contracted network.

When a Veteran walks into an urgent care location, either the Veteran or the urgent care location can dial into an Interactive Voice Response (IVR) system to check the Veteran’s eligibility for urgent care.

The TriWest IVR system is available 24 hours a day, seven days a week at 833-4VETNOW
(833-483-8669)

The IVR can also be accessed through the MyVA311 line at 844-MyVA311
(844-698-2311)

Find an Urgent Care Provider

To find an urgent care provider in VA’s contracted network, Veterans can use the VA Urgent Care Locator, or contact their local VA medical facility.

VA Urgent Care LocatorVA Facility Locator

Types of Urgent Care Locations

There are two types of urgent care network locations: Retail and Urgent.

  • Retail locations include a walk-in health clinic, other than an office, urgent care facility, pharmacy, or independent clinic located within a retail operation. Reasons why Veterans would seek care at a retail location include treatment of an uncomplicated illness such as a sore throat or earache.
  • Urgent locations include an office or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention (aside from emergency rooms). Reasons why Veterans would seek care at a urgent location include treatment of more pressing illnesses or injuries that are not life-threatening, like splinting, casting, lacerations, or wound treatment.

IMPORTANT: VA can only pay for urgent care if the provider is part of VA’s contracted network. If Veterans go to an out-of-network urgent care provider, they may be required to pay the full cost of care. By law, VA cannot pay claims for urgent care rendered to a Veteran from providers that are not part of VA’s contracted network.

Get Urgent Care

When arriving at an in-network urgent care provider, Veterans must:

  • Inform the provider they would like to use their VA urgent care benefit to receive care.
    Note: The urgent care provider will confirm the Veteran’s eligibility.
  • Ask and verify the urgent care provider is part of VA’s contracted network. The urgent care provider may have a sign posted that indicates they are part of VA’s contracted network.

If the provider is not part of VA’s contracted network, Veterans have several options:

  • Agree to pay the full cost of care and receive care immediately
  • Go to a different urgent care provider that is part of VA’s contracted network
  • Go to the nearest VA medical facility
  • Go to the nearest emergency department

Covered Services

The urgent care benefit covers services provided by urgent care centers and walk-in retail health clinics such as:

  • Colds
  • Ear infections
  • Minor injuries
  • Pink eye
  • Skin infections
  • Strep throat

The urgent care benefit also covers diagnostic services like X-rays, some lab testing and some medications (with notable limitations). Therapeutic vaccines are covered when these are required for the treatment of certain conditions covered under the urgent care benefit.

With the exception of a flu shot, vaccines and other preventive care services are not covered through the urgent care benefit. Free flu shots are currently only available through VA’s partnership with Walgreens, but will be available more widely in the future as part of the urgent care benefit.

Learn more about the VA/Walgreen's Retail Immunization Care Coordination Program.

While urgent care is a convenient benefit for nonemergent symptoms, Veterans should always consider talking with or seeing their primary care provider if they are concerned the urgent care location will not understand the complexities of their medical history or medications. Veterans should remember the following when considering urgent care:

  • When in doubt about your health condition or symptoms, Veterans should always seek a higher level of care, such as care from an emergency department. This is because they may have symptoms related to a serious health condition that an urgent care provider may not be able to adequately address.
  • If Veterans have a medical emergency, they should immediately seek care at the nearest emergency room. A medical emergency is an injury, illness, or symptom so severe that a prudent layperson reasonably believes that delay in seeking immediate medical attention would be hazardous to life or health.
  • If you believe your life or health is in danger, call 911 or go to the nearest emergency department right away.
    Important: VA can only pay for care an eligible Veteran receives from a community emergency department in certain circumstances and under specific conditions. For more information, visit the Emergency Care page.

    Information about Emergency Care
Differences Between Urgent and Emergency Care

Urgent Care

Urgent care consists of medical services provided for minor illnesses or injuries that are not life-threatening such as strep throat, pink eye, or influenza.

Emergency Care

Emergency care is inpatient or outpatient hospital services that are necessary to prevent death or serious impairment of health such as severe chest pain; seizures or loss of awareness; heavy uncontrollable bleeding; or moderate to severe burns.

IMPORTANT: Urgent care is not a replacement for a Veteran’s preventive health care. Veterans should work with their primary care provider for this type of care. If a Veteran goes to an urgent care provider and receives noncovered preventive services, they pay the full cost of care.

Copayments

Veterans may be charged a copayment for urgent care that is different from other VA medical copayments. Copayments depend on the Veteran’s assigned priority group and the number of times an urgent care provider is visited in a calendar year. A copayment is not required for a visit consisting of only a flu shot.

Copayment charges are billed separately by VA as part of VA’s billing process. There is no limit to the number of times a Veteran can go to an urgent care provider.

Priority Group(s)Copayment Amount
1-5
  • No copayment for the first three visits during a calendar year.
  • For four or more visits in a calendar year, the copayment is $30.
6
  • If the visit is related to a condition covered by special authority* or exposure:
    • First three visits (per calendar year), the copayment is $0.
    • Fourth and greater visits (per calendar year), the copayment is $30.
  • If not related to a condition covered by a special authority* or exposure, the copayment is $30 per visit.
7-8
  • Copayment is $30 per visit.
1-8
  • $0 copay for visit consisting of only a flu shot
*Special Authorities

Special authorities include those related to combat service and exposures (e.g. Agent Orange, active duty at Camp Lejeune, Ionizing Radiation, Project Shipboard Hazard and Defense (SHAD/Project 112), Southwest Asia Conditions) as well as Military Sexual Trauma, and presumptions applicable to certain Veterans with psychosis and other mental illnesses.

Prescription Medication

VA will pay for or fill prescriptions for urgent care. For urgent care prescription medication longer than a 14-day supply, the prescription must be submitted to VA to be filled.

For urgent prescriptions written by an urgent care provider, Veterans can fill a 14-day supply of medication at a contracted pharmacy within the VA network, in VA, or at a noncontracted pharmacy. If a noncontracted pharmacy is used, Veterans must pay for the prescription and then file a claim for reimbursement with the local VA medical facility.

Some Veterans may be required to make a copayment for medication. Information about copayments can be found at Veteran Copayments. To find an in-network pharmacy, both urgent care providers and Veterans can use the VA Facility Locator.

Veteran CopaymentsVA Facility Locator

Frequently Asked Questions

What specific services are covered by the urgent care benefit?

Individual health conditions are complex and unique to each Veteran. As a result, and to encourage Veterans to seek care when they need it, VA does not publish a specific list of covered services. Preventive care and dental services are excluded.

Will VA reimburse beneficiary travel for urgent care?

VA will reimburse beneficiary travel (BT) for eligible Veterans that travel to receive community care. Payment will be made for the distance to either the nearest VA or community medical facility that could have provided the care or services. Payment will only be made on a one-way basis (e.g., not round-trip) for unscheduled care.

Are urgent care services provided at an emergency department covered by VA?

If the emergency department is part of VA’s contracted network and has agreed to furnish urgent care services in accordance with the contract requirements, VA can pay for these services for eligible Veterans under this benefit.

How do Veterans get more information about the urgent care benefit?

Veterans can call their local VA medical facility for more information. A VA staff member can advise the Veteran on available urgent care providers and may be able to advise them on whether they will be charged a copayment for the care.

Can the urgent care benefit be used by a Veteran’s family member?

Only eligible Veterans can use this benefit. The benefit does not extend to family members and is non-transferrable.

Contacts

For more information, please contact your local VA medical facility.

Facility Locator