Veterans Choice Program (VCP)
The Veterans Choice Program is one of several programs through which a Veteran can receive care from a community provider, paid for by the Department of Veterans Affairs (VA). For example, if a Veteran needs an appointment for a specific type of care, and VA cannot provide the care in a timely manner or the nearest VA medical facility is too far away or too difficult to get to, then a Veteran may be eligible for care through the Veterans Choice Program.
To use the Veterans Choice Program, Veterans must receive prior authorization from VA to receive care from a provider that is part of VA’s VCP network of community providers. The authorization is based on specific eligibility requirements and discussions with the Veteran’s VA provider. VA must authorize care that is needed beyond the scope of the first authorization.
Veterans may be eligible to receive care through the Veterans Choice Program based on one or more of the following conditions:
- VA can’t provide the services the Veteran needs
- VA can’t make an appointment for the Veteran at the nearest VA medical facility within 30 days of the clinically indicated date (the date the Veteran and their VA provider agree should be the next date the Veteran is seen for care)—or, if VA can’t determine this date—the date the Veteran prefers to be seen next
- Veteran lives more than 40 miles (driving distance) from the nearest VA medical facility with a full-time primary care physician
- Veteran has to travel by air, boat, or ferry to get to the nearest VA medical facility
- Veteran faces an excessive burden in traveling to the nearest VA medical facility (such as geographic challenges, environmental factors, or a health problem that makes it hard for you to travel)
VA will work with the Veteran to determine eligibility based on the above conditions and the Veteran’s specific circumstances.
Health Net Federal Services Contract Is Ending — The Department of Veterans Affairs (VA) contract with Health Net Federal Services (HNFS) is ending on September 30, 2018. HNFS is the third party administrator for the eastern region of the Veterans Choice Program (VCP) and Patient-Centered Community Care (PC3) network. When the contract with HNFS ends, VA will take over all activity previously performed by HNFS. The end of the VA contract with HNFS does not affect the VA contract with TriWest Healthcare Alliance, which administers the western region of the VCP and the PC3 network.
VA will work with Veterans, community providers, and VA staff to transition care coordination from HNFS to your local VA medical facility as seamlessly as possible. No immediate action is needed on your part. However, if you are requesting care in the community, please contact your local VA medical facility to coordinate all care after September 30, 2018. If you are unaware of whom you should contact, visit the VA Facility Locator to find your local facility. Please view the annoucement below for more information.Health Net Federal Services Contract Close Out Facility and Service Locator
Replenishment of Choice Funds Notice — The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, signed into law by the President on June 6, 2018, appropriated $5.2 billion in mandatory funding for the Veterans Choice Program to continue to provide care to Veterans until the new, consolidated Veterans Community Care Program is operational. (Posted June 19, 2018)
Exhaustion of Choice Funds Notice — The Veterans Choice Program (VCP) will have exhausted all of its funding as early as May 31, 2018, and possibly as late as June 15, 2018, due to the unique nature of health care and the variability in health care costs. Once the funds are exhausted, VA will no longer be able to provide services under VCP. VA is publishing this notice of the exhaustion of funds as required by the Veterans Access, Choice, and Accountability Act of 2014, P.L. 113-146. VA has also published a notice in the Federal Register regarding the exhaustion of the VCP’s funds. (Posted May 11, 2018)
Federal Register Notice Doc. 2018-10058
Choice Program Support Line: 866-606-8198
Call for additional information or to speak to one of our service agents on standby to assist you.
VA Adverse Credit Helpline: 877-881-7618
VA will help you resolve adverse credit reporting and debt collection issues as a result of using VCP.
- Frequently Asked Questions
Find answers to frequently asked questions concerning the Veterans Choice Program.
- Fact Sheet: Veterans Choice Program – Unusual or Excessive Burden Eligibility Criteria
Describes specific requirements related to the unusual or excessive burden VCP eligibility criteria.
- Fact Sheet: Emergency Care for Veterans
Explains VA payment and authorization criteria for emergency care.
- Fact Sheet: Ambulance Transport at VA Expense – A Guide for Veterans
Explains payment and authorization criteria for ambulance transportation.
- Fact Sheet: Health Net and TriWest Complaint Process
Describes the process for filing a grievance with the third party administrators, Health Net and TriWest, that work with VA to administer VCP.
- VA Form: 10-10EZ – Application for Health Benefits
For Veterans to apply for enrollment in the VA health care system, which is required for a Veteran to use VCP to get care. The information provided on this form is used by VA to determine your eligibility for medical benefits.
- Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113-146, August 7, 2014)
Get the publication from the Government Publishing Office website.