Community Care

Here are 6 examples of when you may be eligible for community care based on each requirement:

Example 1: A service we don’t provide

You need maternity care or in vitro fertilization (IVF) care. But we don’t provide maternity care or IVF at any of our facilities. So, you’re eligible to get these services from an in-network community provider.

Example 2: Drive and wait time standards

For primary care or mental health

You need a primary care or mental health appointment, but the average drive time to your nearest VA clinic is longer than 30 minutes. This means you’re eligible to get primary or mental health care from an in-network community provider because the drive time exceeds the access standards.

You could also qualify if your drive time were within the standard but the soonest available appointment date is over 20 days away.

For specialty care

You need an appointment for specialty care (such as cardiology care for a heart problem), but the soonest available appointment date is over 28 days away. This means you’re eligible to get specialty care from an in-network community provider because the wait time exceeds the access standards.

You could also qualify if your appointment date is within 28 days, but your average drive to the nearest VA facility that offers cardiology is longer than 60 minutes.

Example 3: Your best medical interest

You’re getting recurring treatment for a condition and have medical issues that prevent you from getting to the VA facility that’s within our standards for drive time (such as nausea from recurring cancer treatments). Or you require recurring treatments that we can’t supply in a timely manner, even if they meet our wait time standards. If you and your VA provider agree that it’s in your best medical interest to get care from the community provider, you’re eligible for community care.

Learn how to get community care referrals and schedule appointments

If you’re an eligible Veteran, you can get urgent care at VA medical centers and in‑network urgent care providers near you. Use urgent care for minor injuries and illnesses that aren’t life-threatening—like strep throat, sprained muscles, and skin and ear infections. Keep reading on this page to find out how to get urgent care.

Find urgent care locations

On this page

• Eligibility for urgent care
• Covered urgent care services
• What to bring with you to a community urgent care provider
• What to do when you arrive at a community urgent care provider
• Common questions about urgent care

Eligibility for urgent care

You can get urgent care at VA medical centers and in‑network community providers, if both of these descriptions are true for you:

• You’re a Veteran enrolled in VA health care, and
• You received care at a VA or in-network provider in the past 24 months (2 years)

To check your eligibility, contact your local VA health facility. Or call us at 800-698-2411 (TTY: 711). Select option 1, then option 3, then option 1.

Note: Your family members can’t use your urgent care benefit.

Covered urgent care services

We cover urgent care services at VA medical centers as well as in-network urgent care centers and walk-in retail health clinics. You don’t need to get a referral before you get urgent care.

These are examples of covered services:

• Care for minor injuries and illnesses (like strep throat, pink eye, sprained muscles, and skin and ear infections)
• Diagnostic services like X-rays and some types of lab tests
• Some types of medicines and vaccines

Note: If you think your life or health is in danger, call 911 or go to the nearest emergency room.

What to bring with you to a community urgent care provider

• A valid, government-issued photo ID, and
• A copy of the VA urgent care billing information card

You can download a PDF of the urgent care billing information card to print out or show on your mobile device.

What to do when you arrive at a community urgent care provider

• Confirm that the provider is in our network. Check for a posted sign or ask a staff member. If you go to an out-of-network urgent care provider, you may have to pay the full cost of care. By law, we can’t pay claims for out-of-network providers.
• Fill out the provider’s intake form.
• Tell the provider you want to use your VA urgent care benefit. Show the provider your urgent care billing information card. The provider will call the phone number for your region listed on the card to check your eligibility.
• Don’t pay a copay.

If you need help using your urgent care benefit, call us:

• Call 888-901-6609 if the provider is in Puerto Rico, Washington, D.C., or any of these states: AL, AR, CT, DE, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NY, OH, OK, PA, RI, SC, SD, TN, VA, VI, VT, WI, or WV.
• Call 866-620-2071 if the provider is in any of these states: AK, AS, AZ, CA, CO, GU, HI, ID, MP, MT, NM, NV, OR, TX, UT, WA, or WY.