Community Care
VA Community Care allows eligible Veterans to receive health care from approved providers in their local community when certain requirements are met. Community Care supplements the care VA provides and, in most cases, must be approved by VA before you receive care from a community provider. Use the information below to learn about Community Care eligibility, referrals and appointments, the VA Community Care Network, and your options if you disagree with a VA clinical decision.
Am I eligible for Community Care?
You may be eligible to receive care from a provider in VA's Community Care Network if you're enrolled in or eligible for VA health care and VA approves you for Community Care.
Eligibility may depend on factors such as:
- Whether VA provides the service you need
- Whether VA can provide the care within established drive-time and wait-time standards
- Whether you and your VA provider agree that Community Care is in your best medical interest
- Whether the VA care available to you meets applicable quality standards
- Other eligibility requirements established by VA
Except for certain types of care, such as qualifying urgent or emergency care, you must receive approval from your VA health care team before receiving care from a community provider.
How do I get Community Care?
Before scheduling care with a non-VA provider in the Community Care Network, you generally need a referral and approval from your VA health care team.
1. Find an in-network community provider
You can search for an in-network provider yourself or ask your VA health care team for help finding a provider who meets your needs.
2. Get a referral from your VA health care team
Ask your VA health care team for a Community Care referral. VA will review your request to determine your eligibility and the type of care you need.
3. Schedule your appointment
After your referral is approved, you can schedule your appointment with the approved community provider or ask VA to help schedule it.
4. Review your authorization
VA will provide information about your approved Community Care, including the provider, authorized services and the period for which your authorization is valid.
Important: Make sure the care you receive is included in your VA authorization. VA may not cover services that aren't authorized.
5. Go to your appointment
Attend your appointment with the approved community provider. Follow any instructions from VA or the community provider about information or records you should bring.
6. Follow up as authorized
Your authorization may include approved follow-up visits. If you need care beyond what VA authorized, contact your VA health care team about whether you need another referral.
About the VA Community Care Network and covered services
VA's Community Care Network connects VA with approved community health care providers so eligible Veterans can receive care outside VA when needed.
Community Care must generally be authorized by VA before you receive services. The services VA covers depend on your individual authorization and health care needs.
The Community Care Network is divided into regions and is administered on VA's behalf by third-party administrators. VA's Community Care Network information can help you learn more about:
- Community Care Network providers and regions
- Covered services
- Prescriptions related to Community Care
- Medical equipment and supplies
- Questions about Community Care bills
- Concerns about a community provider
Learn more about the VA Community Care Network and covered services
Clinical Appeals
If VA denies your request for Community Care or you disagree with certain other VA medical treatment decisions, you may be able to request a Clinical Appeal.
A Clinical Appeal allows you to ask VA to review a clinical decision about your care. You can submit a written appeal explaining the decision you disagree with, why you disagree with it, and any supporting information you want VA to consider.
Your VA facility's Patient Advocate can provide information about the Clinical Appeals process and help you submit your appeal.
The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act builds on VA's commitment to providing Veterans timely access to care. Among its Community Care provisions, the Dole Act removed an additional review step when a Veteran and their referring clinician agree that receiving care from a community provider is in the Veteran's best medical interest.