About our VA community care network and covered services
Our VA community care network helps us offer Veterans quality health care outside VA, in their local communities, when needed. Learn about our network and covered services. And get answers to common questions about community care.
How our community care network works
When we can’t provide Veterans the care they need at VA facilities, we offer care from expert health care providers in our community care network.
We work with 2 private companies (Optum Serve and TriWest Healthcare Alliance) to manage our network. These companies act as “third-party administrators.” That means they help us find community providers who meet our quality standards in each region of the U.S. They also help process care claims from community providers.
Community care network regions
Our community care network has 5 different regions across the U.S. Your region depends on where you live.
Select the region you live in to learn which third-party administrator manages the community care network.
Region 1 (East—New England to North Carolina)
Region 1 includes these 14 U.S. states and the District of Columbia (Washington, D.C.):
- Connecticut
- Delaware
- Maine
- Maryland
- Massachusetts
- New Hampshire
- New Jersey
- New York
- North Carolina
- Pennsylvania
- Rhode Island
- Vermont
- Virginia
- West Virginia
Optum Serve is the third-party administrator for this region.
Region 2 (Midwest)
Region 2 includes these 13 U.S. states:
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Michigan
- Minnesota
- Missouri
- Nebraska
- North Dakota
- Ohio
- South Dakota
- Wisconsin
Optum Serve is the third-party administrator for this region.
Region 3 (Southeast and Puerto Rico)
Region 3 includes these 11 U.S. states and territories:
- Alabama
- Arkansas
- Florida
- Georgia
- Louisiana
- Mississippi
- Oklahoma
- Puerto Rico
- South Carolina
- Tennessee
- Virgin Islands (U.S.)
Optum Serve is the third-party administrator for this region.
Region 4 (West, Southwest, Hawaii, and Western U.S. territories)
Region 4 includes these 16 U.S. states and territories:
- American Samoa
- Arizona
- California
- Colorado
- Guam
- Hawaii
- Idaho
- Montana
- New Mexico
- Nevada
- Northern Mariana Islands
- Oregon
- Texas
- Utah
- Washington
- Wyoming
TriWest Healthcare Alliance is the third-party administrator for this region.
Region 5 (Alaska)
Region 5 includes Alaska.
TriWest Healthcare Alliance is the third-party administrator for this region.
Care and services we cover through community care
We cover in-network care for immediate needs such as these:
We cover these services from in-network community providers when approved by your VA health care team:
- Routine medical care
- Surgeries
- Dialysis
- Vaccines
- Rehabilitation
- Nursing homes, assisted living, and home health care
We cover complementary and integrative health services like these from in-network community providers when approved by your VA health care team:
- Biofeedback
- Hypnotherapy
- Massage therapy
- Native American healing practices
- Relaxation techniques
- Tai chi
We also cover dental care from in-network community providers for eligible Veterans who can’t get dental care at their local VA health facility.
Common questions about community care
Yes. We pay for up to a 14-day supply of urgent care prescriptions from in-network community pharmacies.
Here’s what to know:
- You must visit an in-network pharmacy in the same state as your urgent care visit. Or you can fill your prescription through VA.
- If your prescription is for a routine medicine or more than a 14-day supply, you must fill it through VA.
- If you fill a prescription at an out-of-network pharmacy, you may have to pay the full cost. You can file a claim to request reimbursement for the cost.
Find an in-network community pharmacy
If you need help while at a community pharmacy, call us:
- Call 888-901-6609 if the pharmacy 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 pharmacy is in any of these states: AK, AS, AZ, CA, CO, GU, HI, ID, MP, MT, NM, NV, OR, TX, UT, WA, or WY.
This depends on your situation.
You must get all routine medical equipment, orthotics, and prosthetics through us.
But if your in-network community provider decides you need an item right away while you’re at your appointment, we’ll cover the cost.
Your provider can give you the item during the appointment. They must then submit a claim to us through the third-party administrator for their region of the community care network.
We may cover the cost of IVF if you’re enrolled in VA health care and you meet certain requirements. We may also cover the cost of other forms of assisted reproductive technology (ART) or other infertility services.
You must meet all these requirements to be eligible for these services:
- You have a service-connected condition that causes infertility, and
- You’re legally married, and
- You and your spouse can produce the eggs and sperm needed for the treatment. We don’t cover donor sperm, eggs, or embryos. We also don’t cover surrogacy or obstetrical care for non-Veteran spouses.
To get started, schedule an appointment with your VA health care team. If you’re eligible, your team will refer you to a fertility specialist in our community care network. The specialist will create a treatment plan with you.
Request or schedule an appointment online
Find your VA health facility’s phone number
Learn more about infertility and IVF services on our women Veterans website
State Veterans homes provide eligible Veterans with care options like these:
- Nursing home care
- Adult day care
- Home care (also called “domiciliary care”)
State governments own and operate these homes. Each state has its own eligibility requirements for who can get care in the homes. Some homes also offer care to non-Veteran spouses and gold star parents. And care options may vary between homes.
If you’re an eligible Veteran, we may help cover the cost of your care through a state Veterans home. We don’t pay for care for non-Veteran spouses or gold star parents.
To find out if care through a state Veterans home may be right for you, and if we can help cover the cost, contact your VA health care team. Ask to connect with the social worker or case manager.
Yes. You must get a referral from your VA health care team before you make an appointment for care with a community care provider.
Learn how to get a referral and schedule an appointment with a community provider
If you need urgent or emergency care, you don’t need to get a referral before you get care.
These 2 websites can help you learn about the surgeon:
- The Federation of State Medical Boards’ “DocInfo” website. You can search for a surgeon to find which states they’re currently licensed to practice medicine in. You can also find information about the surgeon’s background, such as their education, certification, and specialty.
Go to the DocInfo website to learn about a surgeon - Medicare’s provider comparison website. You can find and compare surgeons as well as other providers, nursing homes, and hospitals near you.
Go to the Medicare provider comparison website
You can always choose to learn more about a surgeon or any provider before you get care from them. Reviewing this information won’t interfere with any scheduled appointments.
We encourage you to report any complaints about in-network community providers to us. You can report any quality or safety concerns. Complaints may also include issues of discrimination, staff rudeness, an unclean office, or long wait times.
To make a report, contact your nearest VA medical center (VAMC) and ask for the patient advocate. Patient advocates are highly trained professionals who work to support the rights of Veterans and their family who receive care through VA.
Your patient advocate will work with the VAMC’s community care office to review the complaint or concern and take one or both of these actions:
- Submit a report of the concern or complaint to the third-party administrator for the community care network region of the provider.
- Report the concern or complaint to the VAMC patient safety manager for any needed corrective action.
We’ll contact you about what action the patient advocate is taking to resolve the concern or complaint.
Call us at 877-881-7618 (TTY: 711). We’re here Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.