VA Offers One Year of Community Care for 30 Types of Treatment

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Veterans referred to health care providers outside the Department of Veterans Affairs (VA)  can now receive a full year of authorized care for 30 specific types of treatment without needing to reapply every few months, the department announced.

Previously, community care referrals were often reevaluated every 90 to 180 days, a process that could delay or disrupt treatment. Now, eligible veterans will be covered for 12 months of care at VA expense before a new authorization is required.

The policy shift is expected to reduce administrative workload for VA staff and community providers while improving health outcomes for veterans through uninterrupted care.

Veterans with questions about how the change may affect their care should contact their local VA Medical Center’s Community Care Office.

What is community care?

Community care refers to medical services provided by non-VA health care professionals in a veteran’s local area. It’s available when VA facilities can’t provide the care needed, or when it’s in the veteran’s best medical interest.

30 services covered by the one-year authorizations

The following types of care are now eligible for streamlined, one-year community care approvals:

• Addiction Medicine (Outpatient)
• Addiction Psychiatry (Outpatient)
• Cardiology
• Dermatology
• Endocrinology
• ENT (Otolaryngology)
• Eye Care Exams
• Family & Couples Psychotherapy (Outpatient)
• Gastroenterology
• Hematology & Oncology
• Mental Health (Outpatient)
• Nephrology
• Neurology
• Neuro-Ophthalmology
• Nutrition Services
• Oculoplastics
• Optometry (Routine)
• Orthopedic General
• Orthopedic Hand
• Orthopedic Spine
• Pain Management
• Physical Medicine & Rehabilitation (Physiatry)
• Podiatry
• Podiatry DS
• Pulmonary
• Rheumatology
• Sleep Medicine
• Urology
• Urogynecology

Earlier VA efforts to streamline care

The one-year authorization policy follows a separate VA update in May that eliminated a key step in the community care approval process. Before that change, both the veteran and their referring VA clinician had to approve the request, which was then reviewed again by a second VA doctor. That extra step is now gone, reducing wait times and simplifying access to outside care.

These updates reflect the VA’s continued push to prioritize customer service and deliver timely, high-quality care. They also align with the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act and build on the 2019 MISSION Act, which expanded veteran access to community care under certain conditions.

Who is eligible for community care?

Veterans may be eligible for care through non-VA providers if:

• The care is in the veteran’s best medical interest
• The necessary care isn’t easily available at a VA facility
• The veteran lives in a state or U.S. territory without a full-service VA facility
• VA can’t meet designated wait time or drive-time standards
• VA care fails to meet quality standards
• The veteran qualifies under distance rules from the former veterans Choice Program

Currently, VA wait-time standards are 20 days for primary care, mental health and non-institutional extended care, and 28 days for specialty care. The distance standards are a 30-minute drive for primary or mental health care and a 60-minute drive for specialty care.

The VA says staff are being taught how to use these new rules and make sure veterans can get the care they need faster and easier. This includes both within VA facilities and through trusted community partners.