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VA Community Care: A Complete Guide for Older Veterans
In many cases you can see local doctors, with the Department of Veterans Affairs covering the cost — here's what you need to know about eligibility, coverage and how to use it
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Key takeaways
- The VA Community Care program lets enrolled veterans see local doctors when VA access isn’t practical or timely.
- You must meet basic enrollment and approval rules plus at least one of six eligibility pathways.
- Costs follow VA copay rules, with some veterans paying nothing based on disability or income.
For many older veterans, getting to a VA medical center isn’t always practical. A long drive, a wait for an appointment or limited services at local clinics can stand between you and the care you need. That’s where VA Community Care comes in.
This guide explains who qualifies for VA Community Care, what’s covered, how to get a referral and how to find a provider near you.
What Is VA Community Care?
VA Community Care is a program that pays for veterans’ medical care from approved providers outside the Department of Veterans Affairs system when VA care isn’t accessible or available. You don’t have to choose community care over a VA provider, but the program can give you more options for treatment.
Community care is a VA health care benefit. If you have Medicare, TRICARE, Medicaid or private insurance, those plans continue to work alongside your VA care.
The VA’s role in community care includes coordinating referrals, conferring authorizations and sharing medical information with your outside provider. Roughly 40 percent of all VA-funded care is delivered through community care, and the VA continues to expand the program.
More Ways to Benefit
- Related Benefit 1
- Related Benefit 2
- Related Benefit 3
- Related Benefit 4
- Related Benefit 5
Community Care versus going to a VA facility
Who qualifies for VA Community Care?
Eligibility for care outside the VA system may be less complicated than you think. Qualifying veterans need to meet two basic requirements and at least one of six additional criteria.
First, you must:
- Be enrolled in or eligible for VA health care and
- Have approval from your VA health care team (except for certain cases like urgent or emergency care).
In addition, at least one of the following must be true:
- The VA doesn’t provide the service you need.
- Your state or territory doesn’t have a full-service VA facility. (As of July 2026 that list includes Alaska, Hawaii, New Hampshire, Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.)
- You were grandfathered in under the old Veterans Choice Program’s 40-mile rule as of June 6, 2018, and you live in Alaska, Montana, North Dakota, South Dakota or Wyoming.
- You and your VA provider agree that community care is in your best medical interest.
- The VA can’t meet its own quality standards for the care you need.
- Getting to or waiting for VA care would take too long. Generally, that means a drive time of 30 minutes (based on average duration, not mileage) or a minimum 20-day wait for the soonest possible appointment. For specialty care, the parameters are a 60-minute drive or a 28-day wait.
What services does VA Community Care cover?
VA Community Care covers a wide range of routine and specialty medical services. The VA expanded coverage last year, extending the Community Care authorization period to a year for 30 specialty services. (Previously, veterans needing these services had to get their referrals reevaluated every 90 to 180 days.) They are:
- Addiction medicine, outpatient
- Addiction psychiatry, outpatient
- Cardiology
- Dermatology
- Endocrinology
- Eye care, examination
- Family and couples’ psychotherapy, outpatient
- Gastroenterology
- Mental health, outpatient
- Nephrology
- Neurology
- Neurology and otology
- Neuro-ophthalmology
- Nutrition intervention services
- Oculoplasy
- Oncology and hematology
- Optometry, routine
- Orthopedics — general
- Orthopedics — hand
- Orthopedics — spine
- Otolaryngology or ENT
- Pain management
- Physical medicine and rehabilitation (physiatry)
- Podiatry
- Podiatry DS
- Pulmonary
- Rheumatology
- Sleep medicine
- Urology
- Urogynecology
Urgent care through community providers
You don’t need a referral or prior authorization to use an urgent care facility for treatment of minor injuries and illnesses such as strep throat, sprained muscles, and skin and ear infections. Diagnostic services like X-rays and some lab tests are also covered, as are some medicines and vaccines.
To be eligible for urgent care at VA medical centers and in-network providers, both of the following must be true:
- You’re enrolled in VA health care.
- You received care at a VA or in-network provider in the past two years.
You can confirm your eligibility by contacting your local VA health facility or by calling 800-698-2411. Select option 1, then option 3, then option 1 again.
Two things to know:
1. Don’t pay a copay at the visit. Bring a VA Community Care billing card. The provider bills the VA, and if there’s a copay, the VA will bill you. Prescriptions from the visit can be filled at an in-network pharmacy.
2. Out-of-network urgent care isn’t covered.
Emergency care at non-VA facilities
For a life-threatening emergency, the VA’s guidance is to call 911 or go to the nearest emergency room. You don’t need to contact the VA first.
The VA will cover emergency care at a non-VA facility until you can be safely transferred to a VA or other federal facility, but whether it covers the bill afterward depends on a few factors.
What you need to do
- Go to the emergency room, not an urgent care center. The VA offers guidance on how to tell the difference.
- Make sure the VA is notified within 72 hours through its Emergency Care Reporting Portal or by phone at 844-724-7842, preferably by the provider, although you or someone acting on your behalf may report your ER visit.
What VA will consider
- Whether you were enrolled in VA health care (or had a qualifying exemption) at the time
- Whether a VA or other federal facility was close enough to reach in time
- Whether a reasonable person in your situation would have believed the delay could endanger your life or health
A separate rule for mental health emergencies
- Emergencies related to mental health have broader coverage. The VA may cover up to 90 days of related services, even for veterans who aren’t enrolled in VA health care, as long as they meet certain service history criteria.
How to find a VA Community Care provider
Online tools and reaching out to your VA care team can help you find the right community care provider for you. Here’s how.
AARP’s free VA Community Care search tool
AARP is collaborating with Health.Vet, a third-party site that offers a free tool to help veterans find VA-covered providers, by location and specialty. You do not need to be an AARP member to use the feature, but you will be asked to provide an email address. Here’s how it works:
- Visit AARP.org/VetCommunityCare,
- Enter your ZIP code, city or state to see providers in your area.
- Search by specialty — primary care, mental health, cardiology or other services covered by VA Community Care.
- A printable list of local providers will be sent to your inbox to save, share or bring to your next VA appointment.
Help from the VA
The VA also has a search tool, which lists both VA facilities and community care providers.
If the online directory doesn’t give you what you’re looking for, your VA care team can help. Ask them about High Performing Providers (HPPs) — community providers the VA monitors and recognizes for consistently meeting or exceeding its standards for treatment outcomes, patient experience, cost and other criteria.
The HPP designation is based on performance data — providers can’t apply for it — and it only covers certain specialties. When your care team helps you schedule an appointment, HPP status is one of the things they consider.
Make sure the provider is in-network
The Community Care Network includes more than a million providers nationwide who deliver care on behalf of the VA. The network is split into five regions managed by two third-party administrators:
- Optum manages regions 1, 2 and 3, covering the East Coast through the Midwest and parts of the South.
- TriWest manages regions 4 and 5, covering the Southwest and West Coast, Alaska, Hawaii and U.S. Pacific territories.
How to get a VA Community Care referral
The VA has a step-by-step process for obtaining a community care referral. For some steps, you might need to wait for a VA response. Here’s what to expect.
1. Find an in-network community provider, as detailed above.
2. Ask your VA care team for a referral. They will review your request to confirm eligibility, contact you to confirm and prepare the referral. This can take up to 14 days, so plan ahead.
3. Schedule your appointment. You can do this yourself or ask your VA health team to do it for you. Even if you self-schedule, notify your care team within 14 days so they can update your chart and coordinate with your provider.
4. Wait for your authorization letter. This is a notification the VA sends out once the appointment is booked. It includes:
- Your authorization number
- Information about your provider
- A description of the care you can receive
- How long you can continue to get care before you need another referral.
5. Go to your appointment. Bring your authorization letter with you. The VA will share your medical records with your local provider in advance, but you will need to bring copies of any images, such as CT scans or MRIs, that the provider requests.
6. Track your appointments and reauthorizations. If you’re approved for continued care, you may schedule follow-up appointments with the same provider. However, the VA won’t cover services that aren’t approved in your authorization letter, so it’s important to keep track of how many appointments you’ve had and how long your approval lasts.
How much Community Care costs
How much you owe for services provided through VA Community Care depends on your priority group, service-connected disability rating, and type and level of treatment.
Who owes nothing?
Some veterans pay $0 out of pocket for community care, including:
- Anyone with a service-connected disability rating of 10 percent or higher. This exemption covers both outpatient and inpatient care.
- Veterans exempt based on income, special eligibility factors or disability rating.
Certain services are free for all veterans:
- X-rays and lab tests
- Preventive services like health screenings and immunizations
- Flu shots at urgent care visits
2026 outpatient copay rates
If you don’t qualify for an exemption, these rates apply to community care and VA facility care:
Urgent care works differently
Urgent care through a community provider has its own rates based on your priority group and how many urgent care visits you’ve had that year.
What’s changing with community care
A major VA reorganization is underway that could affect how community care is run over the next few years.
The VA RISE reorganization
In December 2025, the VA announced the largest reorganization of the Veterans Health Administration in more than 30 years. The plan, called VHA Restructure for Impact and Sustainability Efforts (RISE), consolidates the 18 Veterans Integrated Service Networks into five, supported by 18 health service areas.
The VA says the restructuring will not reduce its health care workforce.
Still have questions?
If you have more specific questions on eligibility, referrals, billing and special coverage, see the FAQ for veterans at Health.Vet.
For urgent help with a VA bill or copay dispute, call 866-400-1238.
If you can’t resolve a bill dispute or another issue with your VA facility, ask to speak with the patient advocate — every VA medical center has one.
The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
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