Community Care and VA Health Care
Did you know the VA can send you to providers in your community? There’s an entire array of community care options available to veterans through the VA. Mental health counseling, primary and specialty care are all potential options. With community care through the VA, you can find the support and guidance that will allow you to get back on track and start living life again. In fact, the VA will typically cover all costs for this care.
What Is Community Care?
Law mandates that the VA provide eligible veterans with the health care they need. However, the VA lacks the needed staff. As a result, the VA is required to use providers in their local community if the VA can’t meet the need. Thankfully, the VA will pay for community care visits as if they were VA visits.
This outside care is called community care. This is not a well-known program, and the VA enjoys keeping it from veterans.
The Best Example of Community Care
The VA has been the subject of several lawsuits regarding emergency room coverage over the years. However, the VA has finally acknowledged that a trip to a non-VA emergency room is part of VA health care through community care. The VA requires that the veteran notify the VA with-in 72 hours, and only covers trips that are necessary. As a result, the VA can choose to not pay if the veteran goes to an emergency room for something that is clearly not an emergency.
However, the VA is not required to cover a visit if veterans do not notify them with-in 72 hours. The VA is the secondary payer to any other insurance, and does not provide reimbursement for certain co payments. However, this is a valuable tool to all veterans with VA health care.
Am I Eligible?
Community care is not a separate program from VA health care. In fact, it is a part of VA health care. As a result, there is no need to enroll specifically in community care. A disability rating of 10% or higher is the most direct way to be eligible for VA health care.
However, combat veterans are also eligible for VA health care for a time period after they separate from service. In addition, certain other veteran classes are eligible for care. Notably, veterans with a Purple Heart, Medal of Honor, or low income are also eligible.
What if you don’t qualify for these benefits? Did you know that we have an entire BOOT CAMP dedicated to receiving VA benefits? Check out exactly how you can receive VA health care and VA disability.
How Do I Receive Community Care?
I have personally used community care many times. I have used it for chiropractor visits, physical therapy, the emergency room, and even an outpatient procedure. Typically, the VA is willing to send you to outside care when they are unable to see you with-in 30 days.
As a result, I typically will ask for an outside referral if the VA is unable to see me in 30 days. However, certain special procedures have a longer timeline. It is essential that you let the VA refer you out. This will require that they pay for everything. You are not able to see a civilian doctor and get covered after the fact.
However, the VA typically pushes back when you request community care. I assume this is the VA employees trying to protect their metrics instead of treating veterans. It is essential that you remain firm and advise the VA that they are required to treat you in a timely fashion. A 90 day wait to see a doctor is not timely.
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