VA San Diego Healthcare System
Community Care for Veterans
VA provides health care for Veterans from providers in local community outside of VA. Veterans may be eligible to receive care from a community provider when VA cannot provide the care they need. This care is provided on behalf of and paid for by VA.
Community care is available to Veterans based on certain conditions and eligibility requirements, and in consideration of a Veteran’s specific needs and circumstances. Community care must be first authorized by VA before a Veteran can receive care from a community provider.
What is the VA MISSION Act?
On June 6, 2018, President Donald J. Trump signed landmark legislation known as the VA MISSION Act of 2018. The Act affects many VA programs, including changes that make dramatic improvements to how Veterans receive health care provided outside of VA facilities.
Will I be eligible for community care under the MISSION Act?
You may be eligible for community care if:
- You need a service that’s not available at VA (e.g. maternity care).
- You reside in a U.S. state or territory without a full-service VA medical facility.
- You met previous distance criteria or live in one of the least populated states (ND, SD, MT, AK, WY), received care prior to June 6, 2018, and receive care within two years after June 6, 2018.
- You meet average drive time or appointment wait-time requirements.
- It’s in your best medical interest to be referred to a community provider.
- You need care from a VA medical service line that isn’t providing care that complies with VA’s quality standards.
When will these changes occur?
The changes go into effect June 6, 2019. At that time, all existing community care programs, including the Veterans Choice Program, will end.
Proposed Access Requirements
- Drive Time. You may be eligible if your average drive time to a specific VA medical facility exceeds:
- 30 minutes for primary care, mental health, and non-institutional extended care services (including adult home day care)
- 60 minutes for specialty care Average drive time is based on the distance from your permanent residence to the closest VA medical facility offering the care or service you need. It is based on geo-mapping software that accounts for a variety of factors, such as rush hour traffic.
- Appointment Wait Time. You may be eligible if the wait time for an appointment at a specific VA medical facility exceeds:
- 20 days for primary care, mental health care, and non-institutional extended care services
- 28 days for specialty care from the date of request with certain exceptions
Helpful information related to VA MISSION Act:
- Understanding the changes in Community Care for Veterans. This is a two-page info sheet / FAQ to help you understand how community care will work when the new VA MISSION Act goes into effect in June 2019. (Current as of March 29, 2019)
- Veteran Community Care – Urgent Care. This is a 7-page document that provides detail on the new urgent care benefit that provides eligible Veterans with greater choice and access to timely care in the community.
- Veteran Community Care – Eligibility. This is a 4-page document that provides detail on Veteran eligibility for non-VA care under the VA MISSION Act.
- Veteran Community Care – General Information. This is a 4-page document that provides general information about the VA MISSION Act including many FAQs.
- Enhanced VA Options under the MISSION Act. This brochure provides important information for Veterans.
For more details, visit www.missionact.va.gov
VA San Diego Healthcare System has a local Customer Service/Liason Team to assist Veterans and community providers when needed. If you have questions, please call (858) 623-1879, between the hours of 7:30 a.m.- 4:00 p.m., Monday through Friday.
For general Mission Act inquiries, please contact: (866) 867-7927 or dial (858) 552-8585, option #9
- San Diego VAMC
Hours of Operation
Monday - Friday
7:30 a.m. - 4:00 p.m.