Community Care: Seeing a Non-VA Doctor on VA's Dime

What it is

VA wants you to get care on time and close to home. When it can't, the Veteran Community Care Program lets you see a local provider in VA's network. VA pays for the approved care, and you pay the same copay you would at VA, if any.

Who qualifies

You must be enrolled in or eligible for VA health care, and VA must approve the care first (urgent and emergency care work differently). You must also meet at least one of these:

• VA doesn't offer the service you need at any of its facilities.
• You live in a state or territory with no full-service VA medical center.
• You were grandfathered under the old 40-mile rule as of June 6, 2018, and live in certain states such as Alaska, Montana, North Dakota, South Dakota or Wyoming.
• VA can't meet its access standards. For primary care, mental health and some extended care, that's an average drive of more than 30 minutes, or a wait of more than 20 days. For specialty care, it's more than a 60-minute drive or a 28-day wait.
• You and your VA provider agree it's in your best medical interest.
• VA can't provide the care up to its quality standards.

Since 2025, under the Elizabeth Dole Act, you and your referring VA clinician get more say in deciding whether community care is right for you.

Urgent care

If you've used VA health care in the last two years, you can go to an in-network urgent care clinic or retail clinic for minor issues like colds, sprains or ear infections without a referral. Copays depend on your priority group and how many visits you've had that year. Check that the clinic is in VA's network before you go.

Emergency care

In a true emergency, go to the nearest ER. You don't need approval first. But you, a family member, or the hospital must tell VA within 72 hours. Doing this helps make sure VA pays.

How to get approved, step by step

1. Ask your VA provider or care team for a community care referral. If you think you meet a rule, like a long wait, say so directly.
2. VA checks your eligibility and sends the referral.
3. Schedule the appointment. VA may schedule it for you, or let you call the provider yourself.
4. Go to the appointment. Bring your ID and any referral details.
5. For follow-ups, make sure your referral covers them. Ask before getting extra tests or visits.
6. Disagree with a denial? You can file a clinical appeal with your facility.

Mistakes to avoid

• Seeing an outside doctor without a referral (outside emergencies). You may get stuck with the bill.
• Missing the 72-hour call after an ER visit.
• Using an out-of-network urgent care. Use VA's facility locator to check.
• Paying a bill yourself. If a community provider bills you for approved care, call VA's community care line first.

Related benefits

See our guides on VA health care, beneficiary travel pay, mental health care, and VA dental care.