Veteran Benefits
Community Care (Care Outside VA)
Community Care lets you get VA-paid health care from a local provider outside the VA when the VA cannot see you close enough to home or quickly enough. It is built on clear drive-time and wait-time standards - so you are not stuck driving hours or waiting months for care you need.
Who this is for
No veteran should have to drive three hours or wait three months for care. The MISSION Act put real numbers behind that promise - if the VA cannot see you within set drive times and wait times, it pays for a local provider instead. The catch is getting the authorization first.
In plain language
What Community Care (Care Outside VA) covers
- The drive-time and wait-time standards that make you eligible
- Qualifying when the VA does not offer a service or has no nearby facility
- How prior authorization works - and when you do not need it
- The separate urgent care benefit for minor illnesses and injuries
VA Community Care: Getting Treated Outside the VAOfficial video - U.S. Dept of Veterans Affairs
5 things most veterans aren't aware of
These apply to nearly every VA claim - and they change how much you get and when.
Your filing date sets your back pay
Benefits are generally paid back to the day you file - not the day you are approved. Filing an intent to file today can protect months, even years, of retroactive pay.
One condition can trigger others (secondary claims)
A service-connected condition that causes another - like sleep apnea from PTSD, or a bad knee from a bad hip - can be rated on its own. Each secondary condition adds to your rating.
A medical nexus is what wins the claim
The VA needs a documented link between your condition and your service. A clear nexus opinion is often the difference between an approval and a denial.
Accredited help is free to file an initial claim
By law, an accredited agent cannot charge a fee to prepare and file your original claim. If someone asks for money up front to file, that is a red flag.
A denial is not the end of the road
You have three appeal lanes - Higher-Level Review, a Supplemental Claim with new evidence, and the Board of Veterans Appeals. Many denials are overturned on review.
30 min / 20 days
Primary care, mental health, extended care access standard
60 min / 28 days
Specialty care access standard
24 months
Urgent care with no pre-approval if VA saw you within this window
The full picture
Everything you need to know
Nothing hidden behind a click, and nothing you have to go looking for on another website. Here is the whole story in plain language - the facts and the figures first - so you can decide what fits your situation.
Key facts & current figures
- Under the MISSION Act, if the VA cannot see you close enough or soon enough, it can send you to an in-network community provider - paid for by the VA (38 U.S.C. 1703).
- Access standards for primary care, mental health, and non-institutional extended care: eligible if your average drive time is over 30 minutes OR the wait is over 20 days.
- Specialty care standards: eligible if your average drive time is over 60 minutes OR the wait is over 28 days.
- You may also qualify if the VA does not offer the service you need, you live in a state with no full-service VA facility, or you and your VA doctor agree it is in your best medical interest.
- Most community care needs VA authorization first - but the separate urgent care benefit lets enrolled veterans (seen by VA in the last 24 months) walk into an in-network urgent care without pre-approval.
General figures, current as of December 2025 and reviewed each year. Your exact amount depends on your situation - always confirm on va.gov.
The access standards, in plain numbers
- Primary care, mental health, and non-institutional extended care: you qualify if the average drive time to a VA facility that offers the service is more than 30 minutes, or if the VA cannot schedule you within 20 days.
- Specialty care: you qualify if the average drive time is more than 60 minutes, or the VA cannot schedule you within 28 days.
- Drive time is figured door-to-door, so rural veterans often meet the standard easily.
Other ways to qualify
- The VA does not offer the specific care you need (for example, certain maternity or specialized services).
- You live in a state or territory without a full-service VA medical facility.
- You and your VA clinician agree community care is in your best medical interest, or the VA service line does not meet its quality standards, or you are covered by a grandfather provision from the old Veterans Choice Program.
Authorization and the urgent care benefit
- For scheduled community care, the VA generally must give written authorization before the appointment - self-referral is not covered and can leave you owing the bill.
- The urgent care benefit is different: if you are enrolled and have been seen by the VA in the past 24 months, you can visit an in-network urgent care clinic for minor injuries and illnesses without pre-approval.
- A small urgent-care copay may apply depending on your priority group; the VA's website lists in-network urgent care and retail locations.
Your complete benefit picture
Care closer to home
if the VA cannot see you within set drive times and wait times, the MISSION Act lets it pay for a local in-network provider instead. The catch is getting VA authorization before your appointment.
Two ways to move forward — both free
Not sure if this applies to you?
Ask our free assistant a few plain questions and get an honest read on what you and your family may qualify for, at no cost. It takes just a few minutes, and there is no sign-up and no obligation of any kind. You will get a clear, plain-language picture of where you stand and what might be worth filing. And if you would rather talk to a real person, an accredited agent is only a message away.
Have a question? Get free information
Ask a question, learn what you may be owed, or find out where you stand. Confidential, free, and no obligation to go any further.
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Decided you want us to work your claim? Registering is free — we match you with an accredited advocate and get you started. We cannot begin until you sign VA Form 21-22a, and fees, if any, are always disclosed up front.
Costly mistake to avoid
Get VA authorization before you see an outside provider
Community care is a right when you meet an access standard - but self-referral is not covered.
If you see an outside provider without written VA authorization first, you can be stuck with the whole bill.
Ask at the long wait
If a scheduler says the wait is too long, that is the moment to ask about community care.
Urgent care is different
Enrolled and seen by VA in the last 24 months? Walk into in-network urgent care - no pre-approval.
A clear path forward
Your step-by-step action plan
No rush and no pressure - but a little order helps. Applying is always free.
FIG. 01 - Gather your paperwork
First
Check the standard
Over 30 min / 20-day wait for primary care, or 60 min / 28-day wait for specialty care? You likely qualify.
FIG. 02 - Fill out the form
Next
Ask for a referral
Ask your VA provider or a patient advocate for a community-care referral and eligibility check.
FIG. 03 - File the claim
Before the visit
Get written authorization
Make sure the VA authorizes the care in writing before you see the community provider.
FIG. 04 - After you file
For urgent care
Use the in-network locator
For minor illness or injury, find an in-network urgent care on va.gov - no referral needed within 24 months.
Who to call & where to go
These are free, official VA lines. Have your Social Security number handy when you call.
MyVA411 - Main VA Line
Not sure who to call? Start here. One number for anything VA - they route you to the right office.
Rather have us handle it?
No phone tag, no hold music. Call our office and a real, VA-accredited person walks you through it - start to finish.
702-992-4883Not sure where to start?
Community care almost always starts with your VA care team: ask your VA provider or a patient advocate for a community-care referral if you think you meet an access standard. The VA checks eligibility and, in most cases, must authorize the care in writing before you see the outside provider. For urgent care, use the VA's in-network locator - no referral needed if you have had VA care in the last 24 months.
More benefits for veterans
These often go hand in hand - tap any card to learn more.
Free information — get a free benefit review
Tell us how to reach you and an accredited team member will help you understand this benefit and claim everything you have earned. No cost, no obligation.
Ready to hire us? Register with us
For veterans who’ve decided they want us on their claim — registering is free too, and it does not make you our client or obligate you to anything. Here is exactly how it works:
- You register. This simply starts the conversation — you are not our client yet, and you owe us nothing.
- You sign and return VA Form 21-22a. It appoints us as your accredited representative and gives us access to your VA file.
- Once we have your signed 21-22a and access to your case, we verify everything is in order.
It involves the registration form and signing VA Form 21-22a — by law we can’t accept your claim, work on it, or contact the VA for you until that power of attorney is signed. You decide whether to move forward.
Official VA links
Answers, in plain language
Common questions about Community Care (Care Outside VA)
What is Community Care (Care Outside VA)?
Community Care lets you get VA-paid health care from a local provider outside the VA when the VA cannot see you close enough to home or quickly enough. It is built on clear drive-time and wait-time standards - so you are not stuck driving hours or waiting months for care you need.
Who qualifies for Community Care (Care Outside VA)?
The VA does not offer the specific care you need (for example, certain maternity or specialized services). You live in a state or territory without a full-service VA medical facility. You and your VA clinician agree community care is in your best medical interest, or the VA service line does not meet its quality standards, or you are covered by a grandfather provision from the old Veterans Choice Program.
How do I apply for Community Care (Care Outside VA)?
Community care almost always starts with your VA care team: ask your VA provider or a patient advocate for a community-care referral if you think you meet an access standard. The VA checks eligibility and, in most cases, must authorize the care in writing before you see the outside provider. For urgent care, use the VA's in-network locator - no referral needed if you have had VA care in the last 24 months.
What does it cost to get help with Community Care (Care Outside VA), and are you VA-accredited?
The single biggest mistake veterans make is going to an outside provider without VA authorization first - if you do, you can be stuck with the whole bill. Community care is a right when you meet the standards, but the paperwork has to happen up front. If a VA scheduler tells you the wait is too long, that is exactly the moment to ask about community care. It is free to talk with us, and no one may charge you to file a first-time VA claim. The Aging Veteran is led by Albert L. Thombs Jr., a VA-accredited claims agent (accreditation #45147) and disabled veteran; any appeal work is handled on a no-fee-unless-you-win basis.
