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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.

A senior Latino male veteran being examined by a friendly community doctor with a stethoscope at a local clinic near home

Who this is for

Veteran

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
A benefits advisor helping a senior veteran understand what he has earned

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. Here is the whole story in plain language, 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.

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.

1

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.

2

Next

Ask for a referral

Ask your VA provider or a patient advocate for a community-care referral and eligibility check.

3

Before the visit

Get written authorization

Make sure the VA authorizes the care in writing before you see the community provider.

4

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.

VA Health Benefits

Enrolling in and questions about VA health care.

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.

702-992-4883

Not 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.

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.

Your information is private and is used only to contact you about your benefits. We never sell your details. The initial review is free - representation, if you choose it later, follows VA fee rules.

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.

Call 702-992-4883

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