VA Community Care
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Thanks For Your Service
Physical Medicine Clinic is proud to serve and give back serve those who selfishly served our country!
Physical Medicine Clinic is part of the Community Care program thru the Veterans Administrations TRIWEST Program.
The Community Care Program provides Veterans with a greater choice over their health care, msk pain and injury, and allows VA to deliver world-class, seamless customer service either through a VA facility or community provider. There are a variety of improvements under the VA MISSION Act of 2018 that make community care work better for Veterans:
Streamlined eligibility criteria. Veterans can easily tell if they are eligible for community care by reviewing the eligibly criteria.
Single community care program. With the sunset of VCP, there is one single community care program. With one program and a single set of rules and processes, there is less complexity and likelihood of errors and problems.
Better customer service. VA has implemented redesigned a streamlined internal process, with improved education and communications resources for Veterans, Veterans Service Organizations (VSO) partners, and VA employees involved in community care operations.
New urgent care benefit. The new urgent care benefit provides eligible Veterans with access to non-emergency care for certain conditions in the VA network of community providers. Veterans can go to any urgent care or walk-in care provider in VA’s network without prior authorization from VA.
A Veteran’s eligibility for community care depends on his/her individual health care needs or circumstances
Veterans must receive approval from VA prior to obtaining care from a community provider in most circumstances.
Veterans must either be enrolled in VA health care or be eligible for VA care without needing to enroll to be eligible for community care.
Eligibility for community care will continue to be dependent upon a Veteran’s individual health care needs or circumstances.
VA staff members generally make all eligibility determinations.
There are six criteria that can qualify a Veteran to receive community care; Veterans only need to meet one of these to be eligible.
1. Veteran needs a service not available at a VA medical facility
2. Veteran lives in a U.S. state or territory without a full-service VA medical facility
3. Veteran qualifies under the “Grandfather” provision related to distance eligibility for VCP
4. VA cannot provide care within certain designated access standards
5. It is in the Veteran’s best medical interest
6. A VA Service Line Does Not Meet Certain Quality Standards
Appointments and Getting Care
Veterans eligible for community care generally have the option of choosing to receive care from a VA medical facility or community provider. For Veterans who choice to receive community care, a VA staff member will discuss with them their preferences for getting care from a community provider.
Finding a Community Provider
Veterans can either choose their preferred community provider or a VA staff member can help select one. The selected community provider must be part of VA’s network. The VA Facility Locator can be used to find a community provider
If there is a specific community provider a Veteran would like to see that is not in VA’s network, VA may be able to add them to its network. In some cases, a VA staff member will work with the Veteran to find other options when:
A community provider cannot be found that meets the Veteran's health care needs
A community provider was, but is no longer part of VA’s network
An existing community provider is no longer available
Once a community provider is selected, an appointment can be scheduled based on the Veteran's preferences and the community provider’s availability.
Before scheduling an appointment, it is important for the Veteran to confirm with a VA staff member that they are eligible and authorized for community care.
Once authorized to receive community care, they have several options for scheduling an appointment with a community provider, depending on the type of care they need. A Veteran may be able to:
Directly schedule an appointment and inform a VA staff member about the appointment
Use VA Online Scheduling to request an appointment for certain types of routine services
Have a VA staff member schedule the appointment
Have VA's Third Party Administrator (TPA) schedule the appointment
VA will send the Veteran and the selected community provider a referral. VA will also send the Veteran's medical documentation to the community provider to ensure proper care coordination between their VA care team and the community provider.
When a Veteran arrives for the appointment, the community provider should have the appointment, VA referral, and medical documentation on file. If a Veteran needs a follow-up appointment, the community provider should check to make sure VA has authorized additional care before scheduling the appointment.
Please call our office for further information at 813-471-8897 or contact your local VA
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