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VA COMMUNITY CARE

VA CC HEADER 1

Rehab 2 Perform™ is now a VA Community Care provider and is able to treat eligible Veterans! Plese view the information below or visit VA.GOV/COMMUNITYCARE HERE

Veterans may be eligible for care through a provider in their local community depending on their health care needs or circumstances, and if they meet specific eligibility criteria. Even if a Veteran is eligible for community care, they generally still have the option to receive care from a VA medical facility.

In most cases, Veterans must receive approval from VA before receiving care from a community provider to avoid being billed for the care. VA staff members generally make all eligibility determinations for community care.

Process Overview

  1. Eligibility: VA confirms a Veteran’s eligibility to receive community care.
  2. Appointments: Veteran or a VA staff member schedules appointment with a provider in VA’s network.
  3. Getting Care: Veteran receives care from a community provider in the VA's network.
  4. Billing: Community provider sends the claim to a Third Party Administrator (TPA) or VA for payment.

Eligibility

A Veteran’s eligibility for community care depends on his/her individual health care needs or circumstances. Please note the following about eligibility for community care:

  • 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.

Appointments

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.

Scheduling Appointments

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.

Getting Care

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.