VA Community Care and American Addiction Centers

The US Department of Veterans Affairs (VA) health administration is one of the largest integrated healthcare systems in the country. An extensive selection of healthcare providers composes a network with the common goal of helping military veterans return to their everyday lives. This is achieved through programs like VA Community Care.1

One such community care provider (CCP), and a member of this network, is American Addiction Centers (AAC). AAC offers specialized VA-approved treatment programs for veterans. Through this program, and other individualized approaches, AAC helps veterans get appropriate addiction recovery treatment.

This also includes behavioral health, since mental health issues often co-occur with substance abuse and addiction, particularly in population groups exposed to higher stress levels. In addition, deployments, military service, and a specific military culture might lead to overlooking or disregarding potential mental health and substance abuse issues. That’s why it’s crucial to raise awareness and give the veterans a chance to identify and address those issues. This is necessary for their well-being, as well as their military career.2

What Does the VA Community Care Program Network Offer?

The VA Community Care program connects veterans with local healthcare professionals and institutions so they can receive treatment outside of the VA system. CCPs are usually private medical centers that accept Veterans Affairs health insurance. Healthcare facilities connected through the VA network of private providers have contracts with the VA that enable them to provide the necessary services to patients without access to adequate care from the Department of Veterans Affairs.3

If the VA can’t offer the required level of care, veterans may be eligible for Community Care services. The VA covers the cost of substance abuse treatment provided by the CCPs. However, a veteran can’t visit a nearby community provider to receive treatment until community care is approved. Each veteran’s needs and circumstances are evaluated when determining whether they are eligible for VA Community Care.4

How to Qualify for the Veterans Affairs Community Care Program?

Qualifying for the VA community care program will depend on fulfilling the established criteria. The primary one is that the veteran is already enrolled in VA healthcare or eligible to enroll. Eligibility is determined according to each veteran’s needs, on a case-to-case basis. Before seeking help from the VA community care network providers, veterans must receive VA approval.5

The most accurate way to determine eligibility is to speak to one of the VA staff members. However, to get a general idea about what it takes to be approved for community care, the main requirements include: 6, 7

• Appropriate service is unavailable at the nearest VA facility.
• No full-service VA facilities are available in the state or territory of the veteran’s residence.
• The veteran qualifies under the so-called “Grandfather” provision, which determines eligibility according to the distance they must travel to receive necessary services.
• The needed services are unavailable to the veteran within a reasonable time and distance. This condition applies if the veteran:
  • Needs to drive longer than 30 minutes for primary or 60 minutes for specialist care;
  • No appointments are available within 20 days for primary care and 28 days for specialist services;
• The veteran’s best medical interest requires referral to a community provider, as agreed by the VA, referring clinician, and the veteran.
• Services available through the VA don’t meet designated standards of care.

How Does the VA Community Care Program Work?

Military veterans can receive the necessary and appropriate healthcare services through the VA community care program. This program works by referring them to local community providers. This is possible when the VA community care can’t provide the needed services even though eligibility criteria are met. However, before scheduling an appointment to receive the necessary service, the veteran must get authorization from the VA.4

Each veteran’s case is carefully examined according to their individual needs and life circumstances. When they get a referral from the VA, both the community service provider and the veteran are notified, so they can proceed to schedule an appointment. Either the VA staff or the veterans themselves can do scheduling, and sending the necessary medical documentation and referral information is the responsibility of the VA.5, 6

What Are the Costs of Community Care Programs and Services?

Most services utilized to treat any military service-related injury, illness, or mental health condition are free. However, a confirmation from the VA is needed before receiving the necessary service. Most services don’t require any additional payment by the veteran. Some veterans can be entirely exempt from any copay due to various eligibility factors. This is usually determined by their income, the type and severity of the service-related disability, or other specific circumstances.7, 8

If the type of care the veteran needs is unrelated to their military service, they’re usually charged a copay. Any other health insurance provider can cover this additional cost if the veteran has alternative insurance, like TriWest. If they don’t, the copayment rates, as of January 1, 2022, are the following:5, 8

• Emergency care is free or, depending on the number of visits and the veteran’s priority group, it may cost $30 per visit.
• Outpatient care requires a copayment of $15 for primary and $30 for specialist appointments, tests, or other services.
• Residential or inpatient care copayment rates will depend on the number and type of required services, length of stay, and veteran’s priority group.

What Is the Difference Between the VA Community Care Program and the Veterans Choice Program?

Both programs were created with the same purpose of helping military veterans ease back into their lives after deployment or getting the necessary care after service-related injuries. However, the Veterans Choice was an older program that ended on June 6, 2019. It was replaced by the Veterans Community Care (VCC) program, in compliance with the MISSION Act of 2018.6

If we compare these two programs, the main differences that the VCC has introduced are:6

• Expanded eligibility requirements that revised driving and waiting times to ease access to community care services.
• Streamlining of the billing process, thanks to a single program that allows manageable and timely payments to healthcare service providers, making finding suitable services easier.
• Better coordination and customer service. Reorganization of the internal process has simplified the coordination between community providers and the VA, and allowed for more accessible scheduling.
• Improved urgent care benefits. Easier and faster access to providers within the VA network because minor illnesses or injuries no longer require preauthorization.

What Are the Main Benefits of VA Community Care?

The VA Community Care Network (CCN) provides benefits to veterans as well as to healthcare providers. Some of the major ones are the simplified process of finding and getting the necessary healthcare services, and the wide selection of high-quality providers. The medical benefits package includes services like:9

• Diagnostics and evaluation.
• Various levels of care, from preventative and primary to specialist.
• Inpatient treatment, also called residential or live-in treatment.
• Partial hospitalization programs.
• Outpatient and intensive outpatient treatment programs. 

Enrolled veterans and their family members don’t need VA authorization to receive care from the VA‘s partner providers, so all beneficiaries can access a wide range of healthcare options best suited to their needs. For detailed and accurate information about available benefits, you can call the veterans community care program phone number:  877-881-7618. There’s also a lot of helpful information on the Basic Medical Benefits Package for Veterans web page.9

What Types of Treatment Can Veterans Get?

Behavioral health services are essential for military veterans. They include treatment for mental health issues and substance abuse disorders that frequently co-occur and aggravate one another. It’s important to note that behavioral and physical health are tightly interconnected, and many chronic conditions might occur as a result of failing to address the underlying mental health issues.10

Incorporating evidence-based therapy approaches is crucial when treating substance abuse disorders. Counseling or psychotherapy can improve the overall quality of life by teaching skills that can help veterans adopt healthier thought and behavior patterns and form connections outside of the military setting. Treatment focuses on rebuilding relationships with family and friends by strengthening communication and developing conflict-resolution skills. This is crucial for learning how to deal with triggers and lower the chance of relapse.11

Types of therapy with the highest rates of successful and lasting recovery include:12

• Cognitive-behavioral therapy (CBT).
• Motivational interviewing (MI).
• Dialectical behavior therapy (DBT).

Substance abuse treatments begin with the admissions process, which consists of an initial evaluation by a team of addiction experts and mental health specialists to determine the diagnosis and the potential presence of co-occurring mental health disorders. After that, the patients go through a medically monitored detoxification process, which sometimes includes the use of medication to alleviate the unpleasant and potentially dangerous withdrawal symptoms, followed by individual and group counseling.13

How to Find VA Community Care Network Providers?

The first step is to make an appointment with the VA staff to confirm eligibility and get prior authorization for community care. It’s necessary to make sure that VA CCN will cover the cost of the services you need. After that, veterans can choose between VA medical facilities and community providers. If you opt for community care, you’ll be asked to select a provider from the VA’s network.5

There are several options for scheduling appointments depending on the required service type. Veterans can do the scheduling themselves or ask a VA staff member to do it for them. If you decide to make your own appointment, the VA community care provider list is easily available through the Veteran Affairs facility locator. You can use it to look for suitable VA facilities and community care providers. Since the referral and your medical documentation need to be sent to the selected facility, it’s important to notify the VA when you schedule your appointment with the chosen provider.5

Frequently Asked Questions