Access to non-VA care no longer requires secondary approval

Millions of veterans rely on Department of Veterans Affairs (VA) for health care and face ongoing challenges of access, delays and administrative hurdles. In response, and in an effort to allow veterans to access care faster at facilities closer to home or with shorter waiting times, particularly as the VA's capacity and staffing face increasing pressure amid growing enrollment and recent budget debates, the VA has announced changes that will make it easier for VA-enrolled Veterans to access health care from non-VA providers at the department’s expense. Instead, the determination will rest solely on the veteran and their referring VA clinician.

Effective immediately, veterans no longer need a second VA physician to review and approve their eligibility to receive non-VA health care.

The policy seeks to reduce wait times and administrative bottlenecks for those who meet the criteria for community care as established under existing law.

“Under President Trump, VA is providing Veterans with more health care choices than ever before,” aid VA Secretary Doug Collins. “Now, we’re making it even easier for Veterans to get their health care when and where it’s most convenient for them. We are putting Veterans first at the department, and that means placing a premium on customer service and convenience. This important change will help us do just that.”

Since 2019, the MISSION Act has given eligible Veterans the option of seeking community care outside VA when they meet any one of these conditions:

-When it is in the best medical interest of the Veteran.

-The care required is not available at a VA medical facility.

-The Veteran lives in a state or territory that does not have a full-service VA facility

-VA cannot meet wait time or distance standards:

-VA cannot offer an appointment within 20 days for primary care, mental health or non-institutional extended care, or within 28 days for specialty care.

-It takes more than a 30-minute drive to reach primary or mental health care, or a 60-minute drive for specialty care.

-VA service does not meet certain quality standards.

-The Veteran meets the grandfathered distance and location provisions of the former Veterans Choice Program.

These decisions have been made jointly by Veterans and their referring clinicians but were not considered final until they were reviewed by a second VA doctor.

The new, streamlined process for determining best medical interest will be backed by training for Veterans Health Administration employees to ensure compliance with the Elizabeth Dole Act.