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July 8, 2019

New changes with the VA Mission Act

Last updated on December 23, 2022

I hope you enjoy reading this blog post.

If you want to learn how to implement these strategies to get the VA benefits you deserve, click here to speak with a VA claim expert for free.

Here ye here ye – as of June 6, 2019, the VA Mission Act allows more ways to access health care by means of approved non-VA providers, including new urgent care access through a wide network of walk-in retail and urgent care clinics.

The objective of the VA Mission Act is to bring better health care options to Veterans through high-quality facilities. Including telehealth, VA facilities, and other options in your immediate community. We are excited about this shift to better health options.

Community Care

Existing programs like the VA Mission Act will fall into one of these programs to remove the complexity of processes and provide better customer service. The expansion of community care providers will be managed and administered through 3rd party agencies however, the VA will work directly with the veterans to schedule community care appointments. VA Community Care Program 

VA Mission Act Eligibility

With VA approval, the veteran will only have to meet one of the six eligibility requirements to qualify for a Community Care option:

  1. The veteran needs a service not available at a VA medical facility
  2. Veteran lives in the U.S. or territory without a full-service VA medical facility 
  3. Veteran qualifies under the Grandfathered provision related to distance eligibility
  4. VA cannot provide care within certain designated access standards
  5. It’s in the veterans best interest 
  6. A VA Service Line does not meet certain quality standards

Here’s a video that discusses the eligibility requirements for Community Care and how to schedule an appointment – VA Community Care Rollout

Urgent Care

Can only use the benefit at VA approved clinics. The veteran will be held responsible to pay-in-full if they use a clinic outside the VA’s contracted network.  VA Urgent and Walk-In Retail Medical Care Program 

Eligibility

Veteran must be enrolled in the VA health care system and received care through the VA from or community provider within the past 24 months. You may enroll online, mail or in person, to sign up go here.

To make appointments with a non-VA provider, you must first receive approval from the VA. Find out how to schedule appointments here.

Copays

Depends on the veteran’s priority status and how frequent they use the urgent care clinic

Priority Groups: 1 – 5 – No copays for the first three visits during a calendar year – four or more visits per calendar year is $30

6 – If the visit is related to a condition by special authority or exposure such as Agent Orange, contaminated water at Camp Lejeune, part of the SHAD/Project 112, Military Sexual Assault, psychosis and other mental health issues – first 3 visits per the calendar year is $0 – four or more visits per calendar year is $30 – If the veteran does not have a condition with a special authority and a part of priority group 6 will pay a $30 copay fee. 

7 & 8 $30 copay per visit

1 – 8 $0 copay for a visit of only the flu shot

As the new Administration continues to make progress within the Veteran Affairs agency, they still have a long road ahead. However, with initiatives like these which provides a seamless process of receiving the medical treatment, we deserve within in a timely manner is outstanding (that’s coming from a VA frequent flyer). Now if we can only get the compensation we’ve already earned and deserved…that would be a true reflection of appreciation for one’s service.


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VA Claims Insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible independent medical opinions and nexus statements (medical nexus letters) for a wide range of disability conditions.

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