VA Community Care Guide: Rules, Eligibility & TRICARE
*TRICARE.Com is an independent reference site and is not a government agency. For official policy and enrollment, visit TRICARE.mil.*
## Quick answer VA Community Care is a program that allows eligible Veterans to receive medical care from private providers in their local community instead of at a VA facility. While similar to TRICARE in its use of private networks, it is a separate benefit managed by the Department of Veterans Affairs (VA) for Veterans, not active-duty service members or their families.
Details
VA Community Care was significantly expanded under the MISSION Act of 2018. It serves as a "safety valve" for the VA system, ensuring Veterans get timely care even if a VA facility is too far away or too busy.
### Eligibility Criteria To use Community Care, a Veteran must generally be enrolled in VA healthcare and meet one of the following six criteria: 1. **Service Availability:** The specific service needed is not available at a VA facility. 2. **Hardship:** The Veteran faces an unusual or excessive burden in traveling to a VA facility. 3. **Grandfathered Distance:** The Veteran lived more than 40 miles from a full-service VA facility as of June 2018. 4. **Access Standards:** The VA cannot meet "wait time" or "drive time" standards. As of 2026, these standards are generally 20 days/30-minute drive for primary/mental health and 28 days/60-minute drive for specialty care. 5. **Best Medical Interest:** The Veteran and their provider agree it is in the Veteran's best interest to see a community provider. 6. **Limit Quality:** The VA facility providing the service does not meet specific quality standards.
### How it Works with TRICARE Many retirees are "dual-eligible," meaning they have both TRICARE (Prime or Select) and VA healthcare benefits. * **Separation of Benefits:** You cannot use TRICARE and VA Community Care for the same invoice. * **Primary Payer:** If you are treated for a service-connected disability, the VA is the primary payer. If you are treated for a non-service-connected issue, you can choose to use TRICARE or the VA, but the VA usually requires prior authorization for Community Care. * **Urgent Care:** Under the MISSION Act, eligible Veterans can use "Value Mission" urgent care providers without prior authorization, though a small copay (varies by 2026 priority group) may apply.
### Regional Management The VA Community Care Network (CCN) is divided into regions. In 2026, these networks are managed by: * **Regions 1, 2, 3, 5, and 6:** Managed by Optum Serve. * **Region 4 (West):** Managed by TriWest Healthcare Alliance. (Note: This is the same contractor that manages the TRICARE West Region).
## Who this affects * **Veterans:** Who are enrolled in the VA healthcare system. * **Military Retirees:** Who are dual-eligible for TRICARE and VA benefits. * **Medal of Honor Recipients:** Who have unique access to VA care. * **Note:** This program does **not** cover TRICARE-only dependents (spouses/children), who must use TRICARE Select or Prime networks.
## Sources * **VA.gov:** [Community Care Overview](https://www.va.gov/communitycare/) * **TRICARE.mil:** [Using the VA as a TRICARE Provider](https://www.tricare.mil/GettingCare/AllProviderListings/VA) * **TriWest Healthcare Alliance:** [Veteran Services](https://www.triwest.com/en/veteran-services/) * **Defense Health Agency:** [TRICARE and the VA](https://health.mil)