VA MISSION Act: What to expect for community care on June 6


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Note: This article is one of a series on VA’s progress implementing the VA MISSION Act of 2018.

As the one-year anniversary of President Trump’s signing of the VA MISSION Act of 2018 (the MISSION Act) approaches on June 6, Veterans can expect to have more choices than ever in getting timely, high-quality care.

VA is required to implement major parts of the new Veterans Community Care Program under the MISSION Act by June 6, 2019.  This new Program will become effective after VA publishes implementing regulations.

Veterans should expect a fairly transparent and seamless transition to the new Veterans Community Care Program.  After June 6, VA cannot furnish care under the Veterans Choice Program (VCP). The two other most important changes that become effective on June 6 include:

Veterans should continue to talk with their VA care team about the best way to get the care they need—either from a VA medical facility or community provider. As they do now, Veterans may also need to pay a copayment for care for nonservice-connected conditions, just as they would if they received care at a VA medical facility.  Special copayment rules apply to the new urgent care benefit.

Sunset of Veterans Choice Program

Starting June 7, 2019, VA can no longer furnish care to eligible Veterans under VCP.  As a result, VCP eligibility criteria will no longer be used to determine eligibility for care beyond that date. To prepare for the end of VCP, VA has already begun transitioning its authorizations for care away from VCP in advance to make sure Veterans do not experience a lapse in care after June 6, 2019.

Certain Veterans that were eligible under VCP based on distance may still be eligible to receive community care after June 6, 2019, under the “grandfather” eligibility criterion established under the MISSION Act.

Veterans who were eligible for community care under VCP should speak to their VA care team or a VA staff member at their local VA medical facility about their eligibility for community care after June 6, 2019.

Veterans can call the VA Adverse Credit Helpline at 877-881-7618 for help resolving adverse credit reporting and debt collection issues as a result of using community care.

Going Forward

Even with all the expected improvements in community care, the Veterans Community Care Program will continue to serve as a supplement to the outstanding health care VA provides to Veterans in-house. VA employees are passionate about caring for Veterans and are highly experienced in meeting Veterans’ specific needs. Because of this, VA believes Veterans will continue to choose VA.

Resources

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. kasey00    

    Wish they would answer the phone…I will say they were very quick to act and get me scheduled for needed care, but I’m getting bills now and all I do is sit on hold, every time I call.

  2. kasey00    

    Wish they would answer the phone…I will say they were very quick to act and get me scheduled for a tumor that grew very quickly, but I’m getting bills now and all I do is sit on hold, every time I call.

  3. s gerhard    

    The Community Care plan worked for scheduling appointments with Dermatologists to remove skin cancer through microsurgery here in Reading, Pa. The reason was that the VA hospital could not schedule an appointment until 3 months later. The VA hospital is 38 miles, 58 minutes travel time to Lebanon, Pa. Coatesville VA hospital is 31 miles, 50 minutes away. Closer! Maybe visiting there would be an alternative. So, Community Care worked with local providers in my case.

  4. Robert Truax    

    From my experience and my point of view: “VCP was a failure for me. VCCP has been a failure for me. Mission Act is a failure for me.” All I have ever been satisfied with is my going to the nearest VAMC to where I live and my receiving at that location the medical needs which I have.

  5. Ned Winans    

    Same BS different name. There are no urgent care providers in San Luis Obispo county California who will accept VA patients. One office had No VA written on their Triwest form in office. The medical establishment knows not to work with the incompetence of the VA system.

    1. Harold Buchanan    

      Thank you fThank you for the information. I travel to SLO town and it helps to know there is no medical care there for veterans.or the information. I travel to SLO town and it helps to know there is no medical care there for veterans.

  6. Bill Gensmer    

    I was worried that the Mission Act would be a disaster, and it looks like I am right so far.

    The entire Mayo Clinic health system had the option to “opt out” of most VA community care programs Nationwide, and they have done just that. Honestly I do not blame them. The VA is very slow to pay, pays the same or less than Medicare for covered services, and at the same time wants providers to jump through all kinds of additional hoops and stipulations before they will even begin to process any payment or claim.

    The main Mayo clinic in Rochester was actually willing to still work with the Minneapolis VA, Tomah WI, and several other local VA clinics on a case by case basis like they have in the past, but under the new laws Mayo cannot do this. It is basically an “all or nothing” inclusion for all veterans, meaning the entire Mayo Clinic health system nationwide would be forced to approve veterans that wanted any kind of specialty care immediately. This would put an incredible burden on them financially as well as being hindersome to new patients who qualify for treatment with timely care.

    My VA PACT team nurse was literally stressed to the max and in tears yesterday at the backlash she was receiving from veterans who were Mayo Clinic patients as well as others who have been left in the dark and/or forced to find a new provider. She suddenly has a lot of chaos to deal with because of the VA’s carelessness. This is in addition to how stressful her job is to begin with.

    I have stage 4 esophageal cancer, and I enrolled in a clinical trial at the Mayo Clinic in Rochester nearly two years ago that did everything short of cure me. Under the new Mission Act, After September 30th I will no longer be able to be seen at the Clinic that likely saved my life so far and did everything short of a miracle. To receive the same medication that I receive at the Mayo Clinic in Rochester, I will now have to drive over 3 1/2 hours, one way, every two weeks to a new facility.

    Before you go boasting about how great something is, be sure and read the “fine print.”

  7. VICCTRIA    

    No cards for this program

  8. Al    

    Mission Act is the beginning of total privatization, Thank you President Trump!!!!!

  9. Bill    

    I’m seeing all the negative out there. I had a good experience just now. Reed in the Va mission act email i received today if we had any bills from hospital visits that was in collections to cal that number. I did, I had two bills in collections one for $3763.00 and another for $856.00. Within 30 minutes those two bills were cleared up. I want to thank the lady in the Claim Status & Billing dept. For treating me as i should be treated. Good Job.

  10. anne snow    

    To Steve LeBard on June 5:

    Oh, poor Steve! Trump isn’t “fixing” the VA system! He’s making things work worse so he can pave the way for PRIVATIZING the VA to the point of eradicating it completely. In back of all this is kowtowing to Big Pharma and lining the pockets of those in the medical industry. “Fixing” the VA with the Mission Program is merely the first stepping stone to achieving his (2016) goal of getting rid of the VA.

    The Department of Veterans’ Affairs is responsible for “fixing” the VA. It’s Trump’s job to find the right Director.. So far, he hasn’t done that. Deliberately.

  11. Sue Churchie    

    The Mission Act is not working as it should. In the Houston VAMC they do not help you . They are confused. The ACT was supposed to enhance the VC program but it has failed to do that. Call the White house hotline for veterans and then you can get results. White House VA Hotline: 1-855-948-2311. Calls are answered by a live agent 24 hours a day, seven days a week, 365 days a year.

  12. Ekim Sharedit    

    Same sh*t different pile. I said F va care years ago and use my disability payment to go to my doctor 5 minutes from my house. Beats driving 30 miles and dealing with unhappy providers. VA blows C and I will never trust them; ha! never trust a C sucker. Just keep sending my checks and we’ll be okay with each other.

  13. Tom Lassek    

    The Department of Veterans Affairs (DVA) in general, and the Central Alabama Veterans Health Care System (CAVHCS) specifically, is a pox attached to the backs of every Veteran. Take this Change in the law option under the Mission Act to obtain civilian healthcare and minimize your exposure to substandard medicine under the DVA. Compare complaint number of Civilian Medicine caregivers to that of the DVA. Why can’t Veterans have equal care under civilian caregivers like the rest of Americans ??

    1. Veteran    

      Wow. Sometimes the system gives back what you put in

  14. Thomas E. Lassek    

    The Department of Veterans Affairs (DVA) in general, and the Central Alabama Veterans Health Care System (CAVHCS) specifically, is a pox attached to the backs of every Veteran. Take this Change in the law option under the Mission Act to obtain civilian healthcare and minimize your exposure to substandard medicine under the DVA. Compare complaint number of Civilian Medicine caregivers to that of the DVA. Why can’t Veterans have equal care under civilian caregivers like the rest of Americans ??

  15. Michael G. Adkins    

    I have waited 2 months for an MRI appointment for prostate cancer and still I am waiting! I don’t see where this system is working for community care. It is so hard to even contact them and when you do get through all they can tell you is that it has been alerted and sent to scheduling! Looks like I’ll die of cancer before I get the appointment.

  16. james robert stewart    

    Forget all U.S. help on any manner of problem you may have this is the DIGITAL AGE OF DEATH.
    Overseas veterans citizens of the U.S. Have no method to correct the smallest problem problem if you have no home address in the U.S. or Phone number in the U.S.
    Try to go to the nearest V.A. Hospital you need an appointment first. Try to fill out request for Appointment [Digital first enter your U.S. address no address form can not continue.]
    Try to use medicare i have a error on my medicare they have my date of birth wrong. How do you correct this ? You call S.S. [ i know when i was born i was in the military for 8 years i have my Passport from the the embassy that has my date of birth. I have Social Security [Am 78 years old] The embassy renued my passport less than a year ago. S.S. says since i live outside the U.S. [ on hold to get live person on phone for 3 hours with S.S. ] S.S. says they can do nothing to fix the error. [Birth date wrong medicare use denied] I must contact the EMBASSY in the country ware i live. I live in the Dominican republic.
    You can only contact the embassy for this type of problem DIGITALLY internet. I send in request to resolve this problem. They respond via email telling me to fill out form to change address that is not the problem my birth date is the problem. After more than 3 email attempts they say they are aware of the problem and will get back to me within 15 days. That was over a month ago i request appointment that is ignored no appointment i request phone number to talk to a living person no reply. I try to contact medicare myself can not do to no U.S. address or phone number. Tried to use friend’s address notice said i am being investigated for by using others address.
    SO OVERSEAS VETERAN you are a forgotten citizen of never never land. Try as best you can but you cannot reason with digitally formatted request for services as they do not accept anything not required by the digital request form. I will just forget V.A. — Forget that i have medicare– forget that i have a U.S. Embassy and just DIE.

  17. Sam    

    Under this can get I get a primary doctor outside as a 100 percent

  18. Robert Patrick Rayl    

    Does this replace Tri care? I am 100% DV service connected. VA doesn’t treat my condition in house so I need referral outside however my choice of neurologist does not accept Tri Care. I am content with my primary doctor at BA it’s just for the one condition spinal stenosis. Looking at decompression surgery. How will mission act work for me. Is there a cost to me. Will VA pay for my choice of Neurosurgeon

  19. Ronald    

    Does this Act also cover a serious dental issue for me as a VA rated 100% combat disabled vet?

  20. Sean stoots    

    For anyone confused, heres my example. I need a medication that the VA does not offer. So, I asked to see an outside doctor. I was told that in order to qualify for that, I would have to be waiting for an urgent appt extending past a month’s time, have a service need that the VA does not provide and even then, IF i qualify for that – a meeting takes place where “they” decide if they WANT to send me to an outside clinic or not. But, for my troubles, I was offered a plethora of terrible meds that they have doped me up with in the past that never worked.

  21. Ron E    

    VA NEEDS TOO DETERMINED WHAT A VETERAN Q QUALIFICATIONS MUST. A solider is not a veteran just because they served in the military.

    1. Billy Weaver    

      I am sure that your statement means that your time in the service makes you better than someone else that served this country also. Condecending sucker. Go ahead and tell us what makes you so special Golden Child. Look down on other veterans from your high horse and tell them why they don’t matter. Why the VA should turn their backs on them….leave them behind…blackball them. Are other veterans that served this country in your way? Maybe you would feel different if you were at the front of the line you selfish, self centered excuse for US serviceman. Which of our brothers or sisters should the VA ignore? Tell us. We are listening.

  22. charles a adams    

    What do we do, SPECIFICALLY, to get local care if we are too far away? All these articles say we have it but don’t tell us how to get it. Step by step-what do us old vets do to get a local Dr? Some of us are not all that computer savvy and need to have easy, NO Jargon, instructions. You are telling us we have all these great things but not telling us what to do to get them for ourselves. Thanks

  23. Reynold Dlueck    

    Oh yes… I forgot to mention… I have to wait over 4 month to see my regular VA doctor. I was having pain in my left shoulder,
    pain in my left center chest, shortness of breath, and allergy problems…I went to the VA Urgent Care, and I left with a bottle of Allergy Pills and told to wait until I could see my reg. VA doctor… I asked for the cat scan on my chest to see what was gong on there… it is over six weeks and I still don’t have an answer????

    Don’t waste you time going to Urgent Care… They can only help or maybe help you with just one problem. I have known one of the Doctors in the Redding VA Clinic for over 19 years when he had his own Medical Practice and he was good then. Right now he is over regulated and over worked and isn’t helping solve medical problems at this Clinic… Period…

  24. Reynold Dlueck    

    I am very unhappy with my local VA Clinic and the VA Clinic in Sacramento… I have been told that I have a mass in my left center upper chest… I was given a cat scan and have been waiting over 6 weeks for an answer why am I having pain there.

    Over a year ago the power assist Chair/Scooter that the Redding VA provided for me was stolen. I have requested three times for a replacement and have been turned down three times… The VA sends me Xerox copies of a form letter with NO signature denying my request…

    I just ran a copy of the U.S. Dept. of Veterans Affairs… News Letter… Quote…”Getthe care you need when and where you need it”

    I will believe it when I see it !!!!!!!!!!!!!!!!!!!!1

    It’s a Lie…………….

  25. Charles Anthony    

    The “Veteran’s Choice ” program was anything but. My hand was painful and my PCP had X-rays taken. The next day I was contacted by Tri-West. They chose a Dr. for me. I was assigned to Tri-West who then assigned me to a Dr. If the Mission program is run like the Veteran’s Choice program, there will be a Third Party Administrator. So, this time the Mission program will be administered by Healthnet a TPA. To me, it sounds like the Choice program warmed over only the TPA has changed.

  26. Steve LeBard    

    Mr. Maynard posted this on one of the links here. I’m reposting it because I believe it to be truth.
    “The bottom line with the new Community Care program is that the VA is trying to protect its jobs by making it difficult for veterans to get care outside of the VA system. Veterans Choice was working well. Now I have to jump through hoops to get authorizations, whether new or renewal. Veterans should simply be given the choice to use VA system or use civilian facilities, period. I shouldn’t have to run over to my primary care provider to get an authorization. The VA system is great for veterans who have nothing but time on their hands and want to spend the day at the Medical Center and hang out waiting for various appointments. It is horrible for those of us that work and have responsibilities. My VA doctor actually suggested that I use civilian insurance instead of the VA. Just give veterans the choice they deserve and stop forcing them to deal with the bureaucratic nightmare of the broken VA system. The VA keeps trying to fix itself, but it is not working. Just give us choice like civilians have.”

  27. Steve LeBard    

    Thank you President Trump for looking out for Veterans. This system has been broken for a long time and it took a non politician to fix it!

  28. Steve LeBard    

    “VA is required to implement major parts of the new Veterans Community Care Program under the MISSION Act by June 6, 2019. This new Program will become effective after VA publishes implementing regulations.”
    The VA is required to implement …….by June 6, 2019………but…….the new program doesn’t become effective until the VA publishes implementing regulations. This makes no sense!

  29. Bill Johnson    

    How convenient will the urgent care locations be? When will we get info on these locations?

    1. Bradford Scales    

      LOL! In Southern Indiana the urgent care facilities are only in CVS Pharmacies! I wonder who got that kick back ?

  30. Earl John    

    It’s basically the same as the Choice Program by Obama, except it’s not just about distance. It’s about wait times,

  31. Vernon Cole    

    I have just had my first experience with this new program. It is very complicated. The Choice program was a lot better. I just had to give my Choice Card to the doctors admin and the VA was charged. Under this program there is a six month window. For instance, I had to see my private Cardiologist because he did the surgery on my heart. He sent me for an ECHO on my visit that was done five days later. Some how the window had closed prior to my office visit and reopened afterwards, but before the ECHO. I was charged for the office visit, but the VA covered the ECHO. It didn’t make sense and took three calls to the VA Undersecretaries office. They got the office paid, but told me from now on to get my VA team to request coverage two months prior to my visit. What happens if I don’t have 2 months before that visit? Should have kept the Choice program.

  32. Paul S. Berger    

    Very interesting!
    I will be looking for more information so that I can see my eligibility.

  33. Paul S. Berger    

    Very interesting.
    I will be looking for more information so that I won’t miss my eligibility.

    1. Vernon Cole    

      Probably, the doctors and the VA admins don’t even understand it.

  34. Dennis Kraynak    

    Do we need a lawyer to understand this? What exactly is community care?

  35. Dennis Kraynak    

    Do we need a lawyer to understand what this is about? What exactly is considered community care?

  36. Valentino O. Garcia Jr.    

    Can VEts who are 100 pct get PT without having to travel into town

  37. Dennis Earl Allen    

    THANK YOU PRESIDENT DONALD J. TRUMP AND SECRETARY WILKIE FOR ” PROMISES MADE, PROMISES KEPT.” AS A VIETNAM VETERAN I FEEL WE ARE FINALLY GETTING THE HELP WE NEED, A LONG TIME COMING?……….THANK GOD!!!

    1. Charles Anthony    

      I have found that the quality of care at the VA depends on what state you live in. In FL it’s called the Florida Department of Veteran’s Affairs. They have a world of their own, detached from reality. I’m in Las Vegas. The care is great. Long Beach, CA is great but N. Carolina, not so much. Each state administers the VA differently. The VA needs to decouple from the Feds. Reagan said that the scariest words are, “I’m from the Federal Government and I’m here to help”.

    2. Carlo Castoro    

      Have you been in a coma? Me and millions of veterans have been getting great care at the VA.

    1. Ronald    

      As a 100% VA rated disabled combat veteran does this benefit also include covering a serious dental issue?

  38. Robert Leon Humble    

    Does this mean I can use my personal Dr. for my VA business?

  39. Steven Ray Blum    

    I have a rheumatology appt June 17 from choice. Have not been since November even though I am supposed to go every 3 months for review. Thought my approval letter was still valid, but not sure after this article.

    1. Kittie Dailey    

      Steven Ray Blum,
      Go to your Rheumatology appt. I developed RA & Sjögren’s from Depleted Uranium in Iraq. VA knows but really doesn’t care unless it’s an injury. They don’t seem to understand how to care for those exposed to Hazardous Environments or Hazardous Weapons. But I refuse to give up. Just go see the Rheumatologist. It can eventually worsen to affect your intestines and major organs. Trust me, Inflammation takes on a whole new meaning when out of control and no treatments work. I’ve been on 7-different RA & Sjögren’s Treatments. Nothing worked. It’s because of the nature of the exposure that activated my RA to begin with.

  40. Ronald Clark    

    Veterans who have Medicare should be able to go to a local physician and have VA pay the difference under Medicare guidelines. VA local facilities do NOT treat patients there. The hospital is too far for us to go to as old people. My physician told me directly that they do not treat patients. I have had a number of times that I have waited at the local office for care and then told they could not help. I left in severe pain without care.Crap service.

    1. charles a adams    

      How do you do it? Who do you call first. My Dr knows nothing about it.

  41. Richard Wayne Frazier    

    What does mission act orovide for veterans overseas

  42. Earl    

    So, I’m on the 40+ program. Will I continue to keep my PCP outside the VA ? Will I receive a new card ?

    1. Sue Churchie    

      We are all trying to figure that out. I asked the person in charge in Houston and they don’t know the answers. We have been having difficulty getting SAR’s approved since the switch. We had to get with the VA doctor to get approvals. Its an extra step we didn’t have to do before. The VA has made this hard and will not approve like they use to. White House VA Hotline: 1-855-948-2311. Calls are answered by a live agent 24 hours a day, seven days a week, 365 days a year.

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