VA MISSION Act: Answers to questions about VA’s urgent care benefit



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

Have a sore throat, earache, or strained muscle? Then consider contacting your VA facility or using the community urgent care benefit available to eligible Veterans under the MISSION Act.  VA facilities across the country offer same-day primary care and mental health services, and many offer additional services as well. With the new community urgent care benefit, eligible Veterans can also visit a local walk-in retail health clinic or urgent care center that is part of VA’s contracted network. Urgent care providers treat non-emergent symptoms or conditions such as ear infections, minor burns, and mild skin infections.

If you believe your life or health is in danger, call 911 or go to the nearest emergency department right away!

To be eligible for the urgent care benefit, you must be enrolled in the VA health care system and have received care from VA (either in a VA facility or a community provider) within the past 24 months. To check eligibility, contact your local VA medical facility or call 1-833-4VETNOW (1-833-483-8669).

Eligible Veterans can receive urgent care from an urgent care provider in VA’s contracted network without prior authorization from VA.

Top 10 Frequently Asked Questions:

1. How do I find the nearest in-network community urgent care provider?

Use VA’s Facility Locator at https://www.va.gov/find-locations/ and click on the VA-approved urgent care locations and pharmacies near you. There are currently two types of urgent care network locations: walk-in retail health clinics and urgent care centers. Seek care at a retail location for an uncomplicated illness such as a sore throat. Visit an urgent location for more pressing illnesses or injuries requiring services such as splinting, casting, or wound treatment.

2. What do I do when I arrive at an urgent care location? What type of identification will I be asked to show?

There is no identification card needed for VA’s urgent care benefit. When you arrive, verify they are part of VA’s contracted network, complete the intake form, and tell the provider you would like to use your VA urgent care benefit. The provider will check your eligibility. Both Veterans and providers can call 1-833-4VETNOW (1-833-483-8669) to confirm eligibility. Veterans can call 1-866-620-2071 for other issues related to the urgent care benefit.

3. Does urgent care cost anything?

No, you do not have to pay anything at the time of the visit. If you owe a copayment, VA will send you a bill. Copayments are $30, but your liability will depend on your assigned priority group and the number of times you have used your urgent care benefit in a calendar year. Learn more about urgent care copayments.

4. How does prescription medication work for urgent care?

VA will pay for or fill prescriptions for urgent care. For routine prescription medication longer than a 14-day supply, the prescription must be submitted to VA to be filled.  Before filling the prescription, VA will verify the urgent care visit. If there are issues with filling your prescription, call 1-866-620-2071.

5. There are no urgent care clinics in my area. What do I do?

Contact your local VA medical facility to discuss options. Same-day primary and mental health services are available at all VA medical centers. In addition, VA continues to expand its contracted network of urgent care providers so that most Veterans are within a 30-minute drive time from their home to a network urgent care/retail location.

6. If there are no in-network urgent care facilities nearby, can I visit an Emergency Department (ED) instead?

If you are having difficulties receiving urgent care services, contact your local VA medical facility. Same-day primary and mental health services are available at all VA medical centers. If you believe your life or health is in danger, call 911 or go to the nearest emergency department immediately. Please note that VA can only pay for a Veteran’s emergency care under certain conditions.

7. Can I use the in-network urgent care provider at my local pharmacy as my primary care provider (PCP)?

No. Urgent care is not a replacement for services your PCP offers. Use urgent care for treating minor, non-emergent illnesses and injuries. The urgent care benefit does not cover preventive health care offered by your primary care physician. Always consider talking with or seeing your PCP if you are concerned that the urgent care provider will not understand the complexities of your medical history or medications.

8. How do I know if I need urgent care or emergency care?

Urgent care is for non-life-threatening illnesses or injuries such as strep throat, pink eye, or a strained muscle. Emergency care is for an injury, illness, or symptom so severe that a prudent layperson reasonably believes that delay in seeking immediate medical attention would be hazardous to life or health. Such life-threatening major illnesses or injuries could include severe chest pain, seizures, loss of awareness, heavy uncontrollable breathing, or severe burns. For emergency care, call 911 or go to the nearest emergency department right away. Please note that VA can only pay for a Veteran’s emergency care under certain conditions.

9. What if I arrive at an in-network urgent care location and have difficulty receiving care?

Call 866-620-2071 or your local VA medical facility.

10. How do I get a free flu shot?

Veterans can receive a flu shot at their local VA medical facility or from any Walgreens location, paid for by VA. Veterans can also receive a flu shot, paid for by VA, at an in-network urgent care location, but it must be administered in conjunction with a condition requiring urgent care.

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. Chuck Neely    

    Have you ever gotten a copy of what the VA employee charted after your visit? It is amazing what these ungrateful people do. One example: I asked for a copy of a hearing test and got all of the info documented in that visit. I was surprised to see the audiologist charted that I worked around loud machines. I filed a complaint to region. The region deferred it to the employee who of course stated that I told her I did work around loud machines. The VA supported the employee and reused to modify the record, basically calling me a liar.

  2. Carol Douglas    

    My question is “What is the difference between Immediate Care and Urgent Care?” when I go to our local clinic they say they are immediate care and not covered under VA, but below it says “local walk-in retail health clinic” would that not be immediate care? To me what you described above as urgent care, they are doing the same thing, sore throat, earache, strained muscle, etc.

    (1st paragraph above: Have a sore throat, earache, or strained muscle? Then consider contacting your VA facility or using the community urgent care benefit available to eligible Veterans under the MISSION Act. VA facilities across the country offer same-day primary care and mental health services, and many offer additional services as well. With the new community urgent care benefit, eligible Veterans can also visit a local walk-in retail health clinic or urgent care center that is part of VA’s contracted network. Urgent care providers treat non-emergent symptoms or conditions such as ear infections, minor burns, and mild skin infections.)

    I would really love someone to reply to me email regarding this please.

  3. Earl kisiel    

    Can we use the shades of green in Orlando?

    Can we get discount tickets through MWR?

    Can we start using the Fam camps in January?

  4. Richard C. Anderson    

    ARE YOU KIDDING……IT WOULD TAKE YEARS TO MEMORIZE EVERY ITEM IN THIS VIDEO TO UNDERSTAND HOW, WHERE, WHO, WHAT DOCTORS, WHAT AILMENTS , WHEN TO GO, WHEN NOT TO GO, ON AND ON AND ON………

    THE MARINE CORPS TAUGHT ME AN IMPORTANT PHRASE TO MAKE THE “CORPS” BETTER AND MY LIFE BETTER….
    …………………………………………KEEP IT SIMPLE STUPID !!!!!

    YOUR VIDEO IS FAR, FAR FROM SIMPLE……….HERE IS MY SUGGESTION:
    I HAVE A “CREDIT CARD”…..WITH THIS SINGLE PIECE OF PLASTIC, I CAN BUY ANYTHING, I CAN TRAVEL IN PLANES, BOATS, TAXIS, I CAN EAT AT ANY RESTAURANT IN THE WORLD, STAY IN ANY HOTEL IN THE WORLD, ATTEND ANY SPORTING EVENT…..ANYTHING THAT COSTS MONEY…..I JUST GIVE THEM THIS PIECE OF PLASTIC AND POW, IT WORKS, I’M IN, I’VE GOT IT……I’M GONE.

    NOW……LISTEN CLOSELY…..WHY IN HELL CAN’T THE VA GIVE EVERY QUALIFIED VETERAN A PIECE OF PLASTIC CALLED A……”VA HEALTH CARD”……THAT CAN BE HANDED TO ANY HEALTH FACILITY, ANY DOCTOR, ANY HOSPITAL OR EMERGENCY ROOM AND “POW”……THE VETERAN RECEIVES THE MEDICAL CARE HE NEEDS????????????

    “KEEP IT SIMPLE STUPID”……THAT’S WHAT THE MARINE CORPS TAUGHT ME. NOW PLEASE, PASS THIS ON TO YOUR SUPERIORS.

  5. Jennifer    

    There needs to be a lot of fixing with this program. I have had two community providers drop me in the middle of procedures because the VA has not been paying them. This is not acceptable!! After they drop you, it takes another two or more months to find new ones and having to start over from the beginning! It’s horrible. I had (and still do have) to wait 30 days between each appointment for the provider who is treating me for severe TMJ because each appointment (same ailment) has to be approved. It has been over a year that it took to get the appointment, a month each before I can see them again from getting an Xray, in between visits, fitted for a splint to getting the splint. If I could of gone after the doctor was approved, it would of taken maybe three months to get to where I am now, over a year ago. I endured so much more pain than I should have because of how ridiculous this is. About the prescriptions. I paid for over $250 for my own prescription that was needed ASAP. Because I do not live near a VA facility and it has to be approved by my VA PCP and then goes to pharmacy, IT TAKES NO LESS THAN 2 WEEKS TO GET IT. If we get community care because of our location why can’t the VA have some sort of program to help us get our medication in the community so we too can get it that very same day, AS THE FORTUNATE PEOPLE WHO GO TO THE VA CAN OBTAIN?? All they have to do is see Dr., get prescription and go to the pharmacy to get their medication that same day. This program is not cracked up to be what people see and that angers me. It takes months to get approved for a procedure,even after being approved for the provider, which also takes months. It took me almost a year to get a dentist and to begin getting the work done that I needed, not to mention the dropping of vets because of non payment. I now have to start from the beginning. I am so frustrated every time I need something. I went through hell in the military I don’t need to go through it now just to take care of my health. I have already reached out to the many people about these MAJOR problems. And trust me nothing has been exaggerated. They have been down played if anything. I am now going to my congressman. I want…deserve to know why this program does not function as it should. I realize there are people have had no problem and good for them. I posted this on a women’s disabled vets facebook page and the responses I received from people all over the US was staggering. It is happening all over the country and some of the stories I read are not even close to what I have to (and still do) deal with. I know I try to deal with a lot of my problems, myself, physical and emotional because of the frustration and angry it brings up in me trying to get anything done for myself. I will continue to fight this until people realize the problems of this program. The first step is to admit the problems and shortcomings and stand up to do better.

  6. Gary A Johnson    

    Call the White House Complaint line and file a complaint !!! I had to use it to get my much needed medication, and boy, I got responses within a week !!!
    1-855-948-2311

    President Trump set this up last year, and it’s mostly run by Veterans I believe. They will take an earful and fill out a complaint as best they can !!!

  7. Charles Roberts    

    Went to your link listed under #1 above for urgent care locations and in VA fashion , the link never loaded after 10 min wait.

  8. J. Hall    

    Regarding above question #10: I tried two Walgreens within my community, I had the form with the VA insurance code and directions to pharmacist, I showed them the Walgreens site touting the program as well, and spite of all that, both pharmacists told me that their Walgreens location would not provide a veterans flu shot. During autumn 2019, I was turned away by two separate Walgreens locations near Annapolis MD for the flu shots. So it isn’t “ANY Walgreens location ” It is only CERTAIN participating Walgreens.

    Stop putting out erroneous information. I am sick of getting VA emails, and advertisements, and blog entries like this one, that promise more than is actually true.

  9. James Grimsey    

    That is exactly my concern. I had my teeth fixed up by the Navy about 40 years ago. Now they are all deteriorated. I can’t afford a dentist to fix them up and I’ve found no one that can give me any direction. Right now I’m thinking about out of country to get this done as it may be the only solution.

  10. A. Sanchez    

    I have Esophageal Cancer and I need to find out how can the VA take care of this. The Bills are streaming in and I can no longer work. The VA in Decatur GA was a hamster wheel, AND the Phone system is impossible to talk for directions. 2+ hours being redirected, placed on hold, and finally a dial tone?!?

    3Ds

    1. Doug Dockter    

      Did you know that the American Legion, DAV, and VFW have field service officers and claims advocates that can help you? They will help you. Also, every VA hospital and medical center has an Ombudsman’s office that can help. All of this is free to the veteran.

  11. Freddie J Kimball    

    Urgent Care Benefit to eligible Veterans under the MISSION Act of 2018. Does this cover Military Retirees and Veterans in Republic of Panama and how does it cover us.

  12. Wally Hines    

    “If there are issues with filling your prescription, call 1-866-620-2071” GOOD LUCK WITH THAT. One pharmacy said they can’t afford to have someone on hold for over half hour trying to get the prescription authorized. 4 times now I’ve used urgent care and they can never get the script authorized. I called and got bounced from 4 people and after over an hour STILL had to pay out of pocket.

    1. Susan Smith    

      I have used this numerous times and the doctor part is fantastic but I continuously have problems getting the medication filled at a pharmacy that is working with the VA. I have had to pay out of pocket because CVS and Walgreens tell me they don’t accept it. I call the number that is on the paper and I am told one story and then the pharmacy tells another story. They keep asking for a new card and they continuously tell me that my coverage has ended. When I ask them to call the number to talk to someone they say that don’t do that. I went today and now CVS tells me no that I have to pay for it over $100.

  13. Levant Grayson Dunning    

    I live outside the USA, I have a VA Health Card issued several years ago, I would like an updated card, Since I live outside of the US how do I get coverage here if needed? Regards, Levant Frayson Dunning

    [Editor: PLEASE DO NOT PUBLISH YOUR PII ON THE INTERNET. This includes SSN, DOB, home address, contact info…]

  14. Jimmy C Mitchell    

    This is a great service. I tried to make an appointment at the VA with my primary care doctor but there were no appointments available for a few weeks. The Houston VA recommended I go to Urgent Care. I do and was seen immediately and served professionally. I will continue to use Urgent Care for minor illnesses and issues. Thank You VA, Houston VA in particular.

  15. Joseph L Pontek    

    I went in for a cardiac appointment and during the appointment, I told the doctor about a leg wound who directed me to Urgent Care. During that visit, I was basically said I should have made an appointment for somewhere else instead of coming to ER. I was going to discuss it with my primary care doctor during an earlier appointment, but my potasium levels were high and was shuffled off to ER and then to a ward. Through all this when I asked about the wound, they all said I had to do that as an Out Patient !
    OK, another 4-5 hous driving for another appointment ! At 76, those trips are taxiing.

  16. Leatherneck    

    Veterans who read this does who passing a Veteran Medical Centers Laws?

  17. Leatherneck    

    Veterans who read this email your Senators or Representative contract Veteran Affairs Committee passed a new Veteran Benefit Law passed a new Disabled Veterans who is 100 percent service connected needs a Dentist know how to G4 implants for free because they don’t have one Dentist work at a Veteran Medical Centers or have a contract with Veteran Administration and if a Disabled Veterans who is 100 percent service connected doesn’t get the G4 implants or it really bad Health Problems plus it would cause really bad Gums Disease also it may cause Cancer…….Semper Fi.

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