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EXAMPLES OF WHEN YOU MAY BE ELIGIBLE FOR COMMUNITY CARE Here are 6 examples of when you may be eligible for community care based on each requirement: EXAMPLE 1: A SERVICE WE DON’T PROVIDE

You need maternity care or in vitro fertilization (IVF) care. But we don’t provide maternity care or IVF at any of our facilities. So, you’re eligible to get these services from an

in-network community provider.  EXAMPLE 2: NO FULL-SERVICE VA HEALTH FACILITY You live in Alaska, Hawaii, New Hampshire, Guam, American Samoa, the Northern Mariana Islands, or the U.S.

Virgin Islands. We don’t have a full-service VA health facility in your state or territory. So, you’re eligible to get care from an in-network community provider. EXAMPLE 3: QUALIFICATION

UNDER THE 40-MILE DISTANCE REQUIREMENT You previously qualified under the Veterans Choice Program’s 40-mile distance requirement on June 6, 2018, and you still live at the same address. And

you live in Alaska, Montana, North Dakota, South Dakota, or Wyoming. So, you’re eligible to get care from an in-network community provider. EXAMPLE 4: DRIVE AND WAIT TIME STANDARDS FOR

PRIMARY CARE OR MENTAL HEALTH You need a primary care or mental health appointment, but the average drive time to your nearest VA clinic is longer than 30 minutes. This means you’re eligible

to get primary or mental health care from an in-network community provider because the drive time exceeds the access standards. You could also qualify if your drive time were within the

standard but the soonest available appointment date is over 20 days away.  FOR SPECIALTY CARE You need an appointment for specialty care (such as cardiology care for a heart problem), but

the soonest available appointment date is over 28 days away. This means you’re eligible to get specialty care from an in-network community provider because the wait time exceeds the access

standards.  You could also qualify if your appointment date is within 28 days, but your average drive to the nearest VA facility that offers cardiology is longer than 60 minutes. EXAMPLE 5:

YOUR BEST MEDICAL INTEREST You’re getting recurring treatment for a condition and have medical issues that prevent you from getting to the VA facility that’s within our standards for drive

time (such as nausea from recurring cancer treatments). Or you require recurring treatments that we can’t supply in a timely manner, even if they meet our wait time standards. If you and

your VA provider agree that it’s in your best medical interest to get care from the community provider, you’re eligible for community care. EXAMPLE 6: QUALITY STANDARDS You need cardiology

care for a heart problem. But we’ve determined that your local VA health facility doesn’t provide cardiology care that meets our quality standards. You may be able to get cardiology care

from an in-network community provider. Learn how to get community care referrals and schedule appointments