Community Care

CCN is a robust network of community providers that provides Veterans greater choice and accessibility to care outside of VA medical facilities. The CCN contracts are developed with a focus on transparency, accountability, quality and increased communications between VA and Veterans.

VA can directly schedule community care appointments for Veterans through their local medical facility, with support, as needed, from VA’s contracted CCN TPA – Optum for Regions 1, 2 and 3 and TriWest for Region 4. Veterans can also schedule their own appointments with support from local VA medical facility staff, if desired.

Health care services provided as part of CCN include medical, behavioral health, surgical, complementary and integrative health services (CIHS), and dental services for Veterans who are unable to receive care at a local VA medical facility. Durable medical equipment (DME) and prescription medications (up to a 14-day supply) will be provided for immediate needs.

CCN expands coverage for additional services to include dialysis, comprehensive rehabilitation, residential care, home-health care, hospice care, dental, immunizations, and long-term acute care. Under CCN, VA also covers CIHS benefits in the areas of biofeedback, hypnotherapy, massage therapy, Native American healing, relaxation techniques, and tai chi.

If a provider determines a prescription is immediately required, medications can be prescribed — up to a 14-day supply — and filled at a participating in-network pharmacy for Veterans who were referred care through a CCN provider with an approved referral. Veterans must provide prescription benefit information to a participating CCN pharmacy.

If Veterans do not have an authorization for care through the CCN contractor or utilize a non-CCN participating pharmacy, they will have to pay out of pocket and seek reimbursement through their local VAMC.

For prescriptions of more than a 14-day supply, or if the prescribed medication is not immediately needed, then the community provider must send the prescription to the local VAMC pharmacy for fulfillment.

If a provider identifies an immediate need for DME, orthotics or prosthetic items, the provider can provide the DME and submit a bill to Optum in Regions 1, 2, or 3 or TriWest in Region 4. Routine DME, orthotics, and prosthetic items require a consult and can be obtained via the Prosthetics and Sensory Aids Service (PSAS) at the local VAMC.

Under CCN, community providers must submit a referral request to VA when a Veteran requires care beyond what is included on the original referral. The referral request will be reviewed by VA and if appropriate, a new referral will be issued.

Yes. Before a Veteran receives care or services from a CCN participating provider, VA must refer the Veteran to a specific community provider.

Under CCN, VA staff can refer Veterans directly to community providers and schedule community care appointments for Veterans through the local VA medical facility. In some instances, VA medical facility staff may elect to receive scheduling support from Optum or TriWest. Veterans can also choose to schedule their own appointment with support from local VA staff.

Eligibility for community care will continue to be dependent upon your individual health care needs, care available at a VA medical facility, and other factors. VA staff will work with you to determine if you can continue to see your current community provider, and to confirm his or her participation in Optum or TriWest’s CCN provider networks. Some providers may not be able to or want to join VA’s CCN. In those cases, VA will work with you to find another contracted provider.

No. There is no effort underway to privatize VA. However, VA recognizes that the health care landscape is constantly changing, and VA’s unique population and broad geographic demands require partnerships with community providers to continue VA’s long-standing tradition of offering community care to Veterans since 1945.

VA directly manages Veteran community care customer service touchpoints while the CCN Regional TPAs support inquiries from community providers and VA.

VA developed a Community Care Contact Center (C4), which provides you, your beneficiaries and representatives with a singular point of contact to assist with questions related to VA community care.