Veterans Community Care Network: Patients One-Pager (PDF) Print at Home Download as PDF Read the page below to see all of the content of this document. Want it on paper? Download the document and open it using your web browser or Adobe Acrobat viewer to print the one-pager in its original format. Download the PDF Download this page as a PDFIntroductionAs a Veteran, you may have access to a broader network of medical care outside the U.S. Department of Veteran’s Affairs (VA). An estimated 500,000 Veterans in the VA system have prostate cancer.1 It is critical for patients to have more options to get treatment and medical care that may be closer to home and easier to access.New options for Veterans are available as a result of recently passed legislation for better access and greater choice in health care within the VA and in the Community Care Network.2Every Veteran is already enrolled in the Community Care Network, but there are a few steps to get started.New Care Options for VeteransThe first step is to meet with your VA physician and discuss your care and treatment options. In order for a Veteran to receive care through the VA Community Care Network, your VA health care team must determine if at least one of the following criteria is met:3It is in the Veteran’s best medical interest, as determined by the VA provider.A service is needed that is not available at a VA medical facility.Veteran lives in a US state or territory without a full-service VA medical facility.Veteran qualifies under the “Grandfather” provision related to distance eligibility for the Veterans Choice Program.VA cannot provide care within certain designated access standards.For average drive time to a specific VA medical facility, the access standards are 30-minute average drive time for primary care, mental health care, and non institutional extended care services or a 60-minute drive for specialty care.For appointment wait times at a specific VA medical facility, the access standards are 20 days for primary and mental health care,and non institutional extended care services or 28 days for specialty care.Veteran needs care from a VA medical facility that VA determines is not providing care that complies with VA’s quality standards.The Next Step for Those Who QualifyYour VA physician will refer your care to the appropriate provider, either TriWest or Optum (see the map to determine coverage based on your location). The provider will make your appointments and contact you. You may also be eligible for self-service appointment scheduling. If you have a referral and have not heard from either provider, contact the VA to ensure your referral is correct and has been issued.Example Of A Veteran's Journey Through The VA Community Care NetworkTo guide you through this process in more detail, please follow these steps below.Veteran seeks care from VAVA determines, based on community care criteria, that the Veteran is eligible for community care for this medical need.VA engages community care provider to accept referral and method of delivery (medical record is included in referral packet).Once the referral is accepted, either VA schedules appointment with community care provider or veteran schedules appointment.Veteran receives care from community care provider.Provider sends medical record to VA.Provider bills Optum or TriWest for the careWhat About Prescription Medicine?For prescription medication, the prescription should be sent to and filled by the nearest VA pharmacyVeterans can receive prescription medication for a 14-day or fewer supply that can be filled at a non-VA pharmacyA prescription for more than a 14-day supply must be filled by VATo Contact TriWest Or Optum:1-855-PCCCVET (855-722-2838) Monday through Friday, 8:00 a.m. – 8:00 p.m. (local time zone)Optum: https://vacommunitycare.comTriWest: https://www.triwest.comVA Community Care Network: https://va.gov/CommunityCareAbout The ZERO Veterans InitiativeZERO is committed to bringing the Veterans community the resources, tools, and education needed to fight and prevent the disease.1 Richman, Mike. VA, Prostate Cancer Foundation seek solutions for aggressive prostate cancer. VA. Published November 13, 2019. Accessed August 18, 2020. https://www.research.va.gov/currents/1119-VA-and-Prostate-Cancer-Foundation-seek-solutions-for-aggressive-prostate-cancer.cfm2 Text - H.R.6285 - 116th Congress (2019-2020): Veterans’ True Choice Act of 2020. Published March 13, 2020. Accessed August 18, 2020. https://www.congress.gov/bill/116th-congress/house-bill/6285/text?r=2&s=13 Community Care - Community Care. VA. Updated August 27, 2020. Accessed August 18, 2020. https://www.va.gov/resources/eligibility-for-community-care-outside-va4 Urgent Care - Community Care. VA. Updated September 21, 2020. Accessed August 18, 2020. https://www.va.gov/COMMUNITYCARE/programs/veterans/Urgent_Care.asp Downloadable Materials More for you
Print at Home Download as PDF Read the page below to see all of the content of this document. Want it on paper? Download the document and open it using your web browser or Adobe Acrobat viewer to print the one-pager in its original format. Download the PDF
Download this page as a PDFIntroductionAs a Veteran, you may have access to a broader network of medical care outside the U.S. Department of Veteran’s Affairs (VA). An estimated 500,000 Veterans in the VA system have prostate cancer.1 It is critical for patients to have more options to get treatment and medical care that may be closer to home and easier to access.New options for Veterans are available as a result of recently passed legislation for better access and greater choice in health care within the VA and in the Community Care Network.2Every Veteran is already enrolled in the Community Care Network, but there are a few steps to get started.New Care Options for VeteransThe first step is to meet with your VA physician and discuss your care and treatment options. In order for a Veteran to receive care through the VA Community Care Network, your VA health care team must determine if at least one of the following criteria is met:3It is in the Veteran’s best medical interest, as determined by the VA provider.A service is needed that is not available at a VA medical facility.Veteran lives in a US state or territory without a full-service VA medical facility.Veteran qualifies under the “Grandfather” provision related to distance eligibility for the Veterans Choice Program.VA cannot provide care within certain designated access standards.For average drive time to a specific VA medical facility, the access standards are 30-minute average drive time for primary care, mental health care, and non institutional extended care services or a 60-minute drive for specialty care.For appointment wait times at a specific VA medical facility, the access standards are 20 days for primary and mental health care,and non institutional extended care services or 28 days for specialty care.Veteran needs care from a VA medical facility that VA determines is not providing care that complies with VA’s quality standards.The Next Step for Those Who QualifyYour VA physician will refer your care to the appropriate provider, either TriWest or Optum (see the map to determine coverage based on your location). The provider will make your appointments and contact you. You may also be eligible for self-service appointment scheduling. If you have a referral and have not heard from either provider, contact the VA to ensure your referral is correct and has been issued.Example Of A Veteran's Journey Through The VA Community Care NetworkTo guide you through this process in more detail, please follow these steps below.Veteran seeks care from VAVA determines, based on community care criteria, that the Veteran is eligible for community care for this medical need.VA engages community care provider to accept referral and method of delivery (medical record is included in referral packet).Once the referral is accepted, either VA schedules appointment with community care provider or veteran schedules appointment.Veteran receives care from community care provider.Provider sends medical record to VA.Provider bills Optum or TriWest for the careWhat About Prescription Medicine?For prescription medication, the prescription should be sent to and filled by the nearest VA pharmacyVeterans can receive prescription medication for a 14-day or fewer supply that can be filled at a non-VA pharmacyA prescription for more than a 14-day supply must be filled by VATo Contact TriWest Or Optum:1-855-PCCCVET (855-722-2838) Monday through Friday, 8:00 a.m. – 8:00 p.m. (local time zone)Optum: https://vacommunitycare.comTriWest: https://www.triwest.comVA Community Care Network: https://va.gov/CommunityCareAbout The ZERO Veterans InitiativeZERO is committed to bringing the Veterans community the resources, tools, and education needed to fight and prevent the disease.1 Richman, Mike. VA, Prostate Cancer Foundation seek solutions for aggressive prostate cancer. VA. Published November 13, 2019. Accessed August 18, 2020. https://www.research.va.gov/currents/1119-VA-and-Prostate-Cancer-Foundation-seek-solutions-for-aggressive-prostate-cancer.cfm2 Text - H.R.6285 - 116th Congress (2019-2020): Veterans’ True Choice Act of 2020. Published March 13, 2020. Accessed August 18, 2020. https://www.congress.gov/bill/116th-congress/house-bill/6285/text?r=2&s=13 Community Care - Community Care. VA. Updated August 27, 2020. Accessed August 18, 2020. https://www.va.gov/resources/eligibility-for-community-care-outside-va4 Urgent Care - Community Care. VA. Updated September 21, 2020. Accessed August 18, 2020. https://www.va.gov/COMMUNITYCARE/programs/veterans/Urgent_Care.asp
