Community Care through the VA and American Addiction Centers

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Veterans are at a high risk of developing substance abuse disorders (SUDs), often accompanied by a co-occurring mental condition. This may largely be attributed to difficulties adjusting back into society due to PTSD or availability of inadequate support systems. This can lead former servicemen to self-medicate. Unfortunately, many veterans may avoid seeking treatment due to the stigma surrounding mental health and fears that if they receive the help they wouldn’t be able to get their benefits. It’s essential that we recognize and address this issue in order to adequately provide aid for our veterans and ensure their continued success even after leaving the armed forces.1

Veterans Health Administration (VHA) works to provide effective healthcare services for veterans in the United States. The integrated healthcare system is the largest in the country and it creates a network of care providers that extends across all states. Veterans Community Care (VCC) is one of its main programs and allows veterans to have access to quality healthcare closer to their homes.2 

American Addiction Centers (AAC) are one of the community care providers (CCP) that are part of this network. All of AAC’s facilities are connected with VCC through the Salute to Recovery program, approved by the VHA. The goal is provide access to evidence-based care, including medication-assisted therapy, increasingly offered in an outpatient setting, as well as residential programs at local facilities.

What is the VA Community Care Program Network

The VCC, or Veterans Community Care program network, is a set of providers located in communities across the country offering care to veterans enrolled in the VHA healthcare system. The program provides convenient access to timely specialty care for veterans, such as mental health and substance abuse treatment, radiology and laboratory services, physical therapy and geriatrics.3

The VA partners with trusted community care providers that have been selected based on quality standards and cost considerations. Veterans receive care from these partners when it’s not available from a local VA facility or if travel beyond a certain distance from their home would be required. This allows veterans to get the care they need close to home, even when a VA medical facility is not nearby or if they’re unable to get help from the Veterans Administration for some other reason.3

CCPs provide access to substance abuse treatment when needed, and coverage for such treatments is offered by the VA. In order to access these facilities, veterans must have been approved first; this approval process is based on a set of criteria that can vary from veteran to veteran. Though CCPs take the form of community care organizations outside the VA‘s own resources, they operate under its strict supervision, making sure cost efficiency and quick service are available to those who qualify.4, 5

Who Qualifies for the Veterans Community Care Program?

Veterans who need specialized healthcare and want to seek it through an outside provider may find their eligibility assessed on a case-by-case basis. To do so, they must first receive the appropriate approval from the VA, even if they are already enrolled in daily care. This regulation is designed to ensure that veterans have access only to necessary medical treatments and services outside of the VA system.6

 To qualify for the program, veterans must meet at least one of six requirements. These include:7

  • They can’t get the help they need at the nearest VA facility.
  • The veterans’ state or territory doesn’t have any VA facilities that offer full-service assistance.
  • The veteran is qualified for the “Grandfather” eligibility provision related to Distance Eligibility. 
  • The veteran cannot access healthcare services, because:
    • They have to drive half an hour or more for primary and an hour or more for specialty care.
    • There aren’t any free appointments within 20 days for primary and 28 days for specialty care. 
  • The veteran and the referring doctor both agree that it’s in the patient’s best interest to seek service from a community provider
  • The VA cannot provide care that meets the supposed quality standards for their facility. 

How does Community Care Work?

VCC provides eligible veterans with access to care locally through a network of community health providers. Referrals are made after careful consideration of the veteran’s specific needs and circumstances to ensure they receive the most appropriate and comprehensive care available.5

Once authorized by the VA, veterans can easily make an appointment with their community provider as both the patient and provider will have been notified of the referral. VCC offers veterans a convenient option to receive quality care closer to home, allowing for better long-term health outcomes for those who have served our nation.5

How much does Community Care Cost?

The cost associated with VA community care largely depends on the specific services being used and the situation of the veterans themselves. Generally, determined medical services which are related to the struggling individual’s military service are eligible for free VA health care and may not require any copays at all.8

This could cover everything from mental health services such as readjustment counseling or SUD treatment to physical health-related treatments like check-ups, laboratory work and prescription drugs. For those veterans who do have to pay a copay, there are certain eligibility factors such as income, disability status or other special criteria that can result in being “exempt” from paying anything out of pocket.8

Non-service-connected treatment typically comes with a copayment charged to veterans. Still, in some cases, veterans may be charged for supplies, medication or services if they have other types of coverage that could cover part or all of the treatment costs. To determine what charges pertain to their specific situation, it is best for veterans to speak with their provider directly about VCC costs and associated payments.6

Copay rates from January 1, 2022, are the following:8

  • Urgent care: Urgent care may be either free or cost $30 for each additional visit. This depends on the priority group and the number of visits.
  • Outpatient care: Copay for primary care visits is $15  and specialty services and tests may cost up to $50.
  • Inpatient care: The rates for treatment at inpatient care facilities depend on the length of stay and the priority group, so they can vary.

The Difference Between the Veterans Community Care Program and the Veterans Choice Program 

The VCC is the successor to the Veterans Choice Program (VCP) and brings a number of advancements to veterans’ healthcare. VCP officially ended on June 6, 2019, after Congress passed the MISSION Act earlier that year. Under the new VCC Program, veterans have an expanded range of options when deciding their healthcare providers and treatments. The program also streamlines existing rules regarding accessing care, making them more transparent and easier to find.9

The new program offers a range of choices that weren’t previously available with VCP:9

  • Expansion of eligibility criteria: Eligibility criteria were expanded to include six requirements and standards related to drive and wait times are less stringent.
  • Simplification of the billing system: The billing process has also been streamlined since all necessary services are now covered under one single plan. As such, VA providers can be paid in a timely manner.
  • Reorganization of the internal process: The improved coordination between VA and community providers means customers have an easier time scheduling appointments.
  • Accessibility of urgent care benefits: VCC offers more accessible urgent care benefits for minor illnesses or injuries that no longer require prior authorization from VA before seeking treatment.

What are the Benefits of VA Community Care Program Network?

Veterans who are eligible for the VCC program can access a host of health benefits. Those who are enrolled in the program get a Medical Benefits Package, which includes:10

  • Diagnosis and assessment services.
  • All levels of care: preventative, primary, and specialty.
  • Access to residential inpatient programs.
  • Access to outpatient programs and services.
  • Access to detoxification from opioids and other substances.

Veterans have access to specialized healthcare through the Basic Medical Benefits Package. By visiting the website or calling the dedicated phone number, treatment-seeking veterans can find out if they qualify for additional programs and services. The extensive mental health care that is available based on individual circumstances and needs is especially significant.10

Services ranging from outpatient solutions to inpatient solutions are tailored to treating a wide range of conditions including SUDs, PTSD, and other conditions requiring psychological treatment.10

There’s a variety of well-equipped private treatment centers for veterans struggling with SUDs. Combining VA with other insurance plans can be a great way of widening the choice of centers, whether the goal is to choose between inpatient and outpatient facilities or even to access high-quality facilities with luxurious amenities.5 While most veterans have some form of insurance coverage, some treatment-seeking individuals might find that they have no coverage when verifying their insurance

This shouldn’t discourage them from seeking help. There are other viable options to pay for rehabilitation services. Many rehab centers will work with the treatment-seeking individual to understand and find ways to manage full or partial payment for their services by creating personalized payment plans or offering financing options. This can help the treatment-seeking individual prepare for treatment financially and psychologically.

What Type of Treatment is offered for Veterans? 

Treatment options for veterans with substance abuse issues go beyond traditional medical practice. Instead, they also need to address the social and psychological challenges veterans face when transitioning to civilian life. This means more than simply trying to treat drug or alcohol addiction – it’s about providing them with the coping mechanisms and resilience tools necessary to be successful both in and out of military service.11   

To foster the best possible outcome for veterans suffering from SUDs, evidence-based therapeutic approaches such as Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) and Motivational Interviewing (MI) are recommended. All provide a safe and compassionate environment tailored specifically to veterans’ needs, addressing their unique circumstances so that each of them can battle their condition and increase their chances of leading a healthier, happier life.12

Once the admission process is over and the treatment-seeking individual is assessed by the staff, the treatment begins. There are a variety of elements that may be incorporated into the treatment, but the approach can vary depending on the needs of an individual. The following are some of the possible elements:13

How do I Find a VA Community Care Network Provider

Veterans can now more easily access medical care provided outside the scope of the VA through the Community Care Network (CCN). The improved network makes it simpler for veterans to connect with community doctors and other healthcare professionals who are close to them, without having to make complicated eligibility decisions or repayments. This is a great advancement in healthcare access for veterans that provides added consistency and convenience.6

To find a Community Care Provider, veterans simply need to call or go online to their local VA center or use the VCP tool to help determine if they qualify for care. Additionally, veterans can also speak directly with an appointed representative who can provide assistance with finding and scheduling an appointment with a provider in the network.6

You or your loved one can also reach out to AAC’s rehabilitation helpline where a trained navigator can provide you with the information you need and find an appropriate facility for you that’s in VCC’s system.

Frequently Asked Questions