VA MISSION Act launch: Here’s how to make an appointment with a private doctor

Abbie Bennett
June 04, 2019 - 9:36 am
The MISSION Act launches June 6: Here’s how to make an appointment with a private doctor.

Photo by Veterans Affairs

The Veterans CHOICE Act will soon expire and be replaced by the MISSION Act which launches June 6. The MISSION Act should provide more flexibility for veterans to seek care through private doctors paid for by the VA if they qualify.

To find out if you are eligible to see a private doctor, click here.

For those who are eligible, here is the process to access “community care,” or private doctors, according to the Department of Veterans Affairs:

  • Schedule an appointment with your VA doctor.
  • Your VA care providers will work with you to determine if you are eligible to seek care from a private doctor based on this criteria
  • The VA can work with you to find a private doctor in the VA’s network and make an appointment or you can choose a private doctor in the VA’s network here.
  • Make sure the VA confirms you are eligible and authorized before you make the appointment.
  • If you need follow-up appointments, make sure the VA has authorized additional care.

IMPORTANT TO REMEMBER:

To get care from a private doctor or “community care provider,” you must have prior approval from the VA.

If you are determined not to be eligible, you can appeal the VA’s decision. Contact your local VA medical facility for more information.

If you get care through a private doctor, you can still continue to get care at the VA. The two should not conflict.

If you currently see a private doctor through CHOICE, there should be no interruption of your care after the MISSION Act goes into effect June 6, VA officials said.

If the doctor you want to see is not already in the VA’s network, the VA may be able to add them. Talk to your doctor and local VA for more information.

To get prescription medications through private doctors, the doctor must send the prescription to be filled at the nearest VA pharmacy, and the VA pharmacy will mail the medication to you. If the prescription is for urgent or emergency care, you can get it filled at a non-VA pharmacy, but you will need to pay for it and submit a prescription reimbursement request to your VA.

The cost to see a private doctor should be similar to when you see a doctor at the VA -- you may have a copay and VA may bill your insurance company for care that is not service-connected.

If you get a bill from your private doctor, that usually means your community provider tried to bill the VA but didn’t get paid. Contact your VA so they can resolve the issue with your doctor.

For more information on the MISSION Act, go to www.missionact.va.gov.

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Follow Abbie Bennett, @AbbieRBennett.