Many veterans do not know they may have the right to see a doctor outside the VA, at VA expense, when the VA cannot see them in time.
The VA MISSION Act of 2018 created the Veterans Community Care Program. Its rules are written in federal regulation at 38 CFR 17.4010 and 17.4040. Knowing them can be the difference between waiting months and being seen within weeks.
The Access Standards
You may be eligible for community care if the VA cannot schedule an appointment for you that meets both of these standards:
- Primary care, mental health care and non-institutional extended care: average drive time of 30 minutes or less, and an appointment within 20 days
- Specialty care: average drive time of 60 minutes or less, and an appointment within 28 days
Two details matter. First, drive time is the average drive from your home calculated by VA mapping software, not how long your last trip took. Second, the wait-time clock does not apply if you agree to a later appointment date with your VA provider, so listen carefully when a scheduler offers a far-off date.
Other Ways to Qualify
- The VA does not offer the care or service you need
- You live in a state or territory without a full-service VA medical facility
- You qualified under the old 40-mile rule of the Veterans Choice Program and meet certain conditions
- You and your VA provider agree that community care is in your best medical interest
- A VA service line does not meet certain quality standards
What Has Changed Recently
The access standards themselves have not changed. Recent changes have been to the process:
- Since May 2025, “best medical interest” referrals no longer require approval from a second VA clinician
- Since November 2025, the VA issues year-long authorizations for 30 standardized types of care, rather than requiring re-approval every 90 to 180 days
- The VA is restructuring its community care network contracts. Secretary Doug Collins has said eligibility is not changing as part of that process
Legislation such as the Veterans’ ACCESS Act (H.R. 740) would write the current standards into law and expand them. As of this writing, it has not passed either chamber.
How to Ask
- Ask your VA scheduler directly: “What is the earliest date VA can see me? Does that meet the community care access standards?”
- If the date is beyond 20 days (or 28 for specialty care), ask to be evaluated for community care. Do not agree to the later date unless you want it
- Ask your VA provider about a best medical interest referral if travel, your condition or continuity of care makes it appropriate
- If you are denied, ask for the decision in writing and contact your facility’s patient advocate
No veteran should be left navigating these rules alone. That is the idea behind Spark Nation: recognize the need, make the connection, and follow through.
Keep Digging With Truth Agent
This article is a starting point. Truth Agent puts the public record at your fingertips, including the Constitution, federal law, regulations, court opinions and oversight reports, so you can look up the VA regulations and the bills that affect your benefits without relying on anyone’s summary, including ours.
Read Next on Truth Trench
- Spark Nation and Truth Trench: Building a Continuum of Care for America’s Veterans
- How Federal Regulations Are Made, and How You Can Comment on One
