More Changes to the Veterans Choice Program

December 14, 2015

On December 1, 2015, the VA announced more changes to the Veterans’ Choice Act. These changes streamline the eligibility requirements and make it easier for veterans to use the Veterans Choice program.

Under the old policy, veterans had to meet the following requirements in order to be eligible:

be enrolled in the VA Health Care system by 8/1/2014, or be a combat veteran (this requirement was already changed in October—see our article from 10/12/15),
have excessive burden due to geographical, environmental, or medical conditions that make travel difficult, or live more than 40 miles driving distance from the closest VA medical facility.

The new changes to the Veterans’ Choice Act mean that, in order to be eligible, veterans must be enrolled in the VA Health Care System andmeet at least one of the following:

Live more than 40 miles driving distance from the closest VA medical facility;
Need to travel by boat, ferry or plane to reach the closest VA medical facility;
Were told by their local VA facility that they cannot receive a care appointment within 30 days of the date their doctor says they need to be seen or, if no date is specified by the doctor, within 30 days of the date the veteran wants to be seen;
Face an excessive burden in traveling to the closest VA medical facility to receive care based on geographic, environmental, or medical conditions, the frequency of care needed, or the need for an attendant. The local VA facility will work with veterans to determine if any of these reasons apply;
Live in a state or US territory without a full-service VA facility (New Hampshire residents who live within 20 miles of the White River Junction VAMC or vets who live in Puerto Rico are excluded).

These changes were made in direct response to input from veterans as well as veterans organizations. Further changes will be phased in over the next several years as the VA focuses on five goals: establishing a single set of eligibility criteria based on wait time, distance, and availability of care as well as expanded outside urgent care; improving access by simplifying the referral and authorization process; offering a tiered provider network of federal, academic, and community providers; using an improved health information exchange to better coordinate care; and improving billing and claims processing to ensure prompt payment.

As programs are implemented, the VA welcomes feedback, which they then use to make changes to better meet veterans’ needs. For more information about the Veterans Choice Program, call 866-608-8198 or visit www.va.gov/opa/choiceact.