Veterans Choice Program – Updated Rules Expand Coverage to More Veterans

The Veterans Choice Program was designed to give veterans enrolled in the VA health care system better and more timely access to health care. The program was supposed to work like this: if the member had to wait longer than 30 days to get an appointment, or if they lived more than 40 miles from a VA health care center, then they would be eligible to see a non-VA doctor for their health care needs.

Veterans Choice Program Eligibility

The intent of the program was to make it easier for veterans to obtain health care. Unfortunately, it didn’t work well in practice, primarily due to the liberal manner in which the VA initially interpreted the way the law was written.

Veterans Choice was too Restrictive. The initial interpretation of the law made it difficult for most veterans to participate. The distance rule was interpreted as 40 miles from a VA health care center, “as the crow flies,” not by driving distance. This meant some veterans had to dive much more than the 40 miles the law stated. The law also stated the veteran had to live within 40 miles the “closest VA health care center,” but did not specify whether the closest VA health care center had to offer the care the veteran needed.

In one case that received a lot of attention, one veteran was denied the ability to receive non-VA medical care because he lived with 40 miles of a VA dental clinic, even though he needed care for cancer, which the dental center obviously did not provide. You can read more about this situation here.

The new program is less restrictive, giving access to thousands of more veterans. The VA has since revised the wording of the program and will use Google Maps or a similar program to determine driving distance. They also expanded the program to allow access to non-VA care if the veteran would have excessive travel burdens to the closest VA medical facility based on geographic challenges, environmental factors, or a medical condition. Staff at the Veteran’s local VA medical facility will work with the veteran to determine if the veteran is eligible for any of these reasons.

About the Veterans Choice Program

If you are already enrolled in VA health care, the Choice Program allows you to get health care from non-VA doctors. Using this program does NOT impact your existing VA health care, or any other VA benefit. Here is a video from the VA, which explains the benefit:

Veterans Choice Program Eligibility

You must first be enrolled in the VA health care system. Then you must meet one of the following two criteria:

  • You have been (or will be) waiting more than 30 days for VA medical care
  • You live more than 40 miles away from a VA medical care facility or face one of several excessive travel burdens.

You can also use this online tool to find out if you are eligible.

How to Use the Veterans Choice Program

Start by determining your eligibility. Then search for participating doctors. Next, call the Eligibility Hotline and Appointment Line: 1-866-606-8198.

Be sure to have the following information available:

  • additional medical insurance info
  • your address
  • your preferred community provider (if they participate). The VA will recommend alternate medical providers if your preferred provider does not participate in the program.

The VA customer service representatives will help you set up your appointment if you meet the criteria. You can learn more about the Veterans Choice Act program at the VA website.

You can learn more about veterans benefits in our Veterans Benefits Guide.