Veterans Choice Program – Updated Rules Expand Coverage to More Veterans

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Veterans Choice Program Eligibility
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…

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.

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About Ryan Guina

Ryan Guina is the founder and editor of The Military Wallet. He is a writer, small business owner, and entrepreneur. He served over 6 years on active duty in the USAF and is a current member of the IL Air National Guard.

Ryan started The Military Wallet in 2007 after separating from active duty military service and has been writing about financial, small business, and military benefits topics since then. He also writes about personal finance and investing at Cash Money Life.

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  1. Army NCO says

    The Denver VA has been manipulating wait lists since I started care in 2003. Currently my 90 day plus wait window allowed me access to veterans choice and I can confirm the above veterans stories of how we are treated. The veterans choice tri-west care openly admit to manipulating our wait times to ‘triage’ veterans in the seriousness of need for care(hogwash). I’ve been waiting over 90 days through veterans access to get an appointment, and when I finally got a primary care appointment, that doctor only gives 30 days worth of meds. Now I have to go through the VA ringer again and get authorized through VA scheduling to get veterans access to get another primary care appointment which is taking over 3 months to get a one month supply of medications. Policy matters over medical necessity at the VA. Why do these people have sovereign immunity?

  2. Jeffry Keith Goins says

    I have been sent to 7 unqualified doctors for my hand. I found a surgeon who will meet with me and have waited a month for permission. This has gone on for a year now. I don’t gave pain relief as I don’t have a surgeon. So I chew ibuprofen and tramidol that I have for arthritis. I have 4-5 different things wrong with my hand. These people put you on hold for hours.

  3. Teresa Johnson says

    Well folks I’ve sadly disturbing news that reveals even MORE flaws in the Choice program… I’ve been told that the provider who did the eye surgery for my husband worked for a firm that had been approved for Choice, thus they approved the initial consult. However, as we moved further along for the actual surgery they (Choice) now states that doctor is not approved. Costs will initially be billed through my husband’s Medicare. Great Gods I hope we get no surprise bills in our mailbox! When I spoke to one of the Choice Champions I was encouraged to contact my congressman as Choice has had so many problems and complaints.
    Last Friday approximately a dozen envelopes were dropped at my local postal office – 2 to newspapers in Colorado Springs (where we live) and 1 to the Denver Post; 1 to the director of the Denver VA hospital and 1 hand carried to the local VA clinic for the gentleman who I was told was director/manager and now find is only 2nd in command; 2 copies each (local offices and DC offices) of my Colorado senators and congressman. I’ve also handed out copies to some of Vets in my husband’s support groups and at least one of his most supportive counselors. I called my letter dropping action “Dropping the Bomb”. With your kind permission I’d like to share my letter and encourage others to raise the awareness to the public, media and politicians in their own areas.

    The True Cost of War
    Someone asked in the Colorado Springs Independent about two years ago “What is the real cost of war?” I’ve mulled it over since publication trying to polish my thoughts… and experiences.
    Obviously there is lives and money.
    Behind the scenes, and many closed doors, there is more. Much more. I say “closed doors” because the general public and pretty much any politician has no real idea of what veterans and their families go through daily.
    News today is full of talk of the Gulf War, Iraq, Iran, and Afghanistan. But let’s go back in time a few decades more.
    My husband is a Vietnam Combat Veteran. The Vietnam War still rages on. Veterans still fight battles – physically, mentally, emotionally, and spiritually. And so do those family and friends close to them. And help, real help, is never easily found or readily available. For those who do eventually seek their deserved “benefits” through the VA (Department of Veterans Affairs), there are untold obstacles and mountains of red bureaucratic tape, delays in health care services and an endless string of “I’m sorry for the inconvenience” from personnel unable, and in some cases sadly unwilling, to make it right.
    In part, we have members of Congress to thank for these continually increased problems. Certain folks in office pass into law changes that broaden the gaps veterans fall through and add to frustrations and delayed care. The biggest gap is the so-called Veteran’s Choice Program. And to rub additional salt into the wounds, these same folks are not accountable to those they’ve helped inflict more harm on nor their families because “you reside outside my district”.
    Seriously?!
    Dear Congressman, you know who you are!
    Yet as I’ve expressed my frustration and growing disappointments trying to advocate for my husband’s health care I’ve faced threats and immediate intimidation tactics with comments like – “You don’t really want to say that out loud”, “Are you having thoughts of injuring yourself or others”, and more of the useless and too often insincere “I’m sorry you’re having to go through this”.
    As stated, my husband comes from the Vietnam Era. Myself and others can’t help but think the VA and Government officials involved are dragging things along hoping these veterans will die off before compensation and benefits due is paid out. Sadder still is the fact that many, too many, younger veterans and their families are beginning to face the same challenges for complete and timely health care through the VA or associated providers. Care is delayed. Claims drag on for months, often a full year for a decision of any sort. Some families who had received compensation for caregiving has lost that income because of flawed evaluations of veterans. Myself, I’ve never received any such compensation ever. What I have received is an ever increasing workload making and keeping appointments, transportation to them, advocating for the best care available, all the while still trying to maintain our home and all that comes with that. I’ve also received the aforementioned intimidations and a bucket full of “I’m sorry.”
    The VA clinics and hospitals are far too overburdened and under staffed. The “Veterans Choice” program is so severely flawed that timeliness for health care is as lacking as dealing directly with VA facilities directly. The few, very few, healthcare practitioners who show genuine concern for veteran healthcare are usually not the ones in position to make policy changes for the better… and it takes a toll on them as well as the veterans.
    Ghandi had stated you can tell the greatness of a nation by how it treats the animals. I’d like to amend that statement to include veterans.

    And for the record –
    Damn those who continue to put our citizens in harm’s way and turn their backs on them and their families!

    Frustrated but respectfully submitted,

    Ms. Teresa Johnson

    Cc: Colorado Springs Independent
    Colorado Springs Gazette
    Denver Post
    Congressman Michael Coffman
    Congressman Doug Lamborn
    Senator Cory Gardner
    Senator Michael Bennet

    • Bodacius says

      I, too, am a veteran in Colorado who is having severe issues with getting much needed surgery which requires a specialist. It was first taken care of, yes- this is a follow up surgery, by the Fee Bases program which I understand does not really exist anymore. My doctor has even called the HealthNet people– yes, the doctor not his staff- to no avail. I have been waiting for this surgery for 7-8 months now? Excuse after excuse– that is what I get from the HealthNet people. Oh- and their little comments like, “I am sorry” or “Thank you for your service” is not only irritating but condescending as well. They finally approved the surgery at the doctor’s office– but won’t pay for the hospital. They can’t do it at the VA medical center– no specialist there can provide the service. So, needless to say, money that we need to pay our regular bills will have to go to paying the hospital and specialists. Probably loose our house because we won’t be able to make our mortgage payment. These people and their “policies and procedures” really suck!

  4. Teresa Johnson says

    Sadly, the Choice Program is more flawed than even your article eludes. I begun advocating for my husband, a Vietnam combat veteran, for necessary corrective eye surgery on June 15, 2015. He had the necessary surgery just yesterday, August 24, 2015. But who will pay the costs? To this date I’ve not received confirmation that the Choice authorization ever went through in spite of over two months working on this health issue alone. I am also in the midst of trying to get Choice to send the necessary authorization for some urological issues my husband suffers….but that battle is only just past a month long of waiting, phone calls and back-and-forth with Choice, Choice Champions (there’s an irony – the program is so flawed VA workers called Choice Champions now exists to help jump the hoops, close the gaps and work for more expeditious healthcare) and VA patient advocates, etc. II’ve spent as long as five and a half hours on the phone in a single day and still not gotten positive results. My husband has memory issues and PTSD that don’t allow for him to advocate for himself. The delays in timely healthcare through the VA clinic, hospital and the Choice program have just about cost our marriage as tensions have escalated. Thank you Congress for another well thought out plan! (yes, that last statement was meant sarcastically in case anyone doubted)

  5. DON HAEY says

    My wife, a Navy vet, has been trying to get some treatment since July 17th, and she has contacted a lot of different people, as she was told to, but still no results of getting in for testing procedures. BIG JOKE ON THIS PROGRAM NOW.
    I hope it changes for the vets really in need.

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