Veterans Affairs (VA) Community Care Program

Starting June 6th, as part of the Mission Act passed by Congress and signed into law by the President, veterans can use authorized urgent care locations without a prior VA authorization. This grants US Military Veterans greater access to timely, high-quality care within VA’s new Community Care Network!

What’s Covered for Eligible Veterans

The program covers treatment at AFC (authorized provider) of injuries/illnesses that require immediate attention but are not life-threatening. In general, these are typical urgent care visits. This includes, but is not limited to, the following:

• Flu-like Symptoms
• Strep Throat
• Minor Burns
• Pink Eye
• Ear/Skin Infections
• Diagnostic X-Rays
• Diagnostic Lab Testing
• Urgent Medications
• Other common Urgent Care visit types

What’s Not Covered

There are select services that are excluded from the program. These are:

• Annual Wellness Visits
• Depression Screenings
• Health Risk Assessments
• Advanced Care Planning
• Preventive Medicine
• Preventive Medicine Counseling
• Behavior Change Intervention
• Pneumococcal
• Zoster

How to Receive Care at an AFC Clinic

1. Veteran self-presents to the AFC Urgent Care clinic front desk
2. Urgent care staff asks the Veteran for his/her:
   • Last four digits of Social Security Number (SSN)
   • Date of birth (DOB)
   • VA Medical Center (VAMC)
   • Home address
3. Urgent care clinic calls TriWest at 1-833-4VETNOW (1-833-483-8669) and inputs Veteran’s SSN and DOB to confirm eligibility
4. Once eligibility confirmed, urgent care treats Veteran
5. The urgent care provider may write a medically necessary prescription for up to a 14-day supply
   • Opioids will be limited to 7 days or less
6. After Veteran leaves, urgent care clinic submits medical documentation to Veteran’s VAMC
7. Urgent care clinic submits the claim to WPS Military and Veterans Health (WPS MVH), TriWest’s claims processor

Care for Non-Covered Veterans

If it is found that a Veteran is not covered under the program, we will work to find alternative coverage options. This would include looking into other plans available to the individual such as Medicare, TRICARE, TRICARE for Life, Medicaid, or other private insurance plans.

Other Contact Information

For more information regarding the Community Care Program, visit VA Community Care, call VA Health Care at (877) 222-VETS ((877) 222-8387), or call VA Benefits at (800) 827-1000.

For questions pertaining to AFC Urgent Care and our role in VA Community Care Program, email info@afcurgentcareportland.com or call (503) 503-6262 and select the clinic you plan to visit.