The MISSION Act: when the VA pays for care outside its walls

The six doors into community care

You may qualify for VA-paid care from a community provider if any one of these is true:

1. The service you need isn't available at a VA medical facility
2. You live in a state or territory without a full-service VA facility
3. You qualify under the "grandfather" distance provision carried over from the Choice Program
4. The VA can't provide care within designated access standards — average drive times of 30 minutes for primary care and mental health or 60 minutes for specialty care, or appointment waits of 20 days for primary care / 28 days for specialty
5. You and your VA provider agree community care is in your best medical interest
6. A VA service line doesn't meet certain quality standards

Community care still starts at the VA: your VA care team confirms eligibility, the VA authorizes and schedules (or you self-schedule with an in-network provider once approved), and the VA pays the community provider directly. Your copays match what the same care would cost at a VA facility — community care isn't a premium tier.

The urgent care benefit

Separately from authorized community care, enrolled veterans who've received VA care in the past 24 months can walk into an in-network community urgent care clinic for minor illnesses and injuries — no prior authorization. Copays follow the urgent care schedule: free for the first three visits each year in priority groups 1–5, $30 otherwise, and always free for a flu-shot-only visit. Find in-network locations through the VA facility locator before you go — out-of-network urgent care isn't covered under this benefit.

What MISSION Act care doesn't change

• It's authorization-based. Outside the urgent care benefit and qualifying emergencies, community care needs VA approval first. A civilian specialist you booked yourself isn't covered retroactively.
• It's not insurance. Eligibility is evaluated per episode of care against the criteria above — it travels with the referral, not with you.
• Prescriptions route back. Community providers' prescriptions are generally filled through VA pharmacy (urgent-care scripts have a short-term local-fill process).