Your Questions about the MISSION Act Answered

Thomas Costello, LCSW, is Project Sanctuary’s Chief of Family Support. He breaks down the most frequently asked questions he receives from family’s in this week’s blog. For further questions about the MISSION Act, contact your VA healthcare provider directly. To access Project Sanctuary’s Family Support services, contact Thomas at familysupport@projectsanctuary.us.

On June 6, 2019, the U.S. Department of Veterans Affairs began implementing the MISSION Act, designed to expand access to care for veterans eligible and enrolled in the VA system. As Project Sanctuary’s Chief of Family Support, I frequently get requests to assist veterans in accessing care. I’ve recently heard a few things stated about the MISSION Act that weren’t true, so I thought it would be helpful to give a summary of the frequently asked questions about the MISSION Act.

I would encourage you to start by watching this short video. All of the information in this blog post comes directly from the Veterans Affairs website and more information can be found here.

When can I receive community care? Eligibility for community care depends on your individual health care needs or circumstances. You should discuss community care eligibility with your VA care team to determine if you are eligible.

Can I get dental care through the MISSION Act? Eligibility for dental services has not changed under the MISSION Act. You should talk to your VA care team about eligibility for dental services.

How does a community provider know I am eligible to receive community care? If your VA care team has determined that you are eligible for community care and you chose a community provider, VA will send the provider a referral and authorization prior to you receiving care. You must receive approval from VA prior to obtaining care from a community provider in most circumstances.

I was authorized for community care under the Choice program. What happens now? The Choice program expired on June 6, 2019, and specific Choice eligibility for community care is no longer being used. If you were eligible for community care under Choice, you should speak with your VA care team or a VA staff member at your local VA medical facility about updated eligibility for community care. Urgent care

How do I become eligible for the urgent care benefit? You must be enrolled in VA health care and have received care through VA from either a VA or community provider within the past 24 months to be eligible for the urgent care benefit.

How can I find an urgent care provider? To find an urgent care location in VA’s contracted network, use the VA facility locator at https://www.va.gov/find-locations/. Select the link entitled “Find VA approved urgent care locations and pharmacies near you”.

What is the difference between urgent care and emergency care? Urgent care consists of medical services provided for minor illnesses or injuries that are not life-threatening such as strep throat, pink eye, or influenza. Emergency care consists of inpatient or outpatient hospital services that are necessary to prevent death or serious impairment of health such as severe chest pain, seizures or loss of awareness, heavy uncontrollable bleeding, or moderate to severe burns.

Do I have to pay a co-payment if I receive urgent care that relates to my service-connected condition? Co-payments for urgent care are different from other VA medical co-payments. Co-payments for urgent care depend on your assigned priority group and the number of times you visit any urgent care provider in a calendar year.

How do I get prescription medication related to an urgent care visit? VA will pay for or fill prescriptions for urgent care. For urgent care prescription medication longer than a 14-day supply, the prescription must be submitted to VA to be filled. For urgent prescriptions written by an urgent care provider, you can fill a 14-day supply of medication at a contracted pharmacy within the VA network, in VA, or at a non-contracted pharmacy. If a non-contracted pharmacy is used, you must pay for the prescription and then file a claim for reimbursement with your local VA medical facility.

For further questions about the MISSION Act, contact your VA healthcare provider directly. To access Project Sanctuary’s Family Support services, contact Thomas at familysupport@projectsanctuary.us.

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