Veterans Choice Program

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The Shores Treatment and Recovery Center is honored to serve our Veterans by participating in the VA Community Care Program, providing top-quality drug and alcohol addiction treatment to Veterans and their families. If you are a Veteran or a family member of a Veteran who is currently enrolled in the VA health care program, you may be eligible to participate in the Veteran Choice Program (VCP). The VCP Act gives Veterans access to VA health care as well as with verified community partners, ensuring Veterans have access to the best care.

Veterans Choice Program

How The Shores Helps Veterans

The Shores Treatment and Recovery is proud to offer dual-diagnosis treatment tailored for our men and women who serve/d our country. By being able to treat both addiction and co-occurring conditions such as PTSD, depression, anxiety, etc., you will gain the tools needed for long-lasting sobriety. Our licensed treatment facility and therapists provide you with a supportive, loving and nurturing environment so you can get back to living your best life.

For admission to The Shores Treatment and Recovery Center call the Veteran Choice Program Call Center at 1-866-606-8198 to verify your eligibility and request The Shores Treatment and Recovery.

If you would like more information on our treatment programs call one of our addiction specialists at 1-888-249-2590 or click here.

What is the Veteran Choice Program

On August 7, 2014 the Veterans Access, Choice and Accountability Act of 2014 (VACAA) was signed into law. This act allows Veterans who are already enrolled in VA health care to receive health care in their community rather than waiting from a VA appointment or traveling to a VA facility.

The VA created this program to enable Veterans to receive care in their community without being burdened to wait for an appointment or travel far to the Veterans nearest VA medical facility.

Veteran Choice Program Eligibility Requirements

In order to be eligible to participate in the Veteran Choice Program (VCP), a Veteran must be enrolled in VA health care and meet at least one of the following criteria:

  • The Veteran is told by their local VA medical facility that they will not be able to schedule an appointment for care either:
    • within 30 days of the date the Veteran’s physician determines they need to be seen
    • within 30 days of the date the Veteran wishes to be seen
  • The Veteran lives more than 40 driving miles from a VA medical facility with a full-time primary care physician
  • `The Veteran faces unusual or extenuating circumstances in which traveling to a VA medical facility is burdensome based off of one or more of the following factors:
    • Geographic Challenges
    • Environmental Factors
    • Medical Condition
    • Travel to the nearest VA medical facility requires air, boat or ferry

The staff at the Veteran’s local VA medical facility will work with the Veteran to determine if any of these reasons make the Veteran eligible to participate in the Veteran Choice Program

  • The Veteran lives in a State or Territory without a full-service VA medical facility

To verify your eligibility, you must call the VCP call center at: 1-866-606-8198 or visit www.va.gov/opa/choiceact.

USA VA Community Care

FAQ – Veterans Choice Program (VCP)

  1. I think I am eligible. Now what do I do now?

Call the VCP call center at 1-866-606-8198 or visit the Veterans Choice Program website to verify eligibility and set up an appointment with your VCP community provider. When you call you will be asked your name, full address, and name of your preferred community provider.

  1. Once I verify my eligibility can I call my non-VA physician to schedule my appointment?

No, you must call the VA call center to verify your eligibility and set up the appointment.

  1. How is the 40 mile distance determined?

The 40 mile calculation is based off of the driving distance from your permanent residence to the closest VA medical facility, which includes Community-Based Outpatient Clinics and VA medical centers.

  1. Does my eligibility cover Beneficiary Travel for travel appointments with a Veterans Choice Program Partner?

Yes, the Veteran Choice Program does provide funds for travel to our community partners for Veterans who are eligible for Beneficiary Travel. Please be advised that the Veteran Choice Program Act does not provide any new Beneficiary Travel eligibility.

  1. What if I did not receive or lost my Choice Card?

To access the Veterans Choice Program you do not need your Choice Card. However, you can call the VA call center at 1-866-606-8198 to receive a new card and make an appointment.

  1. If I need prescriptions, how do I get my prescriptions filled while using the Veterans Choice Program?

Community providers are able to issue prescriptions of a national formulary drug for up to a 14 day supply.

Reimbursement of prescriptions can be done through the Business Office/Non-Va Care Coordination Office at your local VA facilities. Reimbursement cannot be done at the VA Pharmacy. Please be advised that reimbursement can take up to 30-45 days to process and requires a copy of the prescription and the original receipt.

For prescriptions that require more than 14 days, follow the standard procedures to fill your prescription at your VA Pharmacy.

  1. Does the Veteran Choice Program affect my VA health care?

No. The Veteran Choice Program is there to make it easier to access the care that you need. Therefore, you have a choice between VA health care and the Veteran Choice Program. The VA has created a well integrated health care network to offer the best of the VA and the community. By having a well integrated health care network, Veterans have more choices to access care, when and where you need it.

  1. Do I still have to provide the VA my private health insurance information?

Yes. In order to use the Veteran Choice Program you have to provide the VA with your private health insurance information. This means that you are no longer responsible for copayments associated with your private health insurance.

  1. What does clinically indicated date mean?

The clinically indicated date is the date you and your medical provider agree should be the next date you are seen for care. If the VA is not able to schedule a date within 30 days from that date you may be eligible for Veteran Choice Program.

  1. Can I use Veteran Choice Program and see my doctor at my local VA medical facility?

Yes. The Veteran Choice program gives you the flexibility to access medical care in your community as well as with the VA health care system. For instance you can use VCP to receive one type of care and still continue to receive care at your local VA medical facility.

 

Covered Care

Covered Care

Is Emergency care covered by Veteran Choice Program?

No, all care under the Veteran Care Program must be preauthorized. Contact your local VA medical facility for more information on non-VA emergency care.

Do I qualify for the Veteran Choice Program for specialty care or elective surgery?

Yes, you can be referred to the Veteran Choice Program for any type of care except for emergency and long-term care.

As a female Veteran, I require OB/GYN services, but the nearest VA medical facility doesn’t offer this care. Can I go ahead and use the Veteran Choice Program to get an appointment with a preferred physician?

You may be eligible to use the program if the VA can’t schedule your appointment within 30 days of the clinically indicated date or your preferred date.

 

Insurance Information

  1. Do I have to pay copayments for my private health insurance?

No. You are only responsible for your VA copayment because the VA is now the primary coordinator. Your VA copayment will be determined by the VA after you receive your treatment.

  1. Am I responsible for Medicare, Medicaid, or TRICARE cost-shares?

No, these plans are not considered OHI for purposes of the Veteran Choice Program. You will not be billed by Veteran Choice Program for any of the cost-shares associated with these plans.

  1. Will copays be collected by the community partner?

No. VA copays will not be collected at the time of appointment. The VA will bill you after the appointment, the same way you are billed after you receive care at your local VA medical facility.

  1. What if I don’t have a VA copayment, do I still get billed?

Veterans are responsible for the same VA copayments for the Veteran Choice Program. Therefore, if you do not have VA copayments, then you are not responsible for copayments under the Veteran Choice Program.

  1. Can I use the Veteran Choice Program if I don’t have personal/private insurance?

Yes. Not having private health insurance does not exclude you from the program. However, if you have private health care insurance you are required to submit that information to the Veteran Choice Program.

 

Source: https://www.va.gov/healthbenefits/

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