VA Choice program expands eligibility

Jan 19, 2016 | Benefits, Veterans

By Patricia Kime, Staff writer 4:45 p.m. EST December 1, 2015 (Military Times)

An expansion of the Veterans Choice Program is expected to open it up to tens of thousands more vets. (Photo: Getty Images/stock)

The Veterans Affairs Department has announced new eligibility criteria for the Veterans Choice Program that should allow more veterans to access private health services closer to home.

Department officials said Tuesday that VA staffers have been given broader flexibility to determine eligibility for the Choice program if they believe a veteran faces an “undue burden” while traveling for treatment at a VA facility, such as a geographic barrier, environmental factors, a severe medical condition or a need for frequent care, such as chemotherapy or tests that can be done quickly closer to home.

The changes, which are effective immediately, also include an alteration of the program’s 40-mile distance standard from any VA medical facility to include at least 40 miles of driving to a VA facility with a full-time primary care doctor. That change alone will open the program to about 160,000 more veterans.

And the new rules also open eligibility to any veterans who must travel by air, boat or ferry to their nearest VA facility.

In their announcement, VA officials said the change will expand the program, established in late 2014, which allows veterans to see a civilian health care provider if they live in a remote area or can’t get an appointment at a VA facility within 30 days.

“As we implement the Veterans Choice Program, we are learning from our stakeholders what works and what needs to be refined,” VA Secretary Bob McDonald said. “It is our goal to do all that we can to remove barriers that separate veterans from the care they deserve.”

The changes were required as part of the Surface Transportation and Veterans Health Care Choice Act, signed into law July 31, which ordered VA to eliminate a requirement for a veteran to have been enrolled in VA health care by Aug. 1, 2014, to be eligible and set a new requirement for VA to expand eligibility.

Lawmakers in states with no full-service VA medical facilities, such as New Hampshire, and states in which veterans face long trips to the doctor, including Alaska and Hawaii, had pressed for more of their veteran constituents to be able to use the program.

Sen. Johnny Isakson, R-Ga., chairman of the Senate Veterans’ Affairs Committee, said the evolving VA Choice eligibility rules were the direct result of a “heart-to-heart” meeting between legislators and McDonald last summer.

In an August hearing, Isakson said that three-hour conversation led to improvements such as consolidating care, increasing eligibility and improving services.

“We locked arms, we sat down and decided to agree rather than disagree, and we found a solution to the problem,” Isakson said. “And today, the VA Choice program is working better, and our veterans have better access because of that day and that meeting.”

VA officials said veterans interested in finding out whether they qualify for Choice under expanded eligibility should call 866-606-8198.

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VA Choice program expands eligibility

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