The short answer
Mostly because of access, not willingness. Many Veterans live far from VA facilities, families get confused about which program covers them, VA Community Care needs authorizations, and many therapists don't accept CHAMPVA or VA Community Care because of the paperwork. Every therapist who can bill these programs widens the door.
Why is it hard for Veterans to find a therapist?
The barriers are mostly practical. Stigma is real, but plenty of Veterans who want therapy still can't get it quickly. The common obstacles:
- Distance. About a third of Veterans enrolled in VA care live in rural or highly rural areas, according to VA's Office of Rural Health. The nearest VA clinic, or any therapist, may be far away.
- Coverage confusion. VA health care, VA Community Care, CHAMPVA, TRICARE, and Medicare all have different rules. Families often don't know which one applies to them.
- Authorizations. For VA Community Care, VA has to approve the care and send a referral before the Veteran can start. Delays at any step slow the first appointment.
- Too few community providers who take these programs. Some therapists avoid CHAMPVA or VA Community Care because of credentialing, authorizations, and billing they don't know.
- Fit. Veterans often want a therapist who understands military culture, and finding one takes extra searching.
How does provider paperwork affect access?
Directly. When billing a program feels risky or slow, therapists stop accepting it, and the Veterans who depend on that program lose options. A family with CHAMPVA may call a dozen practices before finding one that takes it.
This is a fixable part of the problem. The clinical skills are already out there in the community. What's missing is often a way for therapists to use them without becoming VA billing experts.
What can individual therapists do?
- Accept CHAMPVA. It has no network to join, and many families struggle to find providers who take it. See How to Start Accepting CHAMPVA.
- Offer telehealth. It removes distance for rural clients, as long as they're in a state where you're licensed.
- Ask every client about service. See Why ask "Have you ever served?"
- Learn military culture. VA's free training helps.
- Join a network that handles the admin for these programs.
How ValorWell handles this
ValorWell exists to close this gap from the provider side. It takes on the credentialing, authorizations, billing, and claims for CHAMPVA and VA Community Care, so therapists can treat Veterans and their families without learning those systems. The ValorWell Foundation pays for treatment for Veterans and families that VA won't cover.
ValorWell needs more therapists in every state. Its model is telehealth-first, so a therapist in one city can reach clients anywhere in the states where they're licensed.
Important limits
- No single fix exists. Telehealth doesn't help a Veteran without reliable internet or a private space.
- VA controls eligibility and authorizations. Community therapists can't speed up VA's decisions.
- Some Veterans prefer VA. VA care is excellent for many Veterans. Community care is one option among several.