The short answer
Ask your VA care team for the care you need and say you'd like Community Care. They check your eligibility, confirm your choice, and prepare a referral, which VA says can take up to 14 days. Then you or VA schedule it. Don't go to a routine appointment until VA has approved the care.
Why do I need VA's approval first?
Because VA only pays for routine Community Care it has authorized. Under 38 CFR 17.4020, VA authorizes outside care when you're eligible, you choose it, and VA finds it clinically necessary. If you see a community provider for routine care without that approval, VA generally won't pay, and you could get the bill.
Urgent care at an in-network clinic and emergency care are exceptions with their own rules. See Community Care vs. Urgent Care vs. Emergency Care.
How do I ask for a referral?
- Contact your VA care team. Your primary care provider, mental health provider, or specialist. Secure Messaging is best because it puts the date in writing.
- Say what care you need and that you'd like Community Care for it.
- Ask which eligibility rule applies. For example, VA can't schedule you within 20 days. See Who Qualifies?
- Name a provider if you have one. Under 38 CFR 17.4020(b), you can ask for a specific eligible provider. If you don't, VA picks one.
- VA confirms your choice. According to VA's referral page, VA checks your eligibility, contacts you to confirm you want Community Care and the type of appointment, then prepares the referral.
How long does a referral take?
VA says preparing a referral can take up to 14 days. That's VA's administrative estimate. It's separate from the access standards, which measure how long VA would take to see you. If 14 days pass with no word, follow up. See What to Do If Your Referral Is Delayed or Stuck.
Who schedules the appointment?
You choose. After the referral is ready, you can book it yourself or ask VA to book it. If you book it yourself, VA asks you to tell your care team within 14 days so they can record it and coordinate with the provider. See Scheduling Your Own Appointment.
What do I get once it's approved?
VA sends an authorization letter. VA says it includes:
- an authorization number;
- the approved in-network provider;
- a description of the care you can get; and
- how long you can keep getting care before you need another referral.
Keep it. It's your proof of what VA approved. See Your Community Care Authorization Letter.
What's the difference between eligibility, referral, and authorization?
| Step | What it means |
|---|---|
| Eligibility | You meet at least one rule for outside care |
| Referral | VA sends your request to a community provider |
| Authorization | VA's approval of specific care, a provider, and a time period |
| Appointment | The provider actually schedules you |
Being told "you qualify" isn't an authorization. Check that the provider has the referral before your visit.
What if I need more care later?
Track how many visits you've used and when your approval ends. VA says it won't cover services your authorization letter doesn't include. When you need more, your community provider asks VA through a Request for Service (VA Form 10-10172). Many authorizations for common services now last a full year. See How Long an Authorization Lasts.
Before your first appointment
- VA approved the care, and you have the authorization number.
- The provider on the letter is the one you're seeing.
- The appointment date is inside the approved time period.
- The provider's office confirms they have the referral.
- You know your facility's Community Care office number if something's missing.
What we see in practice
If you ask for a referral and get a "no" on the phone, don't stop there. In our experience, the fastest fix is putting the same request in writing through Secure Messaging, pointing to the exact access-standard regulation, and asking VA to confirm its answer in writing. That usually gets the referral submitted. Steps and a ready-to-send message: What to do if your Community Care referral is delayed or stuck.