VA transitioning urgent care network managers

August 27, 2020

Twenty-three states including Florida affected

Courtesy of the U.S. Department of Veterans Affairs

VA’s goal is to give eligible Veterans who need same-day urgent care for minor illnesses or injuries as many avenues as possible at the right time, right place and right provider.

VA is transitioning its urgent care network managers on Sept. 1, 2020, from TriWest Healthcare Alliance (TriWest) to Optum Public Sector Solutions, Inc. (Optum), which is part of UnitedHealth Group, Inc.

The changes will take place in Community Care Network (CCN) Regions 2 and 3.

VA’s goal is for the transition to be seamless for Veterans. However, the change will result in new urgent care providers being added to its contracted networks while others may be removed.

Minor illnesses at in-network non-VA urgent care providers

Veterans have the option for urgent care treatment of minor injuries and illnesses such as colds, sore throats and minor skin infections at in-network, non-VA, urgent care providers. In addition, Veterans can receive same-day, urgent care treatment at VA medical centers.

Veterans who need urgent care may have the option to use telehealth (phone- or video-based visits) instead of in-person visits at VA or in-network community clinics. Telehealth allows Veterans to conveniently access health care at home while reducing their exposure to COVID-19.

“VA is committed to providing the safest and highest quality health care to Veterans, whether they are receiving their care within VA or in the community,” said Deputy Under Secretary for Health for Community Care, Dr. Kameron Matthews.

Veterans required to pay for out-of-network providers

VA can only pay for urgent care if the provider is part of VA’s contracted network. Veterans who go to an out-of-network urgent care provider must pay the full cost of care.

The change in network management will also affect pharmacies. Veterans who require urgent care prescriptions of 14 days or less can find an authorized in-network provider or contact their local VA medical facility to identify a VA network pharmacy to avoid paying out-of-pocket costs.

States where changes will impact Veterans

The change will impact Veterans in the following locations: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, North Dakota, Ohio, Oklahoma, Puerto Rico, South Carolina, South Dakota, Tennessee, Wisconsin, and the U.S. Virgin Islands.

Veterans in these states or U.S. territories who need urgent care should use VA’s facility locator or contact their local VA medical facility for help identifying in-network urgent care providers.

Through this unified system, VA continues to deliver care for Veterans at VA and in the community.

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