Veterans and military families · VA community care
VA Community Care Network Behavioral Health in Maryland: How It Works
VA community care lets eligible veterans receive some care from providers outside VA, paid for by VA, once VA approves it. This guide explains how eligibility, approval and costs work for mental health care, based on what VA publishes.
Prefer to talk? Call (410) 231-0488
Key takeaways
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VA approval comes first
VA must authorize community care before your visit, except in certain urgent or emergency situations.
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VA decides eligibility
You need to be enrolled in or eligible for VA health care and meet at least one of VA’s community care conditions.
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Mental health access standards
For mental health care, VA uses a 30-minute average drive time or a 20-day wait time as its designated access standards.
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Crisis care is separate
Community care referrals are for scheduled care. If you are in crisis, call 911, go to the nearest ER, or call or text 988.
What is VA community care for mental health?
According to VA’s community care overview, VA can provide care for veterans through providers in their local community when VA cannot provide the care needed. That care is provided on behalf of VA and paid for by VA.
Community care is not a separate insurance plan. It is a way for VA to arrange care outside its own facilities, based on eligibility rules and each veteran’s needs and circumstances. VA also notes that you can always choose to get care at a VA health facility.
For mental health, community care can include outpatient services such as therapy or psychiatric care when VA approves them. Your VA care team can explain which services your approval covers.
Who may be eligible
VA’s community care eligibility page lists two basic requirements. You must be enrolled in or eligible for VA health care, and you must have approval from your VA health care team before you get care from a community provider, except for certain cases like urgent or emergency care. VA community care applies to veterans. If you are on active duty, see how TRICARE East referrals and pre-authorization work for active duty instead.
At least one of these must also be true, according to VA:
- You need a service that VA does not provide at any VA health facility.
- You live in a state or territory without a full-service VA health facility.
- You and your VA provider agree that care from an in-network community provider is in your medical interest.
- VA cannot provide the service you need in a way that meets its quality standards.
- VA cannot provide the care within its drive time and wait time standards.
- You qualified under the older 40-mile distance rule as of June 6, 2018, and meet VA’s remaining conditions for it.
Drive time and wait time standards for mental health
For primary care, mental health and extended outpatient care, VA lists a 30-minute average drive time or a 20-day wait time. If the drive to your nearest VA clinic is longer, or the soonest appointment is more than 20 days away, you may be eligible. VA makes the final decision.
How to get a community care referral
Community care starts with VA, not with the community provider. These steps follow VA’s published process:
- Confirm your VA health care enrollment. If you are not enrolled yet, VA explains how to apply for VA health care.
- Talk with your VA care team. Describe the care you are looking for and ask whether community care is an option for you.
- Wait for VA authorization. VA must approve community care before your first visit with a community provider.
- Ask what your approval covers. Note the type of care, the number of visits or time period, and who to contact if you need more care.
- Plan ahead. If you will need care beyond what VA approved, ask your VA care team about next steps before your approval ends.
VA’s facility locator can help you find VA clinics and in-network community providers near you. If VA denies your request, VA says you can appeal through its clinical appeals process. For each step of the request, see our guide on how to get a VA Community Care referral for mental health in Maryland. If you get care at the Charlotte Hall VA Clinic, our guide to VA community care through Charlotte Hall and the Washington DC VA lists local contacts.
Costs and copays
VA states that, as with care provided directly by VA, veterans are charged a copayment for nonservice-connected care received through community care. VA may also bill your other health insurance for care related to nonservice-connected conditions.
Copay amounts and any exemptions are set by VA and can change. Check VA’s current copay rates or ask your VA care team what applies to you before your visit.
Other support for veterans and military families
Community care is one option among several. Depending on your situation, these may also help:
- VA mental health services at a VA medical center or clinic. Your VA care team can explain what is available locally.
- Vet Centers, which offer counseling and support for eligible veterans, service members and their families.
- TRICARE for active duty service members, military families and eligible retirees. Blue Sails accepts TRICARE, and referral rules depend on your plan and status.
Our page on behavioral health care for Maryland veterans and military families covers how therapy, psychiatry and family support work at Blue Sails.
Behavioral health care at Blue Sails
Blue Sails offers outpatient therapy for individuals, couples and families in Lusby, in Bethesda or by telehealth across Maryland. Psychiatric medication management is available in Maryland.
Blue Sails accepts insurance, including TRICARE. Coverage and authorization rules vary by plan, so our team can review your options with you before you start. See insurance and billing, or call (410) 231-0488 with questions.
Same-day help and crisis lines for Maryland veterans
If you are in crisis, call 911, go to the nearest ER, or call or text 988. Veterans, service members and their families can also press 1 after calling 988 to reach the Veterans Crisis Line.
The Veterans Crisis Line website also offers a confidential online chat. You do not need to be enrolled in VA health care or have a community care referral to reach crisis support.
Blue Sails is not an emergency service. Community care referrals and outpatient appointments are for scheduled care.
Frequently asked questions
Ask our team about therapy, psychiatry and your coverage options.
Do I need VA approval before seeing a community provider?
Yes. VA says community care must be authorized by VA before you receive care from a community provider, except for certain cases like urgent or emergency care.
What are VA’s access standards for mental health care?
For primary care, mental health and extended outpatient care, VA lists a 30-minute average drive time or a 20-day wait time. Meeting a standard may make you eligible, and VA makes the final decision.
Can I still choose care at a VA facility?
Yes. VA notes that you can always choose to get care at a VA health facility, even if you are eligible for community care.
Will I pay a copay for community care?
VA states that veterans are charged a copayment for nonservice-connected care, as with care provided directly by VA. Amounts and exemptions are set by VA, so check VA’s copay rates or ask your VA care team.
What if VA denies my community care request?
VA says you can appeal a community care denial through its clinical appeals process. Your VA facility’s chief medical officer, or someone they designate, reviews the appeal.
Talk with us about care for veterans
Tell our team what you are looking for and how your care is covered. Therapy is available in Lusby, in Bethesda or by telehealth, and psychiatry is available in Maryland.
If you are in crisis, call 911, go to the nearest ER, or call or text 988.