If you get your health care through VA and want mental health care closer to home or sooner, VA community care may let you see a provider outside VA, paid for by VA, once VA approves it. This guide walks Maryland veterans through the request itself: who qualifies, how to ask your VA care team, a secure-message script you can copy, what happens while VA prepares the referral, and how to read your authorization letter. For a shorter overview of how community care works, see our page on VA Community Care Network behavioral health in Maryland. This is general information, not benefits advice, and VA sets and updates the rules.
Key Takeaways
- Community care starts with VA: you must be enrolled in or eligible for VA health care, and VA must approve the care before your visit (VA’s community care eligibility page).
- For mental health, VA uses a 30-minute average drive time and a 20-day wait time as two of its access standards (VA’s community care eligibility page).
- Ask your VA care team for a referral and name a community provider if you have one in mind. VA may take up to 14 days to prepare the referral (VA’s referral and scheduling guide).
- If you schedule the appointment yourself, tell your VA care team within 14 days (VA’s referral and scheduling guide).
- Your authorization letter lists the approved provider, care and time period; services outside it are not covered (VA’s referral and scheduling guide).
- In a crisis, call 911, go to the nearest ER, or call or text 988. Veterans can press 1 after calling 988 to reach the Veterans Crisis Line.
The 5-Step VA Community Care Process at a Glance
Getting a VA community care referral for mental health follows the same basic steps across Maryland. Each step is explained in more detail below, based on VA’s referral and scheduling guide.
| Step | What you do | What VA does |
|---|---|---|
| 1. Check eligibility | Confirm you are enrolled in (or eligible for) VA health care and review the community care criteria | Decides whether you qualify for community care |
| 2. Ask for a referral | Tell your VA care team what mental health care you want, by phone, at a visit or by secure message | Your VA provider requests the care |
| 3. Wait for approval | Hold off on booking; keep your contact details current | Reviews the request, confirms the care and appointment type with you, and prepares the referral (up to 14 days) |
| 4. Schedule | Book with the approved provider, or ask VA to book for you; if you book yourself, tell VA within 14 days | Records the appointment and shares records with the provider |
| 5. Stay within the authorization | Check the authorization letter and ask for a new referral if you need more care | Reviews any request for additional care |
Who Qualifies for VA Community Care Mental Health?
According to VA’s community care eligibility page, you need two things first: you must be enrolled in VA health care (or eligible for it), and you must have approval from your VA health care team before you get care from a community provider, except in certain cases such as urgent or emergency care. If you are not enrolled yet, you can apply for VA health care.
VA also says at least one of these must be true:
- 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 qualified under VA’s former 40-mile distance requirement as of June 6, 2018, and still meet VA’s location conditions for it.
- VA cannot provide the care you need within its access standards for drive time or wait time.
- You and your VA provider agree that getting care from an in-network community provider is in your “best medical interest” (VA’s wording).
- VA cannot provide the service you need in a way that meets its quality standards.
If VA decides you do not qualify, VA says you can ask about its clinical appeals process, which starts with the chief medical officer at your VA facility (VA’s community care eligibility page).
How VA’s Wait-Time and Drive-Time Standards Work
For primary care, mental health care and certain extended outpatient care, VA’s community care eligibility page lists a 30-minute average drive time and a 20-day wait time. If the average drive to a VA facility that offers the care you need is longer, or VA cannot schedule you within 20 days, you may be able to get community care.
| Standard | Mental health care | What it means |
|---|---|---|
| Average drive time | 30 minutes | If the average drive to a VA facility that offers the care you need is longer, you may qualify |
| Wait time | 20 days | If VA cannot schedule the care you need within 20 days, you may qualify |
| Your choice | Always | You can choose to get care at a VA facility even if you qualify for community care |
Your VA care team applies these standards to your situation, so it helps to tell them plainly how far you travel and how soon you were offered an appointment. If you are enrolled at the Charlotte Hall VA Clinic, our Charlotte Hall CBOC and Washington DC VA community care guide lists who to call at each step.
What VA Community Care Mental Health Costs
VA’s community care overview says that, as with care at a VA facility, veterans are charged copays for care that is not related to a service-connected condition, and VA may bill your other health insurance for that care. Copay rules are set by VA, so check VA’s current copay rates or ask your VA care team what applies to you. As of VA’s current copay page:
- First 3 mental health visits each calendar year: eligible veterans may not have to pay an outpatient copay for their first 3 visits with a qualified mental health provider at a VA facility or in VA’s community care network, for visits between June 27, 2023, and December 29, 2027. VA says it will review copays received since June 27, 2023, and reimburse eligible copays you already paid.
- Service-connected rating of 10% or higher: VA says you will not need to pay a copay for outpatient care.
- Special authorities: VA lists certain conditions, including those related to military sexual trauma, among the situations where copays may not apply.
- Medication and inpatient care: these have their own copay rules on the same page.
Questions about your own copays can go to VA’s health benefits hotline at 877-222-8387 (TTY: 711), Monday through Friday, 8:00 a.m. to 8:00 p.m. ET (VA’s current copay rates).
Ask Your VA Care Team for a Community Care Referral
VA’s referral and scheduling guide says the referral starts with your VA health care team. Tell them which mental health care you want to receive in the community, such as individual therapy, couples or family therapy, or psychiatric medication management. Being specific helps the team request the right type of care.
Your team will talk with you about whether community care fits your situation under VA’s eligibility rules. You can bring this up at a visit, by phone or by secure message. A request is not an approval: wait until VA confirms the referral before you book a routine appointment.
Copy This Secure Message Script for Your VA PCP
If a phone call feels like one more hurdle, VA secure messaging lets you make the same request in writing. Sign in on VA.gov, choose your primary care or mental health team, and keep the message to one clear ask. You can adapt this script:
Subject: Request for a community care mental health referral
Hello, I would like to ask about a community care referral for outpatient mental health care, specifically [therapy / psychiatric medication management / both]. I live in [city or ZIP code], and [the drive to the nearest VA clinic offering this care is about __ minutes / the first appointment I was offered was __ days out]. [If you have a preferred provider: I would like VA to consider [provider name], [practice name], [address], [phone], NPI [number].] Please let me know whether I qualify and what the next steps are. You can reach me at [phone or email], [times that work].
Secure messaging is for non-urgent requests. If you are in crisis, call 911, go to the nearest ER, or call or text 988.
Request Your Preferred Provider by Name and NPI
If you already have a community provider in mind, name them early. VA’s guide says you can find a provider yourself or ask your VA care team to help. Approval still depends on VA’s review, so treat the name as a request rather than a promise. Include:
- The provider’s full name and practice name.
- The practice address and phone number.
- The type of care you want from them, such as therapy or psychiatric care.
- The provider’s National Provider Identifier (NPI), if you have it. You can look it up in the federal NPI Registry.
Find an In-Network Maryland Community Care Provider
VA’s facility locator can help you find VA clinics and in-network community providers near your Maryland address. A few tips:
- Search for the specific care you need, such as mental health care, rather than a broad category.
- Check the provider’s address and how far you would realistically travel.
- Call the practice to ask whether they are accepting new patients, since listings can change.
- Share the provider’s full name and location with your VA care team when you request the referral.
If the provider you want is not in VA’s network, VA’s referral and scheduling guide says you can still ask your VA care team for help, and they can talk with you about your options.
What Happens During VA’s Referral Prep
Once your VA provider requests community care, VA’s referral and scheduling guide describes these steps:
- VA reviews your eligibility and care needs.
- VA contacts you to confirm you want community care and to confirm the type of appointment.
- VA prepares your referral. VA says this can take up to 14 days.
Keep your phone number, email and mailing address current in your VA profile so you don’t miss that contact. If you haven’t heard anything, contact your VA care team to check on the request.
Wait for Referral Approval Before You Book
Waiting is hard when you are ready to start. But VA’s community care overview says community care must be authorized by VA before you receive care from a community provider, and VA’s referral and scheduling guide says services not listed in your authorization are not covered. Booking a routine visit before approval can mean the visit is not paid for by VA.
| Usually safe | Can leave you with a bill |
|---|---|
| Booking after VA confirms your referral is approved | Booking a routine visit the day you send your request |
| Seeing the provider named in your authorization | Assuming any community clinic is covered |
| Staying within the services and dates in the letter | Adding services the letter does not list |
Crisis care follows different rules. If you are in crisis, call 911, go to the nearest ER, or call or text 988.
Schedule Your VA Community Care Appointment
After you have your referral, VA’s referral and scheduling guide says you have two options, and VA then sends your authorization letter:
- Schedule it yourself with the approved community provider. If you do, tell your VA care team within 14 days so they can add it to your chart and work with your community provider.
- Ask VA to schedule it for you. Your VA care team or community care staff can make the appointment and let you know the details.
If something changes, such as a cancellation or a new time, let the provider and your VA care team know as early as you can. For questions about your referral or how many appointments you have left, VA lists 877-881-7618 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET (VA’s referral and scheduling guide).
Read Your Authorization Letter and Know Its Limits
Your authorization letter is VA’s approval for a specific episode of care. According to VA’s referral and scheduling guide, it includes:
- The authorization number.
- The name of the approved community provider.
- A description of the care that is approved.
- How long the authorization lasts.
Check that the provider and care you are booking match the letter, and keep a copy for your records. VA says it shares your health records with the community provider so they can coordinate your care.
Request a New Referral for Additional Visits
Needing more visits than your first authorization covers is a common part of care, not a setback. VA’s referral and scheduling guide says that if you need more care than your referral covers, you or your community provider can request a new referral. Signs it may be time to ask:
- Your approved visits are nearly used up, but your treatment plan is not finished.
- The end date in your letter is close and you still need regular support.
- You and your provider identify a service the current authorization does not include.
Ask before your current authorization runs out, and wait for VA’s approval before booking additional routine visits. If you have trouble getting care or resolving an issue, the VA Maryland contact page lists how to reach patient advocates.
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, and our team can review your coverage options with you before you start; see insurance and billing.
Our page on care for Maryland veterans and military families covers how therapy, psychiatry and family support work at Blue Sails, and our guide to veteran and military mental health covers TRICARE basics and planning care around military life. When you’re ready, you can request an appointment. Blue Sails is not an emergency service.
Maryland VA Mental Health Contacts and Crisis Lines
If you are in crisis, call 911, go to the nearest ER, or call or text 988. Veterans, service members and their families can press 1 after calling 988 to reach the Veterans Crisis Line, text 838255, or chat online, 24/7. You do not need to be enrolled in VA health care to use it.
Under VA’s free emergency suicide care policy, eligible veterans and former service members in an acute suicidal crisis can go to a VA or non-VA emergency room. VA says it will provide or pay for that emergency care, including transportation, whether or not you are enrolled in VA health care, and eligibility depends on service and discharge history.
For ongoing care, VA Maryland mental health care lists the services VA Maryland offers and a mental health point of contact. Vet Centers offer counseling for eligible veterans, service members and their families. Our behavioral health resources guide for Maryland collects more options.
Frequently Asked Questions
Can I use other health insurance alongside VA community care mental health benefits?
VA approval still comes first. VA’s community care overview says VA may bill your other health insurance for care related to conditions that are not service connected, and copays for that care follow VA’s current copay rates. Ask your VA care team how your other coverage fits with your referral.
Does VA community care cover psychiatric medication management?
Community care can include outpatient psychiatric care when VA approves it as part of your referral. Ask your VA care team to include it in the request, and ask how prescriptions from a community provider will be filled. Medication copays are listed on VA’s current copay rates.
Will my community care records be shared with my VA treatment team?
VA’s referral and scheduling guide says VA shares your health records with your community provider so they can coordinate your care. If you have questions about how visit notes come back to VA, ask your VA care team and your community provider.
What happens if I miss or need to cancel a community care appointment?
Call the community provider as early as you can, and let your VA care team know about the change. If you have questions about your referral or the appointments you have left, VA lists 877-881-7618 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.
Can dependents or family members receive therapy through VA community care?
VA community care referrals are for eligible veterans. Family members may have other options: Vet Centers offer counseling for eligible veterans, service members and their families, some family members qualify for CHAMPVA, and military families may use TRICARE, which Blue Sails accepts.
Sources: VA: How to get community care referrals and schedule appointments; VA: Eligibility for community care outside VA; VA: Copay rates; VA: Community care overview; VA: Free emergency suicide care; Veterans Crisis Line. Reviewed November 2026; VA rules can change, so confirm details with VA.