Does VA Community Care Network cover rehab? It can. Eligible veterans may get addiction treatment from an in-network community provider through the VA Community Care Network (CCN), but the VA must approve and refer you first; you can’t simply book care and bill the VA. Whether you qualify depends on your VA eligibility and your situation. The Ranch Pennsylvania Outpatient Services accepts VA Community Care Network (VACCN) coverage for outpatient addiction treatment when the VA authorizes care.
This guide explains how VA community care works, who qualifies, which company runs the network in Pennsylvania, and the steps to take if you’re a veteran who wants help with drinking or drug use.
What Is the VA Community Care Network?
The VA Community Care Network is not insurance. It’s a network of community providers that helps the VA offer veterans care outside VA facilities, in their local communities, when needed. According to the VA’s community care network overview, the network is divided into regions, each run by a third-party administrator.
Pennsylvania is in Region 1, which also includes states such as New York, New Jersey, Maryland, Delaware, Virginia and West Virginia. The VA lists Optum Serve as the third-party administrator for Region 1. Optum Serve administers the network for that region, but the VA still decides whether you’re eligible and what care is approved.
Who Is Eligible for VA Community Care?
To use community care, the VA says you must be enrolled in or eligible for VA health care and get approval from your VA health care team before seeing a community provider (except in certain cases such as urgent or emergency care). You must also meet at least one of these criteria:
- You need a service the VA doesn’t provide at any VA health facility.
- You live in a state or territory without a full-service VA health facility.
- You qualified under the 40-mile distance requirement as of June 6, 2018.
- The VA can’t provide the care within its drive-time and wait-time standards. For mental health care, that’s a 30-minute average drive or a 20-day wait; for specialty care, a 60-minute drive or a 28-day wait.
- You and your VA provider agree that community care is in your best medical interest.
- The VA can’t provide the service in a way that meets its quality standards.
Does VA Community Care Network Cover Rehab Programs Like PHP and IOP?
The VA itself offers a full range of substance use care. Its substance use treatment page lists medically managed detoxification, medicines to reduce cravings (such as methadone and buprenorphine for opioid addiction), short-term outpatient counseling, intensive outpatient treatment, marriage and family counseling, residential care, and continuing care and relapse prevention.
When the VA refers you to the community instead, the referral and authorization spell out what care is approved. If your VA care team authorizes outpatient addiction treatment with us, that may include:
- Partial hospitalization (PHP): our addiction PHP runs full days, five days a week, and most clients complete it in about 8 to 12 weeks. PHP clients can live at our 16-bed, substance-free Outpatient Residence with 24/7 support staff.
- Intensive outpatient (IOP): our addiction IOP includes three-hour group sessions three days a week, typically for about 5 to 6 weeks.
- Therapy and psychiatric care, including individual, group and family therapy and medication management, with MAT when clinically appropriate.
We don’t provide detox on site. If medical detox is needed, it can be coordinated with residential care at The Ranch Pennsylvania before stepping down to outpatient care, subject to what the VA approves.
When PTSD and substance use happen together
Many veterans are dealing with trauma as well as substance use. The VA’s National Center for PTSD notes that trauma-focused talk therapies like cognitive processing therapy (CPT) and prolonged exposure have the most research support. We offer CPT as part of integrated dual diagnosis care. Learn more about PTSD in veterans and treating PTSD and addiction together.
How the VA Referral Process Works
- Talk to your VA care team. The VA recommends that veterans already in VA care discuss substance use concerns with their VA provider. If you aren’t enrolled, apply for VA health care first.
- Ask about community care. Your team checks whether you meet an eligibility criterion.
- Get a referral before scheduling. The VA states you must get a referral from your VA health care team before making an appointment with a community care provider.
- Schedule with an in-network provider. Once referred, you can begin care with an approved Community Care Network provider.
How to Check Your VA Community Care Network Coverage
Your VA care team is the best source for your eligibility, referral status and any costs. Ask them exactly which services your referral covers. Our admissions team can also help: verify your insurance or VA referral with us, and we’ll explain next steps. If you also have private insurance, our guide on how to check your insurance coverage for rehab may help.
Frequently Asked Questions
Does VA Community Care Network cover rehab without a VA referral?
No. Outside of certain urgent or emergency situations, you need approval and a referral from your VA health care team before you see a community provider.
Who runs the VA Community Care Network in Pennsylvania?
Pennsylvania is in CCN Region 1, and the VA lists Optum Serve as the third-party administrator for that region.
Can I get community care if the VA wait time is too long?
Possibly. If the VA can’t provide mental health care within a 30-minute average drive or a 20-day wait, you may qualify for community care.
Does the VA also cover mental health care in the community?
It can, with the same approval process. See VA Community Care Network mental health coverage.
Get Help for Addiction in Lancaster, PA
If you’re a veteran in crisis, call 988 and press 1 to reach the Veterans Crisis Line, or call 911 in an emergency. If opioids may be involved in an overdose, call 911 and give naloxone if you have it. The Ranch Pennsylvania Outpatient Services offers addiction treatment programs in Lancaster for veterans across Lancaster County and central Pennsylvania. We accept VA Community Care Network coverage, and care depends on VA authorization. Verify your insurance or referral today. Our admissions team is available 24/7, and calls are free and confidential.
