By Freddy Groves
Veterans who get their medical care from civilian facilities need to keep an eye on what’s coming. In 2026 the contracts (originally signed in 2018) between the VA and community health plan networks are expiring. An RFP (request for proposal) has gone out to solicit new contracts.
Some changes are coming:
The five regions of VA health care are being reduced to two.
The new contracts will require the community providers to follow industry standards, which is shocking. Is that not already included in any contract to provide medical care to veterans?
At this point, 40% of veterans get their care from civilian providers. That will likely increase, as the new plan contracts will open the door for more providers.
Veterans who want to pursue getting medical care at a non-VA facility need to meet eligibility requirements:
• Must be enrolled in VA health care.
• Live in a state with no full-service VA facility.
• The care needed isn’t available through the VA.
• The VA can’t meet quality standards.
• Qualifies under the old Choice Program: a 30-minute drive (or 20-day wait) for VA primary care or 60-minute drive (or 28-day wait) for specialty care.
Remember that the two-step rule changed in 2025, and if your doctor agrees you need to see a civilian doctor, a second doctor doesn’t need to approve it. Depending on the care you need (there are 30 categories of medical care, such as cardiology and dermatology), you’ll likely be approved for one year.
Here’s where you come in, should you choose to do so. If you’re getting civilian care, will their network administrators be putting in a proposal for the next round of contracts? In other words, will you be able to continue getting care there? Do they know the deadline for their proposal is March 16? I would ask. This is part of being proactive in your own care … asking questions.
To learn more about community care, see https://www.va.gov/communitycare/.
