Resources for Veterans
If you are seeking treatment with a doctor outside of the VA healthcare system, there are several ways you may qualify to use your VA benefits to do so:
- The help you need is not offered by the VA.
- You live too far from a VA location.
- There is too long of a wait time at the VA to meet your needs.
Let me explain what that means.
Currently (as of October 2015), the VA San Diego Healthcare System does not specifically have a behavioral (psychotherapy) treatment program for insomnia.
But if you are a Veteran who has been diagnosed with insomnia and seeking treatment, you may qualify for the VA to pay for treatment with a provider outside of the VA (also called “non-VA care”).
You must first be diagnosed by a VA provider with insomnia and request an evidence-based psychotherapy for insomnia (CBT for insomnia). What happens next:
- If the VA is unable to provide it (CBT-I), you may receive a consult to non-VA care.
- When and if approved, you will be referred to a VA-preferred psychologist who provides this therapy.
Connecting Veterans with Care Outside the VA: The Choice Program
Veterans Choice Act
In an effort to address long wait times and increase access to care for Veterans living far away from a VA location, the Veterans Choice Act was established. Congress agreed to fund a temporary program allowing Providers outside of the VA to join a network (TriWest Healthcare Alliance) of providers who have agreed to work with Veterans who cannot be seen at the VA due to excessive wait time or distance. Here is the most up-to-date information on the Veterans Choice Program
Who qualifies for the Choice Program?
Veterans who wish to use the Choice Program to see a Provider outside of the VA may be able to do so for two reasons:
- Excessive wait time (over 30 days) to get a VA appointment
- Living more than 40 miles away from a VA
WAIT TIME OVER 30 DAYS
Here's a general breakdown of how this works:
- Make an appointment with a VA Provider by calling or visiting your local VA. This enables you to "establish a wait time." If the wait time is greater than 30 days, the person making the appointment for you will give you a handout describing your eligibility to use the Choice Act. The phone number for the VA San Diego Healthcare System is 619-400-5000 (Mission Valley) or 858-552-8585 (main).
- Call the Choice Program at 1-866-606-8198. They will ask you for the name of a Provider (a doctor) you would like to see. I, Nancy Lin, am a Choice Act Provider for Behavioral Health at area code 92108.
- Call the VA San Diego Choice Team at 1-858-642-6331 to follow up on the request to use the Choice Program. The VA must submit an approval to the Choice Program that verifies that your wait time is greater than 30 days. Currently, the VA is having some difficulty keeping up with the volume of requests. I recommend following up on a weekly basis to check on the status of your request.
- A TriWest agent administering the Choice Program will call you to set up an appointment. They, too, may ask you for the name of a Provider (a doctor) you would like to see. I, Nancy Lin, am a Choice Act Provider for Behavioral Health at area code 92108.
DISTANCE OVER 40 MILES
The same applies as above. However, you may be offered telehealth if the type of care you need is not available within or outside the VA within 40 miles of your home. Telehealth is a form of care delivered over the Internet from a VA clinic or from your home.