VA Community Care vs. TRICARE: 2026 Guide to Benefits | TRICARE.com

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## Quick answer VA Community Care is a program that allows eligible Veterans to receive medical care from private providers in their local community instead of at a VA medical center. While TRICARE and VA Community Care are separate programs, they often coordinate benefits for retirees who are eligible for both systems.

Details

VA Community Care is governed by the MISSION Act. It is designed to ensure Veterans have timely access to healthcare when a VA facility cannot provide the specific service needed, has wait times longer than 20 days (for primary/mental health) or 28 days (for specialty care), or is more than a 30-minute drive from the Veteran’s home.

### The Role of TriWest Healthcare Alliance As of 2026, **TriWest Healthcare Alliance** serves a dual role that streamlines this process for many in the Western United States. TriWest is the regional contractor for the TRICARE West Region and also manages the VA’s Community Care Network (CCN) in several regions. This overlap often makes authorizations and provider networking more seamless for beneficiaries living in the West.

### Coordination of Benefits (TRICARE vs. VA) If you are a military retiree, you may have "dual eligibility" for both TRICARE and VA benefits. * **For Service-Connected Conditions:** The VA is generally the primary payer. You should use VA Community Care (with prior authorization) to ensure the VA covers the full cost. * **For Non-Service-Connected Conditions:** You can choose to use either TRICARE or the VA. If you use TRICARE, you will be responsible for standard 2026 cost-shares and deductibles (e.g., TRICARE Select Group A retirees typically pay a $30-$50 copay for specialty visits in 2026). * **Using Both:** If you see a private provider through VA Community Care, the VA pays that provider directly. TRICARE cannot be used to pay VA copayments.

### Authorization Requirements You cannot simply visit any doctor and ask the VA to pay. To use Community Care: 1. You must be enrolled in VA healthcare. 2. You must receive prior authorization from the VA. 3. The community provider must be part of the VA’s Community Care Network (CCN).

## Who this affects * **Retirees:** The primary group navigating the overlap between TRICARE and VA Community Care. * **Disabled Veterans:** Those with service-connected disabilities seeking local care. * **TRICARE For Life (TFL) Beneficiaries:** Retirees 65+ who use Medicare and TFL but may still use the VA for service-connected medications or specialized treatment. * **Note:** Active Duty Service Members (ADSMs) and their families typically use the TRICARE network and do not use VA Community Care.

## Sources * **VA.gov:** [Community Care Overview](https://www.va.gov/communitycare/) * **TRICARE.mil:** [Using the VA as a TRICARE Beneficiary](https://www.tricare.mil/va) * **TriWest Healthcare Alliance:** [CCN Provider Portal](https://www.triwest.com) * **Defense Health Agency:** [TRICARE and VA Benefit Coordination](https://health.mil)