AUGUSTA — Veterans can now use some urgent care centers without first getting permission from the VA. 

As part of the implementation of the Veterans’ Affairs MISSION Act, veterans now have access to urgent care at participating urgent care centers without prior authorization. 

“If you are a rural veteran, and you cannot get down to Bangor or Augusta or Portland, it is a total asset,” said Gary Lawyerson, head of the Maine Veterans Coordinating Committee.

The goal of the MISSION Act is to give veterans more access to private healthcare. Potentially, the act decreases wait time for veterans to be seen and prevent the need for veterans to travel for care. Approved in 2018, it went into effect in June. 

Jonathan Barczyk, acting public affairs officer for the VA Maine Healthcare System, said the urgent care benefit was one of the lesser-known provisions of the law.

“Urgent care is one of the best benefits coming out of the MISSION Act,” said Corey Vail, chief of Non-VA Care.

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Previously, veterans in need of urgent care — like treatment for non-life-threatening illnesses or injuries like influenza, minor lacerations or pink eye — received treatment either at a local emergency room or at a general practice facility if the veteran had authorization from the VA. Now, veterans needing urgent but non-emergency treatment can get it and prescriptions associated with the visit when they attend a center in the VA’s contracted network of community providers.

In order to receive urgent care, veterans must be enrolled in the VA healthcare system and have received care through it within the past 24 months. Dependents will not able to receive the care. 

Within 100 miles of the VA medical center at Togus, there are 25 urgent care facilities contracted with the VA, Vail said. He anticipates “in the coming months, we will see the number of contracted urgent care centers grow.”

But Vail acknowledged that there are deficits in urgent care treatment in northern, downeast and western Maine, where populations are small and urgent care centers do not exist. 

“We are looking into other solutions, like walk-in family practice centers, that might be able to take veterans,” he said. 

Vail hopes that all urgent care centers in Maine will contract with the VA; the contracts are administered by a third party, TriWest. So far, he said, those that have are receptive. 

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If the veteran receives care from an urgent care center that is not in the contracted network, the benefit cannot be utilized, and the veteran may be responsible for the bill.

“It has happened already,” Vail said. “If it is not a contracted facility, the benefit does not exist.”

Contracted urgent care centers can be found online at va.gov/find-locations. Veterans can also access the VA call center at 623-8411, ext. 7490, or 877-421-8263.

Veterans can expect a $30 copay for the urgent care treatment, but there is no limit on visits, and they will be billed for the treatment. 

For veterans who do not usually have copays, there will not be one for the first three urgent care visits in the calendar year. They would then have a $30 copay for any additional treatments.

Vail said veterans can still receive treatment at an emergency room, but the treatment must be for what a layperson would consider an emergency, such as a life-threatening injury. He said if the veteran visits an emergency room, it should be part of the contracted network, or a VA facility should not be more feasible to visit. The veteran will have 72 hours to notify the VA of the treatment.

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The potential for misunderstanding creates apprehension for veterans to go outside the VA network, Lawyerson said, especially older veterans from World War II and Korean War eras.

If it could be streamlined, he said, the opportunities offered to veterans under the MISSION Act have potential.

“Veterans want to go to Togus because that is what they consider their military base,” Lawyerson said. “But in some cases, the (private sector) is better than the primary care physicians (in the VA network).”

After diagnosis of liver cancer last year, Lawyerson was treated at private medical centers.

“The doctor in Lewiston knew about liver fluke,” he said, which is a parasite he contracted during the Vietnam War and may have caused his cancer. 

He said it is not just the VA physicians who know about diseases and ailments associated with combat tours. 

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Lawyerson said that when he was last checked, the cancer was not showing. 

“I’m tickled pink with the program as it is working now,” he said.

“I have noticed quite an increase in community care since the MISSION Act has been implemented,” said Vail.

He also reminded veterans that if they have an outside insurance company, the VA may try to recoup from that provider for any health condition that may not be service connected. 

The VA Maine Healthcare System is responsible for overseeing the treatment of about 43,000 veterans and is composed of one main campus in Augusta and community-based outpatient clinics in Bangor, Bingham, Calais, Fort Kent, Houlton, Lewiston, Lincoln, Portland, Rumford and Saco. The Augusta campus does have an emergency room, but it does not have an urgent care center.


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