How to choose treatment for veterans

Six steps to choose the right treatment for a veteran

Following these steps can help you narrow down your options to find the best treatment for you: 

• Step 1: Get an assessment. Seek a clinical assessment to determine the best level of care for your needs.
• Step 2: Check your insurance. Determine if you are enrolled in VA health care or check if you have a different insurance status so you know which network directory to use.
• Step 3: Evaluate MISSION Act criteria. Find out if you meet the criteria for the VA Community Care Network based on local wait times, travel distances, or service availability.
• Step 4: Filter and decide your shortlist. Explore programs that have dedicated veteran tracks or accept your specific benefits. 
• Step 5: Verify benefits and referrals. Call each admissions office on your shortlist of facilities. If using the VA, confirm the correct referral path. If using a private provider through VA Community Care, ensure they have a VA Community Care Network contract and can help coordinate the authorization.
• Step 6: Select the right program for you. Choose the program from your list that best fits your recovery goals and that specializes in veteran care. 

What should you think about first when choosing a program for a veteran?

When you are navigating substance use treatment as a veteran, you cannot just look for a facility that lists "veteran services" on its website and the best rehab is not necessarily the closest facility or the first one that mentions veterans. When you start searching for care, make sure to think about the following: 

• VA enrollment status: If you are already enrolled in VA health care, your primary care provider or local VA clinic can help with your care coordination next steps. If you aren't enrolled, you will need to verify your eligibility and register for benefits.
• The level of care needed: Treatment needs can range from outpatient care to residential care. You need a program that matches an independent clinical assessment to best fit your needs.
• Community Care: Under the VA MISSION Act, if the VA can’t provide the specific care you need, or if the wait time or distance to treatment is too long, you may qualify to receive treatment from an approved private provider through the VA Community Care Network that is closer to you or one that will meet your unique needs. The VA will then pay for care provided by a non-VA provider.
• Co-occurring conditions: If needed, the program you choose should be able to treat co-occurring conditions such as post-traumatic stress disorder (PTSD), depression, chronic pain, or military sexual trauma (MST) alongside substance use.

Should you seek treatment with the VA or a private rehab?

Choosing between the VA and a private treatment provider is an important decision in your path to seeking the best care for you. How to make this choice depends on your eligibility, preferences, and the level of care you need.

The VA can be a great first option because your treatment is tied to existing VA care. A private program may make more sense if you need faster admission, are looking for a specific setting, or you are seeking care at a facility with a dedicated veteran track.

VA MISSION Act criteria

To qualify to seek treatment at a private rehab through the VA Community Care Network, you have to meet at least one of the six specific VA MISSION Act eligibility criteria. For substance use treatment, the most common eligibility criteria are: 

• Wait times: Your local VA can’t see you for an evaluation or you can’t start treatment within 28 days.

• Driving distance: Traveling to the nearest VA facility that provides the care you need takes more than a 60-minute drive from where you live.

• Best medical interest: Your VA provider agrees that a specific private treatment program is in your best medical interest for a variety of reasons, for example, they offer a specialized track for military sexual trauma or co-occurring PTSD that the local VA doesn’t provide.

TRICARE, CHAMPVA, and private insurance options

If you don’t have VA healthcare, you may have one of the following insurance options. Seeking treatment will look different depending on your benefits. 

• TRICARE: If you are a retired or active-duty service member who has TRICARE, you do not go through the VA and instead you use TRICARE, which operates like commercial insurance, allowing you to access approved provider networks.
• CHAMPVA: If you are a dependent or survivor who has CHAMPVA, you also use an approved provider network to seek care. 
• Other health insurance: If you have private insurance and VA benefits, the VA is required to charge your private insurance first for non-service-connected care. Reporting your private insurance will not negate your VA benefits; instead, this can often expand coverage options and make it easier for private rehabs to admit you quickly.

What level of care is right for you

Deciding on the right level of treatment depends on how severe your substance use is, how severe your withdrawal symptoms are, whether you can stay at home while seeking care, and whether you have co-occurring mental health conditions that also need support at the same time. 

• Withdrawal management (detox): You receive short-term, medically supervised care to help you safely stop using alcohol or other drugs and manage withdrawal symptoms. Withdrawal management may take place in a hospital, residential, or outpatient setting, depending on your withdrawal symptoms and risk of complications, and is often the first step before ongoing treatment. Withdrawal management should always be directly linked to longer-term treatment. Some programs may be connected to longer-term inpatient treatment or a residential program. In other cases, outpatient treatment may be appropriate after completion of withdrawal management.
• Inpatient: You stay overnight and receive 24/7 care in a structured setting. This can be in a hospital or a nonhospital residential program, and can be especially helpful if you need intensive support for substance use and other health concerns. Inpatient care often follows withdrawal management when additional stabilization or intensive treatment is needed.
• Hospital: You stay in a hospital and receive medically managed, highly structured care, including 24/7 nursing for substance use and other serious biomedical or mental health conditions. Hospital care often focuses on stabilization and may be short term.
• Outpatient: You live at home and go to a clinic or facility regularly for individual, group, or family sessions with addiction treatment professionals. Outpatient care can range from an hour or less per week to several days per week. Depending on your needs, outpatient treatment may include a partial hospitalization program (PHP), an intensive outpatient program (IOP), or standard outpatient therapy. Typically, higher intensity treatment is advised initially, and once you’ve achieved recovery, sessions can be shorter and/or more spaced out. Some people may also complete withdrawal management on an outpatient basis before continuing treatment.
• Telehealth: You meet with addiction treatment professionals by phone or secure video instead of in person. Outpatient care may be delivered exclusively via telehealth or through a combination of virtual and in-person visits. Telehealth can also supplement  residential or hospital-based care.

When you reach out to facilities, make sure to ask how they determine level of care, how they handle transitions between levels of care, and whether they keep treatment timelines flexible and based on progress rather than a set timeline. This is also known as having a flexible length of stay rather than a fixed length of stay. Beware of programs titled “28 day” or “8 week”. How long the veteran remains in treatment should depend upon their progress toward recovery, not a set number of days. 

To determine which level of care is needed, it is best to speak to a medical professional for an assessment. 

Can you start veteran-specific treatment today?

You can most likely start veteran-specific care today but immediate access depends on the level of care needed and current facility capacity. In most areas, outpatient care can take new patients faster than residential rehabs and starting treatment sooner at an open outpatient program is often more important than waiting for the “perfect” residential spot. Remember, residential programs do not necessarily have better outcomes. Assuming that the home environment is safe and conducive to recovery for the veteran, you may find an evidence-based outpatient program that is equally or even more effective.

If there is a medical emergency, overdose, severe withdrawal, or suicide risk, call 911 or go to the nearest emergency department. If a veteran is in crisis but does not need emergency medical care, call 988 and press 1 to reach the 24/7 Veterans Crisis Line, or text 838255.

Urgent Care: For severe but non-life-threatening situations, veterans can visit a VA-approved urgent care clinic without a prior referral provided the VA is notified within 72 hours of the visit.

What if the program you want is full?

If a VA program or facility tells you they are full, you can ask them the following:

• Do you offer bridge care or telehealth services while I wait for a bed to open up?
• Can I start MAT or outpatient treatment right away?
• Can you refer me to another veteran-friendly program in the area?
• Can you assist with a Community Care authorization if the local VA wait time exceeds the 28-day standard?

Do you need to travel for rehab, or can you receive care locally?

Staying in your area depends on the level of care you need and your benefits. If you are accessing outpatient counseling, intensive outpatient programs (IOP), or medications for addiction treatment (MAT), care is widely available in most communities through local VA facilities or private providers. However, if you require residential treatment, expanding your search can help. 

• VA regional hubs: Many of the VA’s residential programs (especially those with tracks for military sexual trauma (MST), severe combat PTSD, or complex chronic pain) are concentrated at regional medical centers. If you require this level of care, the VA can authorize and coordinate travel assistance.
• Expanding community options: If local facilities face long waitlists or lack dedicated veteran tracks, utilizing the VA Community Care Network can open up spots at private programs in other regions that may have bed availability.

Veteran-specific competency

When choosing a program, it is important to know that a facility that simply "accepts veterans" is different from a program with a dedicated veteran track. Conforming to military culture and dealing with specialized trauma requires expertise. Veteran-specific programs will have clinicians trained in military culture who understand the ways substance use connect with service experiences. They are also equipped to coordinate care across mental health, addiction treatment, medications, and practical needs like housing, employment, or benefits support. Such facilities should also provide peer-support groups with other veterans.

What questions should you ask before starting treatment?

Before deciding on a facility to enroll in, call their admissions office and ask:

• Do you have a dedicated veteran program or just general services that veterans can attend?
• How do you treat PTSD, trauma, and substance use at the same time? 
• Can you directly coordinate care with my existing VA providers, including my primary care doctor?
• Are your counselors and peer-support staff trained in military culture or are they veterans themselves?
• What does your discharge and aftercare planning look like? 
• Do I need an official VA Community Care authorization before checking into care and will your facility help coordinate that?

What does the "best rehab" mean for a veteran?

A more expensive program is not necessarily better, and care that takes place outside the VA is not inherently superior to care within it. Ultimately, the best rehab is the one that is best for your unique situation. Care should: 

• Match your clinical level of need.
• Be credentialed with your exact healthcare benefits.
• Treat co-occurring conditions alongside substance use.
• Ensure a discharge plan that will support reintegration post-treatment.

If you need guidance reviewing the best care choices for your needs, you can connect with: 

• Your local VA health system, a regional VA medical center, or a local Vet Center.
• The official VA Substance Use Disorder Program Locator.

Search for care for a veteran today 

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