Rural Veterans and Access to Healthcare
A disproportionate share of veterans live in rural America. According to the National Center for Veterans Analysis and Statistics and the U.S. Department of Veterans Affairs (VA) Office of Rural Health (ORH), of the nearly 20 million veterans in the United States, 4.4 million live in rural America. 2.7 million, or 61%, of these rural veterans are enrolled in the Veteran Affairs (VA) healthcare system, with 54% of rural enrolled veterans 65 years and older, and 60% affected by a service-related condition.
Veterans living in rural areas may have difficulty accessing health services for reasons similar to other rural residents. Some rural veterans face poverty, homelessness, and substance use disorder, which can exacerbate their health issues. In addition, some veterans are unaware of the benefits, services, and facilities available to them through VA.
VA health facilities have worked to address rural access challenges for veterans by developing partnerships with area community health centers, Rural Health Clinics (RHCs), and hospitals, delivering care via telehealth, using mobile VA clinics, and creating Community Based Outpatient Clinics (CBOCs). VA also depends on nonprofit veterans service organizations to help veterans access healthcare and basic human services. VA addresses the issues affecting rural veterans with programs such as the Veteran Community Care Program, which provides an option for rural veterans meeting certain criteria to receive care from a rural community provider.
Frequently Asked Questions
- What types of health programs are available to rural veterans?
- Who is eligible for VA health benefits?
- How can healthcare providers, counselors, social workers, and clergy help rural veterans who are in need of healthcare, behavioral health, or disability related services?
- What is the VA MISSION Act of 2018 and what does it mean for rural veterans and rural healthcare providers?
- What opportunities are there for rural healthcare facilities to collaborate with VA?
- What are the special health concerns faced by rural veterans?
- Are there grants or programs to assist veterans in rural areas with transportation to VA medical centers and other VA and non-VA facilities for medical care?
- What is the infrastructure within the federal government for addressing concerns regarding rural veterans' health?
- What non-governmental organizations provide assistance to rural veterans to help them address their health needs?
- What are some demographics that characterize veterans who live in rural areas?
What types of health programs are available to rural veterans?
The U.S. Department of Veterans Affairs provides a variety of health benefits and services to veterans meeting certain military requirements. Health benefits available for eligible veterans include:
- Primary care and preventive care services
- Specialty care
- Inpatient care
- Prescriptions
- Dental care
- Vision care
- Mental health services and coverage
- Assisted living and home health services
Who is eligible for VA health benefits?
There are a variety of eligibility requirements depending on the type of healthcare sought and the status of the service member. For details on eligibility requirements of active duty members, National Guard members, Reserve members, and retired veterans and affected families, see Health Benefits: Veterans Eligibility.
How can healthcare providers, counselors, social workers, and clergy help rural veterans who are in need of healthcare, behavioral health, or disability related services?
Healthcare providers and other professionals wanting to help rural veterans in need of healthcare and related services can encourage veterans to apply for veterans health benefits if they have not already done so. The Veterans Affairs Health Benefits website provides information about health benefits, eligibility requirements, and the forms for enrolling in VA healthcare.
Healthcare providers can form a partnership with the Veterans Health Administration (VHA) and provide services to rural veterans as a community provider at a non-VA facility. For a veteran to receive healthcare services from a community provider, the veteran must meet the eligibility requirements of the Veteran Community Care Program. The FAQ, What opportunities are there for rural healthcare facilities to collaborate with VA?, provides more specific information on this topic.
Several resources are available from VA to help guide the professional who is involved in the healthcare of veterans.
- I am a Clinician, Researcher, or Trainee – provides tools and training resources for clinical professionals.
- Community Provider Toolkit – contains tools and resources for clinicians providing mental health services.
- Learn About Military Culture – provides the education, tools, and resources to help healthcare professionals understand the military culture and modify their clinical practice to appropriately treat service members or veterans.
- VA Facilities Locator & Directory – provides information on the closest VA healthcare facility to a specific location.
- VHA Office of Rural Health – establishes and expands national programs and partnerships focused on access to healthcare for rural veterans at the federal, state, and local level.
- VHA Office of Community Care – provides additional information about non-VA medical care including emergency medical services, Indian Health Services/Tribal Health Program, and Patient-Centered Community Care (PC3).
- PTSD: National Center for PTSD – includes training materials and other resources to aid in the assessment and treatment of veterans who may have PTSD.
- PsychArmor Institute – provides free online courses on issues relevant to military and veteran communities, with a focus on mental health, developed by experts for healthcare professionals, educators, and a variety of caregivers.
What is the VA MISSION Act of 2018 and what does it mean for rural veterans and rural healthcare providers?
On June 6, 2018, the VA MISSION Act of 2018 was signed into law, becoming effective June 6, 2019. It includes a variety of reforms to improve and expand access to quality healthcare for veterans. This law replaces the Veterans Choice Program (VCP) with the Veteran Community Care Program, which requires VA to offer non-VA healthcare services to eligible veterans. For information about eligibility, refer to VA's Veteran Community Care Eligibility fact sheet.
Veterans with questions about community care eligibility should contact their VA healthcare provider and VA medical facility for more information.
What opportunities are there for rural healthcare facilities to collaborate with VA?
There are three different ways a rural non-VA health facility can provide service to veterans in rural locations. Rural healthcare facilities can participate as:
- Community Based Outpatient Clinics (CBOCs) – contracted by VA to provide primary care services to veterans
- Community Care Network (CCN) – offers contracts to community providers via 5 regional networks covering primary care, mental healthcare, oral healthcare, preventive services, and specialty care, among other services
- Veteran Community Care Program – allows services by providers contracted with VA through a third party administrator (TPA) — Optum or TriWest — to be an authorized healthcare provider and join the VA's Community Care Network (CCN)
For information about contracting with VA, see How to Become a VA Community Provider. This publication provides information for providers interested in being a part of the Patient-Centered Community Care program and includes the contact information for Optum and TriWest, the VA's third-party community care administrators. In addition, the National Association of Community Health Centers' publication, Providing Care for Veterans in Community Health Centers, provides information on how health centers can participate in the programs resulting from the VA MISSION Act.
What are the special health concerns faced by rural veterans?
The health issues faced by rural veterans may be different from those of the general rural population due to disabilities and adverse health effects caused by their period of service. The VBA Annual Benefits Report, 2022 lists the following conditions as prevalent service-connected disabilities affecting veterans:
- Tinnitus and hearing loss
- Post-traumatic stress disorder (PTSD)
- Musculoskeletal issues
- Scars and burns
- Paralysis of the sciatic nerve
- Migraine
According to the VHA Office of Rural Health, the most common diagnoses for rural veterans in outpatient settings include high blood pressure, type 2 diabetes, acid reflux, post-traumatic stress disorder (PTSD), and depressive disorder, as well as one or more service-connected disabilities.
Service-related and other health issues experienced by rural veterans can be exacerbated by the lack of specialty care in rural areas, as well as other conditions such as poverty, homelessness, and substance abuse.
Are there grants or programs to assist veterans in rural areas with transportation to VA medical centers and other VA and non-VA facilities for medical care?
The U.S. Department of Veterans Affairs program Grants for Transportation of Veterans in Highly Rural Areas awards grants to veterans service organizations that use innovative approaches to assist veterans in rural areas with transportation to VA medical centers and other VA and non-VA facilities for medical care. A list of grantees providing transportation options to veterans living in eligible rural counties is available from the Highly Rural Transportation Grants website. For additional programs that may assist veterans in accessing medical care, see the funding section of this topic guide.
Also, the Disabled American Veterans (DAV) Hospital Service Coordinator Directory provides a state-by-state list of Hospital Service Coordinators (HSCs), their affiliated VA medical centers, and contact information. HSCs manage DAV transportation programs for veterans needing medical care.
What is the infrastructure within the federal government for addressing concerns regarding rural veterans' health?
The VA Office of Rural Health (ORH) advocates on behalf of rural veterans to improve healthcare delivery, and support research and program development to address their challenges. ORH partners with other federal, state, and rural communities to optimize the use of technology, develop additional access points to care, and increase healthcare options for rural veterans.
The Veterans Rural Health Advisory Committee (VRHAC) meets twice a year to learn about health care issues impacting rural veterans. Each year, the Committee drafts a series of recommendations for the VA Secretary to facilitate improved access to veterans' health care in rural areas. The Committee examines ways to enhance Veterans Affairs' healthcare services for rural veterans by evaluating current programs and identifying barriers to healthcare. For more information, see the VRHAC page on the Office of Rural Health's website.
The South Central Mental Illness Research, Education and Clinical Center (MIRECC) is a VA-funded program that supports equal access and quality mental healthcare for veterans in rural and underserved areas.
What non-governmental organizations provide assistance to rural veterans to help them address their health needs?
Several non-VA organizations provide assistance to rural veterans to help them address their health needs. Some of the more common organizations that are accessible in rural areas include:
- American Legion – provides assistance, outreach, and support for veterans and their families with VA claims and healthcare benefits
- Disabled American Veterans (DAV) – assists disabled veterans and their families when applying for benefits and services through VA and other federal agencies
- National Coalition for Homeless Veterans (NCHV) – offers technical assistance and resources for a national network of community-based service providers, including local, state, and federal agencies that provide housing, health services, food, and job training for homeless veterans
The organizations section of this topic guide provides an annotated list of non-VA and VA organizations that provide assistance to veterans.
What are some demographics that characterize veterans who live in rural areas?
According to the 2018-2022 American Community Survey 5-Year Estimates, rural veterans are estimated to have totaled 4,325,934 individuals or 25.4% of the entire veteran population. Other demographics include:
| Period of Service | % of Rural Veterans |
|---|---|
| Gulf War (9/2001 or later) | 19.3% |
| Gulf War (8/1990 to 8/2001) | 21.7% |
| Vietnam Era | 39.0% |
| Korean War | 5.5% |
| World War II | 1.2% |
| Sex | |
| Male | 92.0% |
| Female | 8.0% |
| Race and Hispanic/Latino Origin | |
| White | 88.5% |
| Black or African American | 5.4% |
| American Indian/Alaska Native | 1.0% |
| Asian | 0.4% |
| Native Hawaiian and Other Pacific Islander | 0.1% |
| Hispanic or Latino | 3.7% |
| Poverty | |
| Below Poverty in the Past 12 Months | 6.8% |
| Disability Status | |
| Disability Status with Any Disability | 32.5% |
| Source: Table S2101, 2018-2022 American Community Survey 5-Year Estimates | |
Despite increases in the veteran population during the Iraq and Afghanistan wars, the number or rural veterans is expected to decline. According to a 2017 USDA Economic Research Service chart, between 2006 – 2016, the rural veteran population declined 26% or by 1.1 million people.