St. Cloud VA Health care
System announcement

News & Announcements

A Veterans Guide to Urgent Care

What is Urgent Care?

VA offers urgent care options at VA facilities and community providers so eligible Veterans can access timely, high-quality care for minor injuries and illnesses that need attention right away but are not life-threatening emergency conditions.

In a medical emergency, seek care at the nearest emergency room. A medical emergency is an injury, illness, or symptom so severe that a prudent layperson reasonably believes that delay in seeking immediate medical attention would be hazardous to life or health. If you believe your life or health is in danger, call 911 or go to the nearest emergency department right away.

Also, urgent care is not a substitute for routine preventive health care. Veterans should work with their primary care provider for this type of care. VA cannot pay for most preventive services received at a community urgent care center.

How to get Urgent Care

To obtain urgent care, eligible Veterans can visit the Urgent Care Center at the St. Cloud VA Medical Center, which is open from 8 a.m. to 6 p.m., 365 days a year. Additionally, same-day services are available by calling the Veteran’s PACT team.

To use an in-network community urgent care location:

• eligible Veterans must use an urgent care provider in VA’s network.
• Veterans are eligible for the community urgent care benefit if they are enrolled in VA health care and have received care through VA (from VA or through a VA-authorized community provider) within 24 months prior to receiving this care.
• use the 4-step guide outlined below each time you need urgent care from an in-network provider.

STEP 1: Find an In-Network Urgent Care Provider

To find an urgent care location in VA’s network, use the VA Facility Locator at https://www.va.gov/find-locations/. The Locator tool also contains driving directions and phone numbers for network providers. Enter your location to find nearby providers and call the location to get hours of operation.

The construction of the urgent care network is underway. We continue to add sites to allow most Veterans to be within a 30-minute drive time from their home to a network urgent care/retail location. Please visit the Locator tool before every visit as network provider lists may change.

The following providers are currently enrolled in the VA network (provider lists may change):

In the St. Cloud area:

• MinuteClinic
• Cloud Medical Group South
• CentraCare Plaza Clinic

In the Brainerd area:

• Essentia Health-St. Joseph's Medical Center
• Essentia Health Convenient Care Brainerd
• Brainerd Medical Center Inc
• Essentia Health Convenient Care-Baxter
• Essentia Health St. Joseph's-Baxter Clinic Urgent Care
• Essentia Health St. Joseph's-Emily Clinic

In the Montevideo area:

• Chippewa County Montevideo Hospital
• Sanford Clinic Minneota

In the Alexandria area:

• Sanford Health Broadway Clinic
• Sanford Health Easton Place Clinic
• Alexandria Clinic (A Service of Douglas County Hospital)
• Sanford Health Parkers Prairie Clinic

If a Veteran goes to an urgent care network location and has any difficulty receiving care, call 833‑483-8669 for assistance.

There are two types of urgent care network locations: Retail and Urgent.

• Retail locations include a walk-in health clinic, other than an office, urgent care facility, pharmacy, or independent clinic located within a retail operation. Veterans could seek care at a retail location for treatment of an uncomplicated illness such as a sore throat or earache.
• Urgent locations include an office or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention (aside from emergency rooms). Veterans could seek care at an urgent location for treatment of more pressing illnesses or injuries that are not life-threatening, like splinting, casting, lacerations, or wound treatment.

STEP 2: Verify Eligibility

When arriving at an in-network urgent care provider, Veterans must:

• Inform the provider they would like to use their VA urgent care benefit to receive care. The urgent care provider will confirm the Veteran’s eligibility. The urgent care location can dial into an Interactive Voice Response (IVR) system to check the Veteran’s eligibility for urgent care. The TriWest IVR system is available 24 hours a day, seven days a week at (833-483-8669)

• Ask and verify the urgent care provider is part of VA’s contracted network. The urgent care provider may have a sign posted that indicates they are part of VA’s contracted network.

If the provider is not part of VA’s contracted network, Veterans have several options:

• Agree to pay the full cost of care and receive care immediately
• Go to a different urgent care provider that is part of VA’s contracted network
• Go to the nearest VA medical facility
• Go to the nearest emergency department

STEP 3: Receive Care

Covered Services: The urgent care benefit covers services such as colds, ear infections, minor injuries, pink eye, skin infections and strep throat.

Prescription Medication: VA will pay for or fill prescriptions for urgent care. For urgent care prescriptions greater than a 14-day supply, the prescription must be submitted to VA to be filled.

For urgent prescriptions written by an urgent care provider, Veterans can fill a 14-day supply of medication at a contracted pharmacy within the VA network, in VA, or at a noncontracted pharmacy. If a noncontracted pharmacy is used, Veterans must pay for the prescription and then file a claim for reimbursement. To find an in-network pharmacy, both urgent care providers and Veterans can use the VA Facility Locator at https://www.va.gov/find-locations/.

Some Veterans may be required to make a copayment for medication, but this will be billed to the Veteran by VA—Veterans do not pay co-pays at the point of service.

STEP 4: Billing and Copayments

Veterans do not pay in-network providers or pharmacies. If a Veteran chooses to use an out-of-network pharmacy, the Veteran must pay for the medication and can submit a claim for reimbursement to VA.

Veterans may be charged a copayment by VA for urgent care that is different from other VA medical copayments. Copayments depend on the assigned priority group and the number of times an urgent care provider is visited in a calendar year--see chart below. A copayment is not required for a visit consisting of only a flu shot.

Copayment charges are billed separately by VA as part of VA’s billing process. There is no limit to the number of times a Veteran can go to an urgent care provider.

*Special authorities include those related to combat service and exposures (e.g. Agent Orange, active duty at Camp Lejeune, Ionizing Radiation, Project Shipboard Hazard and Defense (SHAD/Project 112), Southwest Asia Conditions) as well as Military Sexual Trauma, and presumptions applicable to certain Veterans with psychosis and other mental illnesses. 

How to submit a pharmacy reimbursement claim:

Veterans can call (877) 881-7618 for information and assistance in filing a claim for reimbursement. Veterans filing claims for prescription medication reimbursement should include a copy of the prescription (pharmacy label) and receipt and mail to:

OCC Claims Processing – St. Cloud

PO Box 1004

Fort Harrison, MT 59636-1004

Frequently Asked Questions

What specific services are covered by the urgent care benefit?

Individual health conditions are complex and unique to each Veteran. As a result, and to encourage Veterans to seek care when they need it, VA does not publish a specific list of covered services. Preventive care and dental services are excluded.

Will VA reimburse beneficiary travel for urgent care?

VA will reimburse beneficiary travel (BT) for eligible Veterans that travel to receive community care. Payment will be made for the distance to either the nearest VA or community medical facility that could have provided the care or services. Payment will only be made on a one-way basis (e.g., not round-trip) for unscheduled care.

Are urgent care services provided at an emergency department covered by VA?

If the emergency department is part of VA’s contracted network and has agreed to furnish urgent care services in accordance with the contract requirements, VA can pay for these services for eligible Veterans under this benefit.

Can the urgent care benefit be used by a Veteran’s family member?

Only eligible Veterans can use this benefit. The benefit does not extend to family members and is non-transferable.