How does a 100% disabled veteran get community care dental benefits?

SPC James Lewis — Thu, 26 Oct 2023 22:11:20 -0400

I have tried to get benefits for dental care and have been shuffled from provider to provider with nothing being done

Response by COL Randall C. made Oct 26 at 2023 10:50 PM

COL Randall C. — Thu, 26 Oct 2023 22:50:46 -0400

Community care will (unless grandfathered) generally depend on availability or services at the VA, time/distance you are away from the VA dental clinic, and/or the timeframe for being scheduled for services.

The first step is to have an initial exam by the VA dental clinic*. You can request that you receive future care at a community care provider if you meet one of the eligibility criteria*.

If you meet the eligibility based on travel time, then you should have no problem getting future care from a local provider. Other eligibility may be situational (i.e., "yes" for this treatment/procedure, but we'll have to evaluate for future needs).

One item of note - Community Care providers will have to get pre-authorization for everything. Most will "stack" requests up front (for example, an authorization request for a year's worth of exams, cleanings, etc.), especially if your VA facility's community care office takes a while to send an approval back.
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* Facility search - https://www.va.gov/find-locations/
* Community Care Eligibility - https://www.va.gov/COMMUNITYCARE/programs/veterans/General_Care.asp.

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Response by SGT Private RallyPoint Member made Oct 26 at 2023 11:42 PM

SGT Private RallyPoint Member — Thu, 26 Oct 2023 23:42:40 -0400

Usually it will require a consult. One from your primary care doc to dental and then one from dental into the community if such resources are present. If not then they will have to send you to the closest VA with dental facilities available.

Response by 1st Lt Mary James made Nov 1 at 2023 9:22 PM

1st Lt Mary James — Wed, 01 Nov 2023 21:22:59 -0400

Dental care is an essential part of total health and should be afforded to anyone needing it, regardless of rating. I have been fighting this issue for a long time. Also even my colleagues with a 100% rating are fighting to get dental care but the clinic is overwhelmed. Community Care services are constipated at the very least. I hope this situation changes for all of us.

Response by CPO Kenneth Reece made Nov 1 at 2023 10:51 PM

CPO Kenneth Reece — Wed, 01 Nov 2023 22:51:27 -0400

100% DAV are eligible for all dental care. All other vets must have a SC dental issue.
It starts at your local VA clinic. Make appt. for dental. They will evaluate your conditions,
and most likely refer you to a community care civilian dentist who will again evaluate your conditions and make a recommended course of action back to your VA doc. They , the VA will process the request and submit to a higher level for approval and payment. Once this is done, they will notify you by text and letter your appts. and times. At this point you are well on your way to getting complete quality care just as any self paying person would. you will have no out of pocket expenses and even receive travel pay if you qualify. If needed your care will be coordinated to include crowns, bridges, implants, etc. This seems long and intensive but it's not. From my first VA dental appt. to getting care from my community care Doc "cc" was about 30 days. You will receive copies of all procedures and costs as a courtesy and for you to verify if the work was done. These are the same dentists our civilian counterparts' use. You also may as I have, see a variety of dental specialist if needed for surgical, Endo., prosthodontics etc.
No guarantee but this is how it worked for me . There will be no cost to you. As a 100% DAV you paid this bill in advance.
One last note from an old DAV member, The "Golden Rule" can work wonders.
Hope this helps you to navigate your journey.

Good luck,

"Doc Reece"

HMC Ken Reece
USMC/USN Ret.

Yes I was duel service or OSV

Response by PVT James Lafayette made Nov 2 at 2023 8:11 AM

PVT James Lafayette — Thu, 02 Nov 2023 08:11:30 -0400

I have checked with many dental clinic for the cost for implant I just can afford the cost that the dental clinic ask for.

Response by PVT James Lafayette made Nov 2 at 2023 8:28 AM

PVT James Lafayette — Thu, 02 Nov 2023 08:28:16 -0400

My dentist tells me I need a bottom implant I'm not able to chew my food correctly which causes a lot of stomach problems so if you could help please let me no thank you . Mr James Lafayette

Response by SSG Marcia Delay made Nov 2 at 2023 8:43 AM

SSG Marcia Delay — Thu, 02 Nov 2023 08:43:40 -0400

This is all BS the dental care thur VA is a joke this needs to be looked into it should be "no dental care "

Response by HA Ronna Crowder made Nov 2 at 2023 12:36 PM

HA Ronna Crowder — Thu, 02 Nov 2023 12:36:50 -0400

If you are more than 40 miles from the VA then you can request it. Or if it would take more than 30 days to be scheduled for an appointment you an request community care dentistry. You shouldn't be "shuffled" from one dentist to another because the dentist's office will have a contract to fulfill once they accept you as a patient.

Response by SSG Adrian Walker made Oct 30 at 2024 10:07 PM

SSG Adrian Walker — Wed, 30 Oct 2024 22:07:46 -0400

This is one of the reasons why I don't say yes when I'm asked if they should join the military by young people who are interested in doing that, the VA just doesn't care enough to get the community care system fixed , they are more involved in their own crap and they don't care about us.

Response by CPO Robin Brooks made Dec 22 at 2024 5:14 PM

CPO Robin Brooks — Sun, 22 Dec 2024 17:14:56 -0500

Better yet what does a 100% disabled bet do when the VA fails them. The VA dentist when you make an appointment to see them about a serious problem blames you for everything as they lie over and over again to you stealing all your hope and leaving you with nothing.
You have no dental insurance and the work is so extensive that buying it now won't do any good.
Pay for a second opinion but then what do you do with that
How do you get the work to correct the damage that is a result of 24 years of service 5 ships, multiple deployments/underway times to include being part of a forward deployed battle group.
16 years as 100% disabled with initial long waits for deployments that resulted in brittle teeth from unfinished work while in uniform breaking off at such a rate that almost all my appointments were for emergency extractions. The inability to get timely partials led to upper teeth lost not because the teeth were bad but instead because lack of molars on the bottom pushed out the front teeth until almost perpendicular.
I have 4 teeth. If I lose the one upper left I lose the ability to have a partial and since I can't wear a regular denture do to allergies to denture creams and medication that leave me with a dry mouth. What is needed is bone graphs and post. A procedure that is still possible at the moment but will cost me around 50k+ (waiting for full estimate)
What I will then have to do is go out and beg charities for help because the VA has failed me so often and just doesn't fulfill their obligations.
If there is another option I would love to hear it
If there is a way to get the VA to fulfill their obligations and repair the damage caused directly from military service that has resulted in all these new allergies, inability to get timely care, substandard care.,
Beyond that no vet especially at the holiday season should receive a tongue lashing that even drives a Chief to tears and puts them back into the out of control spiral of depression. Only the love I hold for my children and the harm suicide would do to them and their lives stays my hand.

Response by SGT Lorenzo Nieto made Mar 26 at 2025 7:09 AM

SGT Lorenzo Nieto — Wed, 26 Mar 2025 07:09:24 -0400

You’ll have to go to your local VA dentist if they feel you need community care they will tell you but right now is not good time i have been waiting six months for the community care office to call me now when I call the va to inquire they say they are short staffed, good luck it takes a long time.

Response by SFC Jo Ann Klawitter made Mar 26 at 2025 10:07 AM

SFC Jo Ann Klawitter — Wed, 26 Mar 2025 10:07:59 -0400

I also tried, but the government does not have a dental plan But supposed to be if you were 100% disabled so I have no idea what’s going on

Response by MSG Billy Brumfield made Mar 26 at 2025 1:37 PM

MSG Billy Brumfield — Wed, 26 Mar 2025 13:37:42 -0400

This is kind of frustrating for me as I am not allowed to use my retiree dental insurance outside of the VA and I keep falling off the schedule at my local VA. Mainly due to hygienists constantly leaving the VA. My dentist has been great when I see him and they have brought in specialists after hours for things like implants but I keep falling off the schedule. They have offered me community care in the past but I have denied it as my VA dentist is great. Thanks for reminding me to call the dental clinic today! lol

Response by SGT Ruben Lozada made Mar 26 at 2025 1:56 PM

SGT Ruben Lozada — Wed, 26 Mar 2025 13:56:39 -0400

Good morning SPC James Lewis. Excellent post. Thanks for sharing this Specialist. Unfortunately, I don't have an answer for you. I'm sure somebody within RP has an answer. :->

Response by SPC Jeff Daley, PhD made Mar 27 at 2025 12:05 PM

SPC Jeff Daley, PhD — Thu, 27 Mar 2025 12:05:13 -0400

Our Phoenix Healthcare system is below standards when measured by the Phoenix VA’s patient care, which is based on CMS star ratings, HEDIS benchmarks, patient surveys, and the SAIL framework, which focuses on clinical outcomes, safety, wait times, and satisfaction.

If the Dental Healthcare at the Phoenix Healthcare system was measured in isolation it would have the highest results. My personal experience has seen the practitioners work in the realm of excellence.

If your within comute distance to a VA Dental facility your patient advocate persona can help is your having a problem getting this added to your 100% benefit package.