How VA Community Care Fits—Step-by-Step
Short version: Your first appointment with a qualified, state-authorized osteopathic physician (DO) for medical cannabis certification is almost always out-of-pocket because the VA cannot certify patients for state programs or pay for cannabis. After that initial certification, many veterans continue follow-up care for conditions such as chronic pain, PT/rehab, oncology symptom support, post-operative recovery, and sports medicine with a DO who also participates in VA Community Care. These follow-ups can be covered through the VA if you are eligible, the provider is part of the Community Care Network (CCN), and the VA issues an authorization.
Congress has advanced measures that may allow VA doctors to recommend cannabis in legal states, but nothing has changed yet. Currently, VA clinicians still cannot certify or complete state forms. (Veterans Affairs, Stripes, Marijuana Moment, Congress.gov)
Why the First Visit Matters (and Why You Pay for It)
That first private appointment with a state-qualified DO serves two key purposes:
1. Certification for your state program
The DO reviews your medical history, confirms qualifying conditions, and, if appropriate, enters you into your state’s registry so you can apply for a medical cannabis ID card.
2. Education & safety
You receive guidance on dosing forms (tinctures, capsules, topicals, vaporized flower—if allowed), potential interactions, and realistic care goals. Many veterans seek cannabis for chronic pain, rehab support, oncology symptoms, sleep disturbance, or muscle spasticity. Getting expectations right is part of harm reduction.
VA is a federal agency, and cannabis remains illegal federally. For now, VA cannot complete state certifications or pay for these visits or products.
Bills in both chambers of Congress could change this once signed and implemented, but until VA updates Directive 1315, current restrictions remain. (Veterans Affairs)
Two Lanes, Clean Lines: VHA vs. VBA (and Where Community Care Fits)
Veterans often confuse the two major VA branches:
VHA = health care
Primary care, imaging, PT, pain medicine, consults, and Community Care authorizations.
VBA = disability ratings
VBA reviews evidence to determine compensation; it does not manage treatment plans.
These lanes stay separate. You may use a private cannabis certification and still receive VA care or Community Care for medical needs. VA cannot deny care or benefits because you use cannabis in a legal state program. (Veterans Affairs)
The 2025 Federal Update (Where Things Stand Today)
House (2025):
Passed a spending-bill amendment to allow VA doctors to recommend cannabis in legal states if enacted that fiscal year. (Stripes)
Senate (2025):
Advanced similar language. On August 1, 2025, the Senate approved a package including permission for VA clinicians to recommend cannabis. (Marijuana Moment, Congress.gov)
What must happen next is that the House and Senate must pass a final reconciled bill, the President must sign it, VA must update VHA Directive 1315, and implementation must begin. What is true today is that veterans will not lose VA care or benefits for cannabis use, and VA clinicians may discuss and document cannabis use; however, they still cannot recommend cannabis, certify patients, or submit state forms. (Veterans Affairs)
Florida-Specific Notes (For Many Mendry Readers)
Florida’s program is run through the Office of Medical Marijuana Use (OMMU). To participate, you must:
- Be a Florida resident (permanent or seasonal)
- Be diagnosed with a qualifying condition by an OMMU-qualified physician
- Be entered into the registry
- Apply for a state-issued medical cannabis card
Qualified physicians must follow state rules (e.g., 64B8-9.0181 / 64B15-14.013), including proper documentation, informed consent, and follow-up. These are state processes, not VA processes. (Medical Marijuana Use, Florida Board of Medicine)
Key Florida Reminders for Physicians and Patients
- Qualified physicians must comply with state rules (e.g., 64B8-9.0181 / 64B15-14.013), including informed consent, proper documentation, and periodic review.
- The OMMU website is the go-to resource for up-to-date rules, physician requirements, and registry steps. The registry and ID card are mandatory before you can purchase products. (Florida Board of Medicine, Medical Marijuana Use in Florida)
After Certification: How to Use VA Community Care (Covered Follow-Ups)
Once certified, you may still need medical care outside cannabis itself—OMT, PT/rehab, imaging, oncology support, post-op care, etc. These may be covered through VA or Community Care with proper eligibility and authorization.
The Eight-Step Roadmap
- Get your private DO’s visit note with diagnosis codes, history, and a plan.
- Share it with your VA PCP and request Community Care if you meet access standards.
- Wait for authorization — a consult alone is not enough.
- Confirm the provider is in CCN (TriWest or Optum).
- Authorize the provider’s office with your VA paperwork.
- Ensure notes flow back to VA after each visit.
- Verify billing goes to VA, not you.
- Track renewals — providers may file VA Form 10-10172 for added/extended services. (Veterans Affairs)
Bottom line: Cannabis certification visits (initial and renewal) remain private/out-of-pocket. But clinical follow-ups—like PT, OMT, imaging, or oncology symptom care—can be covered through VA or Community Care if you’re eligible and authorized. (Veterans Affairs)
What VA Covers (and What It Doesn’t)
- Covered (with eligibility & authorization): clinical evaluations, OMT, PT/OT, imaging, surgical follow-ups, pain management, oncology support, and similar medically necessary services.
- Not covered: cannabis certifications, state ID fees, or cannabis products. (Veterans Affairs)
Clean-Hands Compliance for Dual-Role DOs
Some DOs both understand cannabis pharmacology and participate in VA Community Care. This benefits veterans when boundaries are clear:
- Separate visits: certification vs. VA-covered medical care
- No bundling of certification with VA appointments
- Follow state rules first, then VA authorization rules. (Florida Board of Medicine)
Common Pitfalls (and How to Avoid Them)
- Don’t schedule follow-ups until you have the written authorization.
- Don’t expect VA coverage for renewal paperwork or state fees.
- Keep documentation flowing from your community DO back to VA.
- Track authorizations — changes require VA Form 10-10172. (Veterans Affairs)
“Will VA Doctors Soon Be Able to Recommend Cannabis?”
Maybe—but not yet. Here’s the accurate, current read:
- What moved: Both chambers advanced provisions in mid-2025 to allow VA doctors to recommend cannabis in legal states. (Stripes, Marijuana Moment)
- What’s required: A final signed law, VA policy update (Directive 1315), and implementation. (Congress.gov)
- What’s true today: VA providers may discuss and document cannabis use, but cannot yet certify or recommend. (Veterans Affairs)
Florida Veteran? A Quick How-To
- Confirm your DO is qualified under OMMU (and CCN if follow-ups are needed).
- First visit (self-pay): evaluation + registry entry + your card application. (Medical Marijuana Use in Florida)
- Bring notes to your VA PCP to determine if PT/OMT/symptom care should stay in VA or go through Community Care.
- If CC is appropriate, wait for authorization, confirm CCN status, and ensure documentation returns to VA.
- Keep certification and VA care fully separate.
- Reassess every 90 days; use Form 10-10172 if services need modification. (Veterans Affairs)
Conversation Starters for Your VA PCP
- “Here’s my DO’s note. Should PT/OMT be through VA or Community Care?”
- “If CC is appropriate, can we authorize twelve OMT visits + PT?”
- “Any medication interactions to monitor with my cannabis use?”
Bring your DO’s note + medication list to stay safe and coordinated.
How Mendry Help
- Provide clear, plain-English explanations of the dual-lane system.
- Offer visibility to CCN-participating DOs (no booking, no sales).
- Create easy checklists, templates, and Florida-specific guidance.
- Track policy changes at Congress and VA, especially updates to Directive 1315.
Bottom Line (2025)
- First visit (state certification) = private/out-of-pocket.
- Follow-up care for treatable conditions may be VA-covered with authorization and an in-network provider.
- Policy watch: Congressional progress exists, but VA has not yet implemented changes. Directive 1315 remains in force. (Stripes, Marijuana Moment, Congress.gov, Veterans Affairs)
IMPORTANT NOTICE
Educational use only. No medical or legal advice.
Mendry is a 501(c)(3) nonprofit, not a government agency, and not affiliated with the VA or any federal or state agency.
Mendry does not provide treatment, prescribe or sell cannabis, or collect PHI.
Healthcare decisions are yours and your licensed clinicians’ only.
Emergency: 911 | Veterans Crisis Line: 988 (Press 1)