Written By

Patrick Acker

Published On

April 21, 2026

TriWest Community Care Home Health in North Dallas, TX — VA Referrals, Authorization, and How to Start

TriWest Healthcare Alliance administers the Department of Veterans Affairs Community Care Network in Texas — connecting veterans with home health providers outside the VA system when the VA cannot deliver timely or geographically accessible care. BrightStar Care of North Dallas is a Joint Commission-accredited, TriWest-authorized home health provider serving veterans throughout Richardson, Far North Dallas, Plano, Garland, Sachse, Rowlett, Addison, and Dallas and Collin counties. Call or text 214-295-4667 to start your VA community care home health referral.

Important distinction — TriWest is not TRICARE. TriWest Healthcare Alliance handles VA community care referrals for veterans enrolled in Veterans Affairs healthcare. TRICARE is a completely separate Department of Defense health insurance program for active-duty service members, military retirees, and their families. If your VA provider referred you to a community care provider and TriWest is managing the authorization, you are in the right place. If you carry a TRICARE Prime or TRICARE Select plan, visit our TRICARE home health page instead.

If your VA provider has recommended home health services and you have been told that TriWest Healthcare Alliance will handle your referral, this page explains exactly what TriWest is, how the Veterans Affairs community care authorization process works, what home health services are covered, what it costs, and how BrightStar Care of North Dallas receives and fulfills TriWest referrals for veterans in the North Dallas area. We also clarify how TriWest differs from TRICARE and CHAMPVA — two programs that veterans and their families frequently confuse with TriWest community care.

What Is TriWest Healthcare Alliance?

TriWest Healthcare Alliance is a third-party administrator (TPA) contracted by the Department of Veterans Affairs to manage the VA Community Care Network (CCN) in Regions 4, 5, and 6. Region 6 includes the entire state of Texas. TriWest is headquartered in Phoenix, Arizona, and serves veterans across 28 states plus the Pacific territories.

TriWest is not an insurance company. It does not sell insurance plans. It does not set premiums or collect monthly payments from veterans. TriWest is also not TRICARE — although the two names sound similar and TriWest has a historical connection to TRICARE, they are entirely separate programs serving different populations. TRICARE is Department of Defense health insurance; TriWest is a Veterans Affairs community care contractor.

TriWest was founded in 1996 and originally operated as a managed care support contractor for the TRICARE program in the western United States. In 2019, TriWest transitioned away from TRICARE entirely and became the VA's dedicated community care contractor. Today, TriWest's sole mission is executing VA community care — processing referrals from VA medical facilities, managing a network of authorized community providers, issuing service authorizations, and handling claims for care delivered outside the Veterans Affairs system.

When a veteran enrolled in VA healthcare needs home health services and the VA determines that community care is appropriate, the VA sends a referral to TriWest. TriWest then identifies an authorized provider in the veteran's area — such as BrightStar Care of North Dallas — issues a formal authorization for services, and processes the resulting claims after care is delivered. The Veterans Affairs medical team makes the clinical decision. TriWest executes the logistics.

How VA Community Care Works Under the MISSION Act

The VA MISSION Act of 2018 established the modern framework for when and how veterans can receive healthcare outside Veterans Affairs facilities. Before the MISSION Act, the Veterans Choice Program handled community care referrals. The MISSION Act consolidated and improved that system, creating clearer eligibility standards and a more streamlined referral process through the community care network.

Under the MISSION Act, veterans enrolled in VA healthcare may be eligible for community care when any of the following conditions are met:

Drive time exceeds access standards — Average drive time to the nearest VA facility offering the needed service is more than 30 minutes for primary care or mental health, or more than 60 minutes for specialty care
Wait time exceeds access standards — The VA cannot schedule an appointment within 20 days of the date of request for primary care or mental health, or within 28 days for specialty care
Service not available at a VA facility — The VA does not provide the specific service the veteran needs at any accessible VA location
Best interest determination — The veteran and their VA provider agree that receiving care in the community is in the veteran's best medical interest
No full-service VA medical facility in the veteran's state — A grandfathered provision that applies in certain states without comprehensive VA hospital coverage

The referral flow follows a defined sequence: the veteran's VA provider determines that home health care is needed and enters a consult into the VA system. The Veterans Affairs community care office reviews the referral and confirms that the veteran meets at least one MISSION Act eligibility criterion. Once approved, the referral is transmitted to TriWest, which identifies an authorized community provider near the veteran's home, issues a service authorization specifying the type of care, frequency, and duration, and notifies both the provider and the veteran. The authorized provider — BrightStar Care, in the case of North Dallas veterans — then contacts the veteran to schedule intake and begin services.

Veterans cannot bypass this process. The referral must originate with a VA provider and pass through the Veterans Affairs community care office before TriWest becomes involved. You cannot call TriWest directly to request home health services.

When Veterans Qualify for Community Care Home Health

Home health care is one of the services most commonly referred to community providers through TriWest. The VA does operate its own home-based care programs — most notably the Home Based Primary Care (HBPC) program — but demand frequently exceeds capacity, and the VA's in-house home health resources have geographic limitations.

Veterans in the North Dallas area may qualify for community care home health through TriWest under several common scenarios:

VA HBPC waitlist — The VA North Texas Health Care System's HBPC program maintains a waitlist. When a veteran needs home health services now and HBPC cannot accommodate them within the MISSION Act's access standards, the VA refers to TriWest for community care placement.
Geographic access — If the nearest Veterans Affairs facility offering home health services requires a drive time exceeding the 30-minute standard, the veteran qualifies for community care. Many veterans in Sachse, Rowlett, Garland, and eastern Dallas County meet this criterion.
Services not available through the VA in-home — The VA's in-house home health programs may not offer every service a veteran needs at home. For example, extended-hour skilled nursing, private duty nursing, or intensive physical therapy protocols may not be available through VA HBPC in certain cases.
Best interest of the veteran — When the VA clinician and the veteran agree that community-based home health better serves the veteran's recovery and well-being — such as when the veteran has complex care needs that benefit from a dedicated home health team with flexible scheduling — community care is authorized.
Post-discharge urgency — Veterans being discharged from VA Dallas Medical Center, Medical City Dallas, Medical City Richardson, or another facility who need immediate home health follow-up may be referred to TriWest when VA home health cannot begin services quickly enough to ensure continuity of care. This often overlaps with transitional care needs.

The key point is that the VA clinician initiates the referral. Veterans who believe they may qualify for community care home health should raise the topic with their Veterans Affairs primary care provider or care team. If the VA agrees that community care is appropriate, they will start the referral process.

The TriWest Prior Authorization Process for Home Health

Here is what to expect after the VA decides to refer for community care home health:

VA provider determines home health is needed — The veteran's VA clinician evaluates the veteran's condition and enters a home health consult or referral in the VA electronic health record. This includes the specific services needed (skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide, or a combination) and the clinical justification establishing medical necessity.
Veterans Affairs community care office reviews eligibility — The VA community care staff at the veteran's VA facility confirms that at least one MISSION Act eligibility criterion is met. They verify the veteran's enrollment status, review the clinical need, and approve the referral for community care.
Referral transmitted to TriWest — The approved referral is sent electronically to TriWest through the VA's community care referral system. The referral includes the veteran's information, the services requested, clinical documentation, the physician order, and any special instructions from the VA provider.
TriWest identifies an authorized provider — TriWest reviews its community care network of authorized home health providers in the veteran's geographic area. BrightStar Care of North Dallas is an authorized TriWest community care provider serving Richardson, Far North Dallas, Plano, Garland, Sachse, Rowlett, Addison, and the surrounding communities in Dallas and Collin counties.
TriWest issues the prior authorization — TriWest creates a formal service authorization that specifies the type of home health services approved, the number and frequency of visits, the authorized duration (typically 60 or 90 days), and any service-specific parameters. This authorization is sent to both the provider and the veteran.
BrightStar Care receives the authorization and schedules intake — Once we receive the TriWest authorization, our team contacts the veteran to schedule an initial in-home assessment. A registered nurse conducts the intake evaluation, develops a plan of care based on the VA's referral and the veteran's current condition, and coordinates with the VA care team.
Care begins and TriWest processes claims — Home health visits begin according to the authorized plan of care. BrightStar Care submits claims to TriWest for each visit, and TriWest processes payment directly. The veteran does not receive a bill from BrightStar Care in most cases.

The typical timeline from VA referral to first home health visit is 5 to 7 business days for standard authorizations. Urgent referrals — such as those for veterans being discharged from Medical City Plano, Baylor University Medical Center, UT Southwestern Medical Center, Texas Health Presbyterian Hospital Dallas, or a VA facility who need immediate home health follow-up — can be processed faster, sometimes within 24 to 48 hours. If you have been told a referral is in process and have not heard from a provider within 7 business days, contact your VA community care office or call TriWest directly at 1-833-283-0487 to check the status.

Home Health Services Covered Through TriWest VA Community Care

The Department of Veterans Affairs authorizes a range of home health services through TriWest community care. The specific services included in each authorization depend on the veteran's clinical needs as determined by the VA provider. Common home health services authorized through TriWest include:

Skilled nursing — Registered nurses and licensed vocational nurses providing wound care, medication management, IV therapy, chronic disease monitoring, post-surgical care, catheter and ostomy management, diabetic education, and comprehensive health assessments in the veteran's home.
Physical therapy — Licensed physical therapists working with veterans on mobility, strength, balance, gait training, fall prevention, and functional recovery after surgery, stroke, injury, or prolonged illness.
Occupational therapy — Licensed occupational therapists helping veterans regain or maintain independence in activities of daily living, including adaptive techniques for dressing, bathing, cooking, and home safety modifications for veterans with TBI, stroke, or progressive neurological conditions.
Speech-language pathology — Licensed speech therapists addressing communication disorders, swallowing difficulties, cognitive-linguistic deficits, and voice disorders resulting from stroke, TBI, neurological disease, or head and neck conditions.
Home health aide services — Certified home health aides providing personal care assistance with bathing, grooming, dressing, transfers, and light household tasks under the supervision of a registered nurse. Home health aide services through VA community care must be part of a plan that also includes at least one skilled service.
Medical social services — Licensed social workers assisting veterans with care coordination, case management, community resource navigation, counseling related to illness adjustment, caregiver support, and discharge planning.

It is important to understand that the VA — not TriWest — determines what services are authorized, how many visits are approved, and for how long. TriWest executes the authorization that the Veterans Affairs system issues. If a veteran needs a change in services (more visits, additional therapy disciplines, extended duration), the request goes back through the VA provider, who submits a modified referral or re-authorization request to TriWest. This utilization review process ensures that the veteran's evolving needs are met while maintaining clinical oversight.

Cost to the Veteran for TriWest Community Care Home Health

One of the most common questions veterans ask is whether community care home health through TriWest will cost them anything. For the majority of veterans, the answer is no.

Veterans enrolled in Veterans Affairs healthcare are assigned to one of eight priority groups based on their service-connected disability rating, income, and other factors. Veterans in Priority Groups 1 through 6 — which includes most veterans with any service-connected disability, former POWs, Purple Heart recipients, veterans exposed to certain environmental hazards, and veterans below income thresholds — pay no copay for community care services, including home health.

Veterans in Priority Groups 7 and 8 — generally those with higher incomes and no service-connected conditions, or those with 0% non-compensable service-connected conditions above income thresholds — may have copayments for certain community care services. However, even in these groups, copays for home health are typically modest, and many veterans in these groups qualify for exemptions based on specific circumstances.

In practice, most veterans receiving community care home health through TriWest in the North Dallas area pay nothing out of pocket. The VA and TriWest handle all billing between themselves and the authorized provider. BrightStar Care bills TriWest directly — the veteran is not responsible for submitting claims or managing insurance paperwork.

This cost structure is fundamentally different from other programs veterans and their families may be familiar with. TRICARE, which covers active-duty service members, retirees, and their dependents, operates on a plan-based model with varying copays, cost-shares, and deductibles depending on the specific TRICARE plan. CHAMPVA, the VA program for dependents and survivors of disabled veterans, uses a 75/25 cost-sharing model where the veteran's family member pays 25% of allowable charges after meeting an annual deductible. TriWest community care, by contrast, is a Veterans Affairs benefit for the veteran directly — and the VA covers the full cost for most enrolled veterans.

VA North Texas Health Care System and Community Care Referrals

The VA North Texas Health Care System (VANTHCS) is the primary Veterans Affairs healthcare network serving veterans in the Dallas-Fort Worth metroplex and surrounding areas. The system is anchored by the Dallas VA Medical Center, located at 4500 South Lancaster Road in Dallas. VA North Texas also operates several community-based outpatient clinics (CBOCs) spread across the region, providing primary care, mental health services, and specialty care at locations closer to where veterans live.

For veterans in the North Dallas service area — including Richardson, Far North Dallas, Plano, Garland, Sachse, Rowlett, and Addison — VA North Texas is the healthcare system that manages their VA enrollment, primary care, and specialty referrals. When a VA North Texas provider determines that a veteran needs home health services and the VA's own home-based care programs cannot meet the veteran's needs within access standards, the VA North Texas community care office initiates the referral to TriWest.

Veterans in the North Dallas corridor are also frequently discharged from area hospitals including Medical City Richardson, Medical City Dallas, Medical City Plano, Texas Health Presbyterian Hospital Dallas, Texas Health Presbyterian Hospital Plano, Methodist Richardson Medical Center, Baylor University Medical Center, and UT Southwestern Medical Center. When these veterans have VA community care eligibility, the hospital discharge team or the VA care coordinator can initiate a TriWest referral for home health services to begin immediately after discharge.

BrightStar Care of North Dallas receives VA community care referrals from VA North Texas on an ongoing basis. We understand the documentation requirements, communication protocols, and care coordination expectations that the Veterans Affairs system requires. When a veteran is referred to us through TriWest, we coordinate with the veteran's VA care team — sharing progress notes, communicating changes in condition, and supporting a smooth transition back to VA care when the authorization period ends.

Why Joint Commission Accreditation Matters for TriWest Providers

The VA and TriWest maintain quality standards for the community providers in their network. While not every provider in the TriWest community care network is required to hold Joint Commission accreditation, the Department of Veterans Affairs places significant weight on quality credentials when evaluating community care partners.

BrightStar Care of North Dallas holds Joint Commission accreditation — the highest recognized standard for home health quality and patient safety in the United States. Joint Commission accreditation means that an independent, nationally recognized organization has evaluated our clinical processes, patient safety protocols, infection control practices, staff qualifications, medication management procedures, and outcome tracking systems — and has determined that we meet or exceed national standards.

For veterans and their families, Joint Commission accreditation means that when the VA refers a veteran to BrightStar Care through TriWest, the veteran is receiving care from a provider independently validated against the same standards used by the nation's top hospitals and health systems. In the North Dallas area, Joint Commission-accredited home health agencies represent a small fraction of the total provider pool.

How BrightStar Care Works with TriWest Referrals

When BrightStar Care of North Dallas receives a TriWest authorization for a veteran's home health services, we follow a structured process designed to get the veteran into care quickly while maintaining the documentation and communication standards that the VA and TriWest require.

Referral receipt and review: Our intake team reviews the TriWest authorization to understand the specific services approved, the visit frequency and duration, and any clinical notes from the VA provider. We verify the authorization details, confirm the physician order, and confirm that we can deliver the services within the required timeframe.

Veteran contact and scheduling: We contact the veteran or their designated family member within one business day of receiving the authorization. We explain who we are, confirm the services authorized, and schedule an initial in-home assessment at a time convenient for the veteran.

Initial RN assessment: A registered nurse visits the veteran's home to conduct a comprehensive assessment. This includes reviewing the veteran's medical history, current medications, functional status, home safety, caregiver availability, and specific care needs. The RN develops an individualized plan of care that aligns with the VA's referral and the TriWest authorization.

Care delivery: Skilled nursing visits, therapy sessions, and home health aide services begin according to the plan of care. Each visit is documented in our electronic health record, and our clinical team monitors the veteran's progress against the goals established in the care plan. Services may include wound care, IV therapy, medication management, and physical, occupational, and speech therapy as authorized.

VA care team coordination: We communicate with the veteran's Veterans Affairs care team throughout the authorization period. This includes sending progress summaries, alerting the VA to significant changes in the veteran's condition, and providing clinical updates that support the VA's ongoing case management.

Claims submission: BrightStar Care submits claims to TriWest for each authorized visit. TriWest processes these claims and remits payment directly to us. The veteran is not involved in the billing process and does not receive invoices from BrightStar Care for authorized services.

Re-authorization: When a veteran's initial authorization period is nearing its end and continued home health services are clinically necessary, we work with the VA care team to request a re-authorization through TriWest. We provide the clinical documentation demonstrating ongoing medical necessity, and the VA determines whether to extend the authorization for additional services.

Common Home Health Scenarios for VA Community Care Veterans

The following scenarios reflect common situations we encounter when serving veterans through TriWest authorizations in North Dallas:

Post-surgical discharge from VA Dallas: A veteran undergoes knee replacement surgery at the Dallas VA Medical Center. The surgical team determines that post-discharge home health is needed, including skilled nursing for wound monitoring and physical therapy for rehabilitation. The VA's HBPC program cannot begin services within the required timeframe due to existing caseload. The Veterans Affairs community care office refers the veteran to TriWest, and BrightStar Care receives the authorization to provide transitional care nursing and in-home physical therapy three times per week for 60 days.

Service-connected TBI requiring multi-discipline therapy: A veteran with a service-connected traumatic brain injury needs ongoing in-home physical therapy, occupational therapy, and speech therapy. The combination of all three therapy disciplines at the required frequency is not available through the VA's home-based programs in the veteran's area. TriWest authorizes BrightStar Care to provide all three therapy services in the veteran's Richardson home, coordinating schedules to minimize disruption to the veteran's daily routine.

Chronic condition management for elderly veteran: An 82-year-old veteran with congestive heart failure, diabetes, and COPD needs weekly skilled nursing visits for medication reconciliation, vital sign monitoring, wound checks, and diabetic foot care. The veteran lives in Garland, and the nearest VA clinic offering home-based nursing is more than 30 minutes away. TriWest authorizes weekly skilled nursing through BrightStar Care, with the authorization renewable every 90 days based on continued clinical need.

Complex wound care requiring daily visits: A veteran recovering from a service-connected injury has a complex wound requiring daily skilled nursing visits for dressing changes, wound assessment, and infection monitoring. The intensity of daily visits exceeds what VA HBPC can provide for this veteran. TriWest authorizes BrightStar Care for daily skilled nursing visits focused on wound management, with a plan to step down to three times per week as healing progresses.

Home health aide support alongside skilled nursing: A veteran with Parkinson's disease needs both skilled nursing for medication management and health monitoring, and home health aide assistance with bathing, dressing, and mobility support. TriWest authorizes BrightStar Care to provide skilled nursing twice per week and personal care through a home health aide three times per week, all under the RN's supervision as required by the authorization.

IV therapy following hospitalization: A veteran discharged from Medical City Richardson or Texas Health Presbyterian Hospital Plano needs ongoing IV antibiotic therapy at home for a post-operative infection. The Veterans Affairs community care office authorizes TriWest to place the veteran with BrightStar Care for daily IV infusions administered by a registered nurse, eliminating the need for repeated hospital visits during the treatment course.

TriWest vs. TRICARE vs. CHAMPVA — Understanding Which Program You Have

Veterans and their families frequently confuse TriWest community care, TRICARE, and CHAMPVA. These are three completely separate programs with different eligibility criteria, different administrators, different cost structures, and different purposes. Understanding the distinction is critical because each program has its own referral process, provider network, and billing procedures. The table below clarifies the differences:

Feature	TriWest VA Community Care	TRICARE	CHAMPVA
What it is	Department of Veterans Affairs third-party administrator for community care referrals	DoD health insurance for military-connected beneficiaries	VA health benefits program for dependents and survivors
Who it covers	Veterans enrolled in Veterans Affairs healthcare who are referred to community care	Active-duty service members, retirees, National Guard/Reserve, and their families	Spouses and children of veterans with 100% permanent and total disability or who died from service-connected conditions
How it works	VA refers; TriWest authorizes and processes claims	Enrollee selects a plan (Prime, Select, etc.) and uses network providers or gets referrals	Beneficiary uses CHAMPVA-authorized providers; 75/25 cost-share after deductible
Cost to beneficiary	$0 for most enrolled veterans (Priority Groups 1-6)	Varies by plan — copays, cost-shares, deductibles apply	25% of allowable charges after $300 individual / $600 family annual deductible
Who administers	TriWest Healthcare Alliance (Regions 4-6), Optum (Regions 1-3)	Humana Military (East), Health Net Federal Services (West)	VA Health Administration Center in Denver
Can you self-refer?	No — VA provider must initiate referral	Depends on plan — Select allows self-referral; Prime requires referral for most specialty care	Yes — beneficiary can see any CHAMPVA-authorized provider
Premiums	None — this is a Veterans Affairs benefit, not insurance	Varies by plan and sponsor status	None

If you are a veteran enrolled in VA healthcare and your VA provider has initiated a community care referral, TriWest is your contact for authorization and provider matching. If you are an active-duty service member, military retiree, or family member of a service member, you likely have TRICARE. If you are the spouse or child of a veteran who is 100% permanently and totally disabled (or who died from a service-connected condition), you may have CHAMPVA. BrightStar Care of North Dallas works with all three programs.

Not sure which program applies to you? Call or text 214-295-4667 and our team will help you determine the right path.

The information on this page is provided for general educational purposes only and should not be considered legal, medical, or benefits advice. VA community care policies, TriWest authorization procedures, eligibility criteria, and covered services are subject to change without notice. BrightStar Care of North Dallas makes no representations or warranties — express or implied — regarding the accuracy, completeness, or timeliness of the information presented here. We accept no liability for any decisions made or actions taken based on this content. Always verify your eligibility and community care options directly with the Department of Veterans Affairs (1-800-827-1000) or TriWest Healthcare Alliance (1-833-283-0487) before making care decisions. This page does not create a provider-patient relationship.

Related Resources

Frequently Asked Questions

What is TriWest Healthcare Alliance?

TriWest Healthcare Alliance is the Department of Veterans Affairs third-party administrator for the Community Care Network in Regions 4, 5, and 6, which includes Texas and 27 other states. TriWest is not an insurance company and is not affiliated with TRICARE. Its role is to process VA community care referrals, manage a network of authorized community providers, issue service authorizations, and handle claims processing when veterans receive care outside Veterans Affairs facilities. When the VA determines that a veteran needs care in the community, TriWest connects that veteran with an authorized provider like BrightStar Care of North Dallas.

Is TriWest the same as TRICARE?

No. TriWest and TRICARE are completely separate programs. TriWest administers Veterans Affairs community care for enrolled veterans — it is not insurance, charges no premiums, and only becomes involved when a VA provider refers a veteran to a community provider. TRICARE is Department of Defense health insurance for active-duty service members, military retirees, and their families. TRICARE is currently administered by Humana Military (East region) and Health Net Federal Services (West region). The name similarity causes confusion, and TriWest did historically administer TRICARE in the western U.S., but that role ended in 2019 when TriWest transitioned exclusively to VA community care.

How do I get a VA community care referral for home health?

You cannot self-refer for VA community care home health. The referral must originate with your Veterans Affairs healthcare provider. Start by talking to your VA primary care provider or specialist about your home health needs. If your VA provider determines that home health is clinically necessary and you meet at least one MISSION Act eligibility criterion — such as excessive drive time to the VA, wait time exceeding access standards, or the service not being available at a VA facility — the VA community care office will submit a referral to TriWest. TriWest then identifies an authorized provider in your area, issues an authorization, and the provider contacts you to begin services. The process typically takes 5 to 7 business days.

Can I choose my own home health provider through TriWest?

In many cases, yes. The MISSION Act gives veterans the right to choose from any provider in the TriWest community care network for the service they need. When the VA sends a referral to TriWest, veterans can express a preference for a specific authorized provider. If you would like BrightStar Care of North Dallas to be your home health provider, you can let your VA community care office know when the referral is being processed, or contact TriWest at 1-833-283-0487 to request BrightStar Care by name. The provider must be in the TriWest network and able to accept the referral in the required timeframe.

Does VA community care home health cost anything?

For most veterans, VA community care home health through TriWest costs nothing out of pocket. Veterans in Priority Groups 1 through 6 — which includes those with service-connected disabilities, former POWs, Purple Heart recipients, and veterans below certain income thresholds — have no copay for community care services. Veterans in Priority Groups 7 and 8 may have copays depending on their specific situation, but these are typically modest. BrightStar Care bills TriWest directly, and the veteran is not responsible for filing claims or handling billing paperwork.

What home health services does TriWest authorize?

TriWest authorizes the home health services that the VA provider specifies in the referral. Common services include skilled nursing (wound care, medication management, chronic disease monitoring, IV therapy), physical therapy, occupational therapy, speech-language pathology, home health aide services under skilled supervision, and medical social services. The Department of Veterans Affairs determines what services are needed, how many visits are authorized, and for how long. TriWest issues the authorization based on the VA's clinical decision — TriWest does not independently decide what care a veteran receives.

How long does it take to get a TriWest authorization?

Standard TriWest authorizations for home health typically take 5 to 7 business days from the time the VA submits the referral. Urgent referrals — such as those for veterans being discharged from the hospital who need immediate home health services — can be processed within 24 to 48 hours. If you have been waiting more than 7 business days and have not been contacted by a home health provider, call TriWest at 1-833-283-0487 or contact your Veterans Affairs community care office to check the status of your referral.

Does BrightStar Care accept TriWest/VA community care referrals?

Yes. BrightStar Care of North Dallas is an authorized provider in the TriWest community care network. We regularly receive and fulfill Department of Veterans Affairs community care referrals for home health services, including skilled nursing, physical therapy, occupational therapy, speech therapy, and home health aide services. Our Joint Commission accreditation meets the VA's quality standards for community care providers. We serve veterans throughout Richardson, Far North Dallas, Plano, Garland, Sachse, Rowlett, Addison, and Dallas and Collin counties. Call or text 214-295-4667 if you have a TriWest authorization or expect to receive one soon.

What is the MISSION Act and how does it affect my home health care?

The VA MISSION Act (Maintaining Internal Systems and Strengthening Integrated Outside Networks Act), signed into law in 2018, established the current framework for Veterans Affairs community care. It replaced the Veterans Choice Program with a more streamlined system and set specific access standards — drive time limits of 30 minutes for primary care and 60 minutes for specialty care, and wait time limits of 20 days for primary care and 28 days for specialty care. If you meet any of these standards, or if a service is not available at a VA facility, or if you and your VA provider agree that community care is in your best interest, you may be eligible for community care home health through TriWest.

Can I get 24-hour home care through TriWest?

VA community care authorizations through TriWest are typically structured as intermittent home health visits — skilled nursing, therapy, or home health aide visits at defined frequencies (for example, three visits per week). Twenty-four-hour continuous home care is not a standard VA community care home health authorization. However, the Department of Veterans Affairs does authorize extended-hour or shift care in specific clinical situations, particularly for veterans with high-acuity service-connected conditions. If you need extended home care beyond standard intermittent visits, discuss your needs with your VA provider, who can determine what level of care is clinically justified and submit the appropriate referral. BrightStar Care of North Dallas has the staffing capacity to provide extended-hour care when authorized.

What if TriWest denies my home health authorization?

If TriWest denies a home health authorization, the denial is typically based on the referral not meeting one of the MISSION Act eligibility criteria for community care — not on a judgment about whether you need home health in general. The Veterans Affairs system still determines your clinical needs. If your community care referral is denied, you have several options: ask your VA provider to review the referral and resubmit with additional documentation, contact the VA community care office at your facility to discuss alternative pathways, request that the VA provide the home health services through its own programs (such as HBPC), or file a formal appeal through the VA's community care appeals process. The VA patient advocate at your facility can also help you navigate a denial.

How does VA community care work with my other VA benefits?

VA community care through TriWest is one component of your overall Veterans Affairs healthcare. Receiving home health through a community provider does not affect your other VA benefits — your VA primary care, specialty care, prescriptions, mental health services, and other VA programs continue as normal. Community care is an extension of VA care, not a replacement for it. Your VA care team remains responsible for your overall care management and coordinates with the community provider (BrightStar Care) throughout the authorization period. When the community care authorization ends, your care transitions back to the VA system seamlessly. If you also receive benefits through other programs, such as Aid and Attendance or a VA pension, those benefits are not affected by community care.

What VA facilities serve the North Dallas area?

The VA North Texas Health Care System serves veterans in the North Dallas area. The primary facility is the Dallas VA Medical Center at 4500 South Lancaster Road in Dallas. VA North Texas also operates community-based outpatient clinics (CBOCs) throughout the region, providing primary care, mental health, and some specialty services closer to where veterans live. When VA North Texas determines that a veteran in Richardson, Plano, Garland, Sachse, Rowlett, Addison, or Far North Dallas needs home health services that the VA cannot provide within MISSION Act access standards, the referral goes to TriWest for community care placement with an authorized provider like BrightStar Care of North Dallas.

Disclaimer: The information on this page is provided for general educational purposes only and should not be considered legal, medical, or benefits advice. VA community care policies, TriWest authorization procedures, eligibility criteria, covered services, and cost-sharing structures are subject to change without notice. BrightStar Care of North Dallas makes no representations or warranties — express or implied — regarding the accuracy, completeness, or timeliness of the information presented here. We accept no liability for any decisions made or actions taken based on this content. Always verify your eligibility and covered benefits directly with the Department of Veterans Affairs (1-800-827-1000) or TriWest (1-833-283-0487) before making care decisions. This page does not create a provider-patient relationship.

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