US Vets: Plan "B" or not?

dddave · February 22, 2018

This is directed at expat US military veterans enrolled in the VA healthcare system.

Do you continue to pay for Medicare "Plan B" coverage (basically: outpatient treatments and meds.) or did you withdraw from "B", thus saving about $120 a month?

I did withdraw from "B" when I became fully enrolled in the VA system last year, figuring it was redundant coverage. Now, I'm having second thoughts as I discover how difficult it can be to schedule some procedures with the VA that I could get much more easily from a Medicare provider on a walk-in basis.

Interested in other's thoughts and experiences.

Pib · February 23, 2018

When you say fully enrolled in the VA system, do you mean you enrolled while in the States or in Thailand? If you enrolled outside the U.S. then you are saying your enrolled in the VA Foreign Medical Program (FMP) which is a somewhat different enrollment process than VA enrollment in the U.S.

As far as I know there are no VA FMP facilities/providers in Thailand. Assuming you are enrolled in VA FMP you would still need to pay 100% upfront for medical care and then seek reimbursement through the VA FMP. And as you know the VA only covers medical conditions related to your specific rated disabilities; not just any medical issue/accident that may strike. VA coverage is usually challenging enough even when living in the U.S.; if living outside the U.S. it gets a lot tougher unless maybe living in a country that has some VA FMP providers/facilities.

Now if you are a military retiree (with or without a VA disability rating) covered under Tricare which does provides worldwide coverage--even in Thailand--your Tricare coverage ends when turning 65 "unless you sign-up for Medicare Part B."

Now Medicare does "not" provide coverage/reimbursement outside the U.S. except in some unique emergency situations for certain countries, but the fact you are paying the Part B premium keeps you in the Tricare system under the Tricare for Life (TFL) program....same coverage/reimbursement at 75% as regular Tricare...same worldwide coverage. You continue to send you reimbursement claims to Tricare. And when back in the States you are covered by both Medicare and Tricare....in this case your medical provider or you first send your claim to Medicare ...Medicare usually reimburse at 80% and then automatically send the claim to TFL who pick up the remaining 20%....end result 100% reimbursement minus any annual deductibles for Medicare/Tricare.

The annual Medicare Part B premium is now $134 unless you might be paying a little less for now like the $120 your mentioned due to previous years where a person was protected from Medicare premium increases under the "hold harmless" law related to no-or-low Social Security COLA increases. But with inflation growing again and Social Security now getting back into COLA increases the "hold harmless" rule will not protect a person from Medicare premium increases...will only take a year or two to get a person back to the most current Medicare premium.

dddave · February 23, 2018

Thanks Pib. Actually, I have no service connected disability so am not enrolled in TriCare. I am not eligible for any medical benefits outside the USA. I believe I was classified as "Level-5" in terms of benefit eligibility.

Thanyaburi Mac · February 23, 2018

Medicare Part B $134 a YEAR? Or monthly?

Mac

Pib · February 23, 2018

Tricare, inside or outside the U.S., predominately applies for active duty personnel, military retirees, and their dependents. Just being a veteran does not qualify you for Tricare except in some special cases like being medically retired from active duty before you served an entire career like say 20 years.

Now many veterans who served X-amount years but didn't make a career of it and those who did serve an entire military career say of 20 years or more have a VA disability ratings ranging from 0% to 100%. Any veteran (or military retiree) can apply for VA care and their disability rating will be the key factor in determining what Priority Group, 1 thru 7, they will be given for medical care. In your case a 0% disability rating put in in Priority Group 5....which is easy to be in for "any" veteran...it's pretty much the group for those with nothing wrong with them at the time the priority group rating was issued to you based on the VA evaluation of your health, service connected issues, etc.

Until you get into Priority Group 1 thru 3 which includes those folks with various levels of disability rating from 10 to 100% your chances of getting VA medical care "in the U.S." are very low....unless you just happen to live very close to a major VA facility....then it might be a tad above very low to just low. And even then the VA support of your medical condition can come with all kinds of fine print related to whether your condition can be considered service connected, etc...etc...etc.

If you think VA medical care is going to equal Medicare medical care in terms of availability to you especially in your case with a VA 0% disability rating then you are making a big mistake in thinking.

Pib · February 23, 2018

3 minutes ago, Thanyaburi Mac said:

Medicare Part B $134 a YEAR? Or monthly?

Mac

Monthly.

nervona81732 · February 23, 2018

Bangkok Hospital Pattaya takes FMP. I am enrolled in FMP and have 7 service connected disabilities and I am in the BHP data base and my first three visits only required a signature. One needs to first enroll in FMP , get your FMP letter ( 2 pages ) then go to BHP and get yourself entered in to their data base with your FMP documents. You will need your passport ect.

The person who runs the international insurance department there is Mr. Danny Quaeyhaegens. A real easy individual to work with.

I don't know where you are from Pattaya but this a sure solution to FMP. I live way out in the bush from Ubon but was lucky enough that people from my new VFW post in Banchang introduced me to this.

Just passing this on.

ToS2014 · February 23, 2018

8 hours ago, Pib said:

When you say fully enrolled in the VA system, do you mean you enrolled while in the States or in Thailand? If you enrolled outside the U.S. then you are saying your enrolled in the VA Foreign Medical Program (FMP) which is a somewhat different enrollment process than VA enrollment in the U.S.

As far as I know there are no VA FMP facilities/providers in Thailand. Assuming you are enrolled in VA FMP you would still need to pay 100% upfront for medical care and then seek reimbursement through the VA FMP. And as you know the VA only covers medical conditions related to your specific rated disabilities; not just any medical issue/accident that may strike. VA coverage is usually challenging enough even when living in the U.S.; if living outside the U.S. it gets a lot tougher unless maybe living in a country that has some VA FMP providers/facilities.

Now if you are a military retiree (with or without a VA disability rating) covered under Tricare which does provides worldwide coverage--even in Thailand--your Tricare coverage ends when turning 65 "unless you sign-up for Medicare Part B."

Now Medicare does "not" provide coverage/reimbursement outside the U.S. except in some unique emergency situations for certain countries, but the fact you are paying the Part B premium keeps you in the Tricare system under the Tricare for Life (TFL) program....same coverage/reimbursement at 75% as regular Tricare...same worldwide coverage. You continue to send you reimbursement claims to Tricare. And when back in the States you are covered by both Medicare and Tricare....in this case your medical provider or you first send your claim to Medicare ...Medicare usually reimburse at 80% and then automatically send the claim to TFL who pick up the remaining 20%....end result 100% reimbursement minus any annual deductibles for Medicare/Tricare.

The annual Medicare Part B premium is now $134 unless you might be paying a little less for now like the $120 your mentioned due to previous years where a person was protected from Medicare premium increases under the "hold harmless" law related to no-or-low Social Security COLA increases. But with inflation growing again and Social Security now getting back into COLA increases the "hold harmless" rule will not protect a person from Medicare premium increases...will only take a year or two to get a person back to the most current Medicare premium.

Great points! Just to add, some larger hospitals in Thailand now accept both Tricare and the FMP insurance. If outpatient and not seen under VA compensated disabilities, you still must pay up front costs and then seek reimbursement via the normal procedures. If covered by the VA, they direct bill even for outpatient visits/'script refills. The easiest way is to ask your local hospital.

thaikahuna · February 23, 2018

There are several hospitals that accept the FMP in Thailand. That list is as follows:

Samitivej Sri Racha

Praram 9

Chiang Mai Ram

And the following Bangkok Hospital Group Facilities:

Bangkok - In-patient only

Bangkok-Pattaya

Bangkok-Hua Hin

Bangkok-Udon Thani

Bangkok-Korat

Bangkok-Chiang Mai

All these facilities have a 5000 - 10,000 baht threshold. Your bill must meet that threshold for the facility to directly submit to the FMP. You must present your Passport, and FMP Authorization letter to be eligible for the direct payment program. If you missed that, Those hospitals, all 9 of them, will treat your service-connected conditions for no out of pocket if your bill is over the threshold. It will vary from facility to facility but you must be prepared to pay first and submit for reimbursement.

The FMP pays ONLY for those items for which you have a rated (even 0%) disability. As of last October 1, the VA for all intent and purpose ceased to exist in the Philippines. It is phasing out operations and expected to cease completely within the next year.

There is an even larger list of facilities that accept Tricare but I do not have that. Just a few that I am aware of are the listed hospitals plus Bumrungrad, BNH, Mission Hospital and many others throughout the Kingdom.

Manipha Clinics in Bangkok and Pattaya provides prescription services for both FMP and Tricare.

As far as withdrawal from Medicare, should you need it in the future again, You can be assessed a 10% penalty for every year of eligibility that you were not enrolled.

If anyone has FMP questions, send me a message and I will try to answer it for you. It was 2 friends and I that helped get this network of hospitals on board with the program. We started with 2, Samitivej Sri Racha and Chiang Mai Ram. That was nine years ago.

Pib · February 23, 2018

1 hour ago, thaikahuna said:

There is an even larger list of facilities that accept Tricare but I do not have that. Just a few that I am aware of are the listed hospitals plus Bumrungrad, BNH, Mission Hospital and many others throughout the Kingdom.

Would love to see such a list. I'm aware that Bumrungrad (and maybe a few others) accepts/direct bills Tricare for "active duty" personnel and their dependents "as the U.S. military has made that contract arrangement with them"...but once again that is for active duty and their dependents.

But for military "retirees" using Tricare my understanding is Bumrungrad (and maybe a few others) will not direct bill Tricare but they will take a 25% payment of the bill (you pay that) and then give you X-amount of time for you to file a claim for reimbursement and then you go back and pay the remaining balance. But they do this on a case-by-case basis for retirees.

Pib · February 23, 2018

1 hour ago, thaikahuna said:

There are several hospitals that accept the FMP in Thailand. That list is as follows:

Samitivej Sri Racha

Praram 9

Chiang Mai Ram

And the following Bangkok Hospital Group Facilities:

Bangkok - In-patient only

Bangkok-Pattaya

Bangkok-Hua Hin

Bangkok-Udon Thani

Bangkok-Korat

Bangkok-Chiang Mai

All these facilities have a 5000 - 10,000 baht threshold. Your bill must meet that threshold for the facility to directly submit to the FMP. You must present your Passport, and FMP Authorization letter to be eligible for the direct payment program. If you missed that, Those hospitals, all 9 of them, will treat your service-connected conditions for no out of pocket if your bill is over the threshold. It will vary from facility to facility but you must be prepared to pay first and submit for reimbursement.

The FMP pays ONLY for those items for which you have a rated (even 0%) disability. As of last October 1, the VA for all intent and purpose ceased to exist in the Philippines. It is phasing out operations and expected to cease completely within the next year.

I hope above is true....but below is a snapshot form the Joint U.S. Military Assistance-Thailand RAO website talking FMP in Thailand. Seems to conflict somewhat with above. I'm now confused on which is correct....your info or the RAO. What is the source of your info? Thanks.

watcharacters · February 23, 2018

Fellows and ladies that spent their time in grade to reach retirement in the US military deserve the benefits they were once promised.

Taxes just have to made due for this.

Edited February 23, 2018 by watcharacters

thaikahuna · February 24, 2018

13 hours ago, Pib said:

I hope above is true....but below is a snapshot form the Joint U.S. Military Assistance-Thailand RAO website talking FMP in Thailand. Seems to conflict somewhat with above. I'm now confused on which is correct....your info or the RAO. What is the source of your info? Thanks.

Considering I work directly with these hospitals, I would say mine is the more accurate. As for item 2, the Veteran is ultimately responsible for all medical treatment and medical facility participation is at its discretion. I helped set up this network, not the RAO. I am one of the two independent but unoffical FMP advisors in Thailand. To Item 4, The following is a cut and paste from an email with an FMP Processing Unit.

All claims with a service date from October 1, 2017 from the Philippines belong to the FMP; so the full shift has already happened.

Thanks,

Rick

Richard M

Supervisory Program Analyst

Foreign Claims (FMP & CVAF)

Any more questions I might assist with? I am not versed on Tricare but I do know that the facilities I named will accept Military length of service or medically retitred for service. They need to contact the SOS office in Singapore for coverage. The nurses in JUSMAG are there for the benefit of the active duty personnel and not authorized to approve or deny coverage on Tricare matters for anyone else.

Pib · February 24, 2018

Big thanks for the VA FMP feedback.

Please, please contact the JUSMAGTHAI RAO to provide them more detailed info so they can evaluate whether to provide your info to the the many U.S. military veterans/retirees registered with them across Thailand. See if your info can make it into some official crossfeed channels like the RAO website/newsletter.

http://www.jusmagthai.com/rao.html

JUSMAGTHAI RAO Mission

Quote

Our Mission: To provide assistance to U.S. Military Retirees, service members in Thailand about to retire, and eligible family members of the above. This includes maintaining this website with useful links to information and offices that can assist you in areas beyond our charter. This RAO is an official U.S. Air Force activity staffed by a small group of retired U.S. military volunteers. We welcome your emails and can assist you and eligible family members on a walk-in basis. We also maintain an RAO Newsletter (below) with useful information updates as they occur.

Regarding Tricare, as both you and I mentioned at JUSTMAGTHAI there is also some Tricare reps/nurses but they are dedicated to support of active duty and their dependents. Their support provided to military retirees is as a courtesy/time permitting (an they do provide some support....nice ladies); otherwise, retirees must contact Tricare directly.

http://www.jusmagthai.com/medical.html

dddave · February 24, 2018

22 hours ago, Pib said:

Until you get into Priority Group 1 thru 3 which includes those folks with various levels of disability rating from 10 to 100% your chances of getting VA medical care "in the U.S." are very low....unless you just happen to live very close to a major VA facility....then it might be a tad above very low to just low. And even then the VA support of your medical condition can come with all kinds of fine print related to whether your condition can be considered service connected, etc...etc...etc.

I am fortunate that my sister lives less than a mile away from the VA Med. Center in Boston. I enrolled in 2015 and returned to Boston in late 2016. I walked in to Urgent Care with no prior appointment and complained of chest pains I had been having for the past year. Within an hour I was in an ambulance on my way to their surgical facility where several days later I had coronary bypass surgery.

In the two months following my surgery, I not only received post operative care but several other non-critical issues were dealt with without too many roadblocks, such as an opthalamologic exam resulting in free new glasses, dermatological exam resulting in removal of some growths and general health consultations with my primary care physician.

It did become clear that having a decent and assertive primary care physician made getting what I needed in the time frame I had was of paramount importance.

All this to say that as a "Level-5" I got what I needed when I needed it. I am fully aware that all this may easily not apply at other VA facilities because, as we all know, the quality of care and patient load varies enormously, site to site.

Issanjohn · February 24, 2018

20 hours ago, thaikahuna said:

There are several hospitals that accept the FMP in Thailand. That list is as follows:

Samitivej Sri Racha

Praram 9

Chiang Mai Ram

And the following Bangkok Hospital Group Facilities:

Bangkok - In-patient only

Bangkok-Pattaya

Bangkok-Hua Hin

Bangkok-Udon Thani

Bangkok-Korat

Bangkok-Chiang Mai

All these facilities have a 5000 - 10,000 baht threshold. Your bill must meet that threshold for the facility to directly submit to the FMP. You must present your Passport, and FMP Authorization letter to be eligible for the direct payment program. If you missed that, Those hospitals, all 9 of them, will treat your service-connected conditions for no out of pocket if your bill is over the threshold. It will vary from facility to facility but you must be prepared to pay first and submit for reimbursement.

The FMP pays ONLY for those items for which you have a rated (even 0%) disability. As of last October 1, the VA for all intent and purpose ceased to exist in the Philippines. It is phasing out operations and expected to cease completely within the next year.

There is an even larger list of facilities that accept Tricare but I do not have that. Just a few that I am aware of are the listed hospitals plus Bumrungrad, BNH, Mission Hospital and many others throughout the Kingdom.

Manipha Clinics in Bangkok and Pattaya provides prescription services for both FMP and Tricare.

As far as withdrawal from Medicare, should you need it in the future again, You can be assessed a 10% penalty for every year of eligibility that you were not enrolled.

If anyone has FMP questions, send me a message and I will try to answer it for you. It was 2 friends and I that helped get this network of hospitals on board with the program. We started with 2, Samitivej Sri Racha and Chiang Mai Ram. That was nine years ago.

I'm 100% disabled with multiple combined disabilities so I'm definitely eligible for FMP. According to the VA website FMP will ONLY reimburse you for medical expenses incurred overseas. Is that true? Or will they actually bill FMP directly with no out of pocket expense or some out of pocket expense? Can you clarify that because I'm doing my own research and I'm seriously considering enrolling in fact I think this is something that I better get enrolled in now.

thaikahuna · February 24, 2018

You would be wise to enroll in the FMP. Registration is easy. I have attached a registration form. You can fill it out on line, then dowload, sign, scan and email to the FMP at [email protected]. If you are a military retiree, length of service or medically separated, or if you are 100% DAV. you are also eligible for a APO Box at the Consulate in Chiang Mai or the JUSMAGTHAI Mailroom in Bangkok. I recommend this as it keeps all your correspondence within the USPS mail system. If you are not eligible, I'm sorry, you must use your Thai address.

It takes 4-6 weeks to get you in the system and get your FMP Benefits Authorization Letter to you. It will have all your service connected disabilities listed on it. I would suggest that you take that benefits letter along with your passport and Thai DL if you have one and copy of your lease, yellow book, etc. The participating facilities will vet your information. It will decide if they will directly bill the FMP.

You have 2 years from date of service or discharge on a service connected issue to submit for reimbursement.

You need four items for every claim. You need an FMP cover sheet [ https://www.va.gov/vaforms/medical/pdf/10-7959f-2-fill_012317.pdf ],

A copy of your paid bill, an itemized breakdown of charges and a medical certificate or discharge summary for EACH DATE OF SERVICE. It matters not you were seen for the same thing 4 times, you need 4 sets of paperwork.

The FMP will reimburse for the following:

1. Treatment of a service connected condition (even if rated 0%).

2. Treatment for something that aggravates a service connected condition

3. Treatment for something that mitigates a service connected condition

It is the facility that decides if it will bill the FMP, so be prepared to pay up front.

I hope this helps.

FMP Registration Form.pdf

Edited February 24, 2018 by thaikahuna
Missing data

Issanjohn · February 24, 2018

2 hours ago, thaikahuna said:

You would be wise to enroll in the FMP. Registration is easy. I have attached a registration form. You can fill it out on line, then dowload, sign, scan and email to the FMP at [email protected]. If you are a military retiree, length of service or medically separated, or if you are 100% DAV. you are also eligible for a APO Box at the Consulate in Chiang Mai or the JUSMAGTHAI Mailroom in Bangkok. I recommend this as it keeps all your correspondence within the USPS mail system. If you are not eligible, I'm sorry, you must use your Thai address.

It takes 4-6 weeks to get you in the system and get your FMP Benefits Authorization Letter to you. It will have all your service connected disabilities listed on it. I would suggest that you take that benefits letter along with your passport and Thai DL if you have one and copy of your lease, yellow book, etc. The participating facilities will vet your information. It will decide if they will directly bill the FMP.

You have 2 years from date of service or discharge on a service connected issue to submit for reimbursement.

You need four items for every claim. You need an FMP cover sheet [ https://www.va.gov/vaforms/medical/pdf/10-7959f-2-fill_012317.pdf ],

A copy of your paid bill, an itemized breakdown of charges and a medical certificate or discharge summary for EACH DATE OF SERVICE. It matters not you were seen for the same thing 4 times, you need 4 sets of paperwork.

The FMP will reimburse for the following:

1. Treatment of a service connected condition (even if rated 0%).

2. Treatment for something that aggravates a service connected condition

3. Treatment for something that mitigates a service connected condition

It is the facility that decides if it will bill the FMP, so be prepared to pay up front.

I hope this helps.

FMP Registration Form.pdf

FMP Registration Form.pdf

Thanks yes I'm 100% disabled 20 years. I would get the APO box that's a great deal but I live in Korat. So they only reimburse after you're signed up they don't bill directly to FMP for anything? What if it's for something super expensive? I've had so many medical issues even cancer that I'd probably be covered for just about anything. I'm total combined disabled 100%.

Pib · February 24, 2018

29 minutes ago, Issanjohn said:

Thanks yes I'm 100% disabled 20 years. I would get the APO box that's a great deal but I live in Korat. So they only reimburse after you're signed up they don't bill directly to FMP for anything? What if it's for something super expensive? I've had so many medical issues even cancer that I'd probably be covered for just about anything. I'm total combined disabled 100%.

I hope you get your wish. However, I think you will find what is covered/reimbursable must be linked to a "VA rated, service connected condition"....they are not going to cover just anything.

Take a look at below VA webpage/partial quote talking FMP benefits and claims.

But also keep in mind a VA rating for a service connected condition can still be 0% which just means the VA confirmed the condition is service connected but they will not award any disability pay for that particular condition which they rated as minor in condition. However, you can still get medical care/reimbursement for that condition if VA approved.

https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/fmp_benefits_claims.asp

Quote

Foreign Medical Program Benefits and Claims Information

FMP Benefits

Unlike typical health benefit/insurance plans, where the range of benefits is standard among all enrolled beneficiaries/subscribers, FMP benefits are limited to services that are medically necessary to treat a VA-rated, service-connected disability or for a condition that is associated with and held to be aggravating a service-connected disability. Supporting medical documentation is always required.

thaikahuna · February 24, 2018

The VA FMP is not like back in the USA. IF you have paid bills already, sign up and send them all in at the same time. If you are submitting bills for SC issues, they will pay that and anything related to it. Turn time is around 45-60 days currently. They will mail you a US Treasury check. (God I wish they'd go direct deposit.)

thaikahuna · February 24, 2018

5 hours ago, Issanjohn said:

I'm 100% disabled with multiple combined disabilities so I'm definitely eligible for FMP. According to the VA website FMP will ONLY reimburse you for medical expenses incurred overseas. Is that true? Or will they actually bill FMP directly with no out of pocket expense or some out of pocket expense? Can you clarify that because I'm doing my own research and I'm seriously considering enrolling in fact I think this is something that I better get enrolled in now.

Yes, they will not pay for any US accrued bills. I think best you send me a message so I can discuss your situation with you privately.

Issanjohn · February 24, 2018

3 hours ago, Pib said:

I hope you get your wish. However, I think you will find what is covered/reimbursable must be linked to a "VA rated, service connected condition"....they are not going to cover just anything.

Take a look at below VA webpage/partial quote talking FMP benefits and claims.

But also keep in mind a VA rating for a service connected condition can still be 0% which just means the VA confirmed the condition is service connected but they will not award any disability pay for that particular condition which they rated as minor in condition. However, you can still get medical care/reimbursement for that condition if VA approved.

https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/fmp_benefits_claims.asp

Hey thanks so much for this information I was never aware of FMP until reading this thread. I understand how disability compensation works I have several different service connected rated disabilities and yes a few of them are rated at 0%. I am rated from 10% to 100% for all my different combined rated disabilities that are service connected. All my disabilities that are considered "Not Service Connected" in eBenefits are rated at 0% and a few of my "Service Connected" disabilities are also rated 0%. Although I'm rated at at least 10% for all of my service connected disabilities.

I've been retired for almost 4 years so I understand now how all that stuff works and I know the difference between service and Not Service Connected Disabilities. I've figured out almost everything but every once in a while I still learn something new such as this, FMP. All my ratings vary I'm rated at 10%, for some things 20% for some things, 30% for other things, and 50% for one thing. It all adds up to a total of 340% so they actually rounded mine down to 100%. The VA has an funny way of calculating disability I don't even try to understand it because I'm way over 100% with everything combined. Mine is called Total Combined Disability because I've been rated for several different things. More than half of my ratings are permanent and total although some of them are not considered to be permanent. So technically I'm not considered to be permanent and total although in reality I am permanently disabled because I have so many multiple ratings that are considered to be permanent disabilities.

Even my history of cancer is considered Servive Connected but I'm rated at 0% for my history of cancer. I was told at Walter Reed that my cancer was linked to something I was exposed to in Afghanistan because of the area I was in and during the time I was there. Supposedly I wasn't the only one diagnosed with the same type of cancer who was in the same area at the same time I was in Afghanistan but they never did tell me what the supposed cause was. I was in Afghanistan multiple times on multiple tours before my one tour in Iraq but I was also actually part of the initial invasion of Afghanistan in October 2001 with Special Forces. I heard rumors about some sort of chemical agent that was left behind during the Soviet invasion of Afghanistan but I honestly have no idea why my cancer history is considered Service Connected and somehow linked to my first tour in Afghanistan.

Regardless I was rated at 0% for my cancer history and it is considered a Service Connected disability so I would assume that my annual CT Scans and post cancer follow up appointments that I require once a year for the rest of my life would be covered under FMP. It says if it's Service Connected than it's covered so I would assume so. I was diagnosed in 2005 and I was in remission by 2006. I have just so many different ratings for so many different medical issues that there's probably not much I wouldn't be covered for. You name it and I'm probably rated for it, the list is very long. I am also a 2 time Purple Heart recipient. TBI, back problems, knee problems, I have a blown out right hip, I have sever insomnia which is linked to panic disorder and PTSD, tinnitus, and just too many things to list plus obviously I'm not going to post all my issues online.

So I fully understand how my disability is rated and I understand the difference between service connected and not service connected. It took me a while to figure out all that stuff after I retired.

My question is for the FMP benefits is it reimbursement only after filing a claim? Or can we actually get the local Thai hospital to bill the FMP service at the VA directly if it's for something service connected? I've been paying out of pocket for a lot of medical care that would have probably been free in the states.

Another thing is that I'm due for another colonoscopy. I've had 3 colonoscopies when I was in the states from 2011 through 2013 when I was still on Active Duty because of another medical problem which is now another one of my Service Connected Disabilities. So hopefully that'll be covered as well. They told me at Bangkok Hospital in Korat that a colonoscopy costs about 40,000 baht I was thinking about just paying for it out of pocket like I've been doing but if I can get it covered that would be great.

So how does it work? Do you file a claim after the fact and then get reimbursed after paying for it out of pocket? Or is there a way to set it up so they can bill FMP through the VA directly and prevent me from having to pay anything up front? Or is it just reimbursement for service connected medical bills only over here? Also I'd love to get an APO Box at JUSMAG, I definitely meet the eligibility requirements that you mentioned for one except I live in Korat which is about 5 hours north of Bangkok. I wonder if I could get an APO box set up at JUSMAG and if they'd forward me all my mail. I've never really had any problems with the Thai post office. I always use my local Thai address the VA has my local address on file and so does DEERS and TRICARE. I have an eBenefits account so I can easily update my information online. Also I'm sorry but what did you mean when you said that you hope I get my wish? What were you referring to I missed that?

Issanjohn · February 24, 2018

4 hours ago, thaikahuna said:

The VA FMP is not like back in the USA. IF you have paid bills already, sign up and send them all in at the same time. If you are submitting bills for SC issues, they will pay that and anything related to it. Turn time is around 45-60 days currently. They will mail you a US Treasury check. (God I wish they'd go direct deposit.)

Huh they use direct deposit for everything else my monthly pension payments have always been paid by direct deposit for the past 3 plus years. Checks are no problem for me I still use my bank in the states I use USAA and I can deposit checks directly into my USAA account in the states using my iPhone. I'm pretty sure any smartphone has that capability you just log in to your account using the online banking app and take a picture of the check using the banking app on your smartphone and the funds are instantly deposited into your account. If you're unaware of that it works really well, although yeah Direct Deposit is so much faster. I always receive my pension payments a day early through Direct Deposit, payday is on the 1st of every month and I always get paid a day early. Of course if the 1st falls on a weekend or holiday then payday is even a day earlier. I don't know about Thai banks but pretty much every bank in the states has that capability of depositing checks electronically with a smartphone banking app if you're having issues with checks.

Thanks for all the information by the way I really appreciate it. So is it reimbursement only or can I somehow get it set up at the local Thai hospital so they can bill FMP directly through the VA for anything service connected? I've been paying A LOT of medical bills out of pocket pretty much every time I ever see the doctor or go to the hospital it's always for something Service Connected.

Basically what I'm wondering is does the FMP system only cover foreign medical bills by reimbursement only? Is there any kind of system where you can have the local Thai hospital bill FMP directly for Service Connected issues?

I really ought to visit JUSMAG next time I'm in Bangkok. I'd love to get an APO Box I definitely meet the requirements for one being 100% disabled with 20 years in service except I live way up in Korat 5 hours north or Bangkok. I wonder if JUSMAG forwards people's mail. If so then it would probably be worth it for me to get an APO box at JUSMAG, if not then I'll just keep using my local address because I usually only make it down to Bangkok like only 2 or 3 times a year. When they build that train we'll probably be spending more time down in Bangkok. I also really should join one of the VFW organizations around here. I met a guy at the Embassy last time I was in Bangkok from a VFW organization down south I just can't seem to find his phone number that he left me. I visit the embassy at least once a year to get my Proof of Income Affidavit when it comes time to get the annual extension of stay.

Anyway thanks for letting me know about that.

Thanyaburi Mac · February 24, 2018

Here's VFW in Korat: http://www.vfw10217.org/

Mac

not eligible for VFW, so AmLeg China Post 1

Korat, Camp Friendship, Feb '64-Feb '65

thaikahuna · February 25, 2018

IsaanJohn,

I would suggest you speak with the international Department at Bangkok Hospital Korat. I will check with my contacts here in Bangkok to see if they are indeed participating. The big minus in getting hospitals to participate is getting them past the that the FMP IS NOT insurance. It is a reimbursement program.

You have the handbook, the registration form and a claim form cover sheet. That will get you started. Remember, each date of service or hospitalization must be on a separate claim with the 4 items I noted previously. NOTE: For example your MD is planning a procedure and want to do labs 3-4 days ahead of the procedure - The Labs are a separate claim even though related to the other procedure.

Trust me, you may not get it perfect the first time. Just send me a note and I'll help get you straightened out. MY first time I just sent in a fistful of paperwork with one cover sheet. I got an EOB (Explanation of Benefits) that accompanies all claims with all being denied. I will missing medical certs, itemized breakdowns, etc. On the bright side of that I had another year to figure it out. I had around $6000 in claims and got all but about $300 back. the one I did not get paid for was because I screwed up and missed the deadline. You have two years from date of service to file and I missed it by a week.

Pib · February 26, 2018

In addition to the great FMP info thaikuhuna has provided, below is a link to a 15 page FMP Handbook that I think does very good job in over viewing FMP to include things like the claims process...points of contact....example of a FMP EOB, how FMP interfaces with those of us on Tricare for Life or other health insurance plans, etc. Definitely worth a read....does a good job in consolidating a lot of the docs/info on the FMP website into one document.

I still have questions in my mind about FMP to include some questions about FMP and Tricare for Life interface/any possible downsides in using both, best way to use both, etc., but I'll work through those. Will probably call both FMP and Tricare for Life to ask a few questions.

http://oasisgrp.org/PDF/FMP-Handbook-121009web.pdf

Pib · February 26, 2018

Update: I made that phone call to the FMP Office in Denver....in only a minute or two I was talking to a representative. I was expecting a healthy wait time to talk to a rep, but instead I'm talking to a rep really fast. A representative that was cheerful and answered my questions (I only had a couple mostly related. to Tricare for Life interaction).

The rep said I can even "email" my registration form versus mailing or faxing. In fact, he highly recommended I use email over mail or fax. I just need to complete, sign, scan, and attach the registration form to an email addressed to the email address at the top of the registration form. If the creek don't rise I'll do that tomorrow

And the rep also confirmed I can "email" my old Tricare claims with EOB (i.e., scan and email) going back 2 years for FMP consideration of reimbursement of anything that Tricare didn't cover. Of course any additional FMP reimbursement would need to meet the service connected requirements.

Since I still have my Tricare claims with EOBs going back two years I will fill-out a FMP claim cover sheet, scan the FMP claim sheet along with a Tricare claim w/EOB, and email to FMP to see how it goes...test the waters first with one claim.

I'm not really expecting any FMP reimbursement since from my point of view none of my Tricare claims have been for medical conditions related to my VA rated service connected disabilities (even the 0% ones). But maybe FMP will see it differently. As mentioned this will be part of my "testing of the FMP waters." Heck, if I get some FMP reimbursement from my test claim I'll send in some more Tricare claims which are less than two years old.

Even if I don't get any additional reimbursement, by registering with FMP I will be set with FMP come the possible day my service connected disabilities do require further medical care and meet FMP reimbursement requirements.

gk10002000 · February 27, 2018

Very interesting topic, Med B with standard VA benefits. I can qualify for VA once I stop working, but I will have to move a lot of financial things around to lower my passive income. I wasn't thinking of trying to keep being qualified for VA ( I am not retired, no disability, just standard 10 years in during the 80s-90s). It just seemed easier to do Medicare and get Supp B or some equivalent Supp(s). That decision is still one year away. But reading all the posts in this forum, I didn't really see a firm answer. I won't have tricare or anything like that. I would in general plan to return to the USA for any medical treatment of any significance, as I probably won't be staying more than 1/2 of each year in Thailand. The idea of "free" VA medical with no premiums, while I might purchase some local Thai medical for convenience is bouncing around in my head. I am 61 now and still working, but am extremely likely to "retire" later this year or mid next year. Being 62, I will have a gap of a few years before I would be eligible for medicare, so I will have to do something. The tentative thoughts have been Thailand medical and then VA in the USA as needed. Or Thai medical all the way, now that Obamacare is not going to be required or at least one won't be penalized for not having it, assuming I understand the current law change.

thaikahuna · February 27, 2018

Medicare is worthless outside the US & VA FMP only pays for service connection disabilities. Essentially, there is no VA outside the USA.

Sent from my SM-G930F using Thailand Forum - Thaivisa mobile app

JimGant · February 27, 2018

Quote

Medicare is worthless outside the US

Granted -- unless you're on Tricare for Life, which requires the Medicare B premium. And my experience with TFL here in Thailand (under the Tricare Overseas Program - TOPs) has been exceptional. Yes, as a retiree, you'll need to pay upfront. Hopefully, most can do that for most procedures. And, since medical costs in Thailand are considerably below what they'd be in the States, you'll most likely come in under the Medicare/Tricare "amount allowed" cap for most procedures. And, as it's been for eons, the annual deductible is $150, and $3000 catastrophic cap (after which no 25% co-pay). (But, this will probably change in the near future.) Just scan all your medical paperwork, combine into a single document with the Tricare form DD2642, and fire off as an email attachment. Direct deposit, in US dollars to your US account, shortly thereafter. (Here's where my wife will be cursing my early departure...scanning, combining, and sending -- slow learning curve with these Thai ladies somehow....). Anyway, the TOPs program is well-defined and efficient to use. Well worth our 2 x $134 per month fee for coverage here in Thailand. I retired from active duty, but I'm sure those who stayed in the Reserves until retirement are happy they did -- as they get the same benefits.

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