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US Vets: Plan "B" or not?

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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.

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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.

 

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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.

 

 

 

  

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3 minutes ago, Thanyaburi Mac said:

Medicare Part B $134 a YEAR?  Or monthly?

 

Mac

Monthly.

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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.

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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.  

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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.

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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. 

 

 

 

  

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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.

 

image.png.f3a24b3fce65d131d8bd28ce12aa502a.png

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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 by watcharacters

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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.

 

image.png.f3a24b3fce65d131d8bd28ce12aa502a.png

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. 

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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.

 

image.png.36392eb61059e24c326e8793169a96f4.png

 

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

 

 

 

 

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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. 

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BANGKOK 22 August 2018 09:31
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