In This Column








* Categories *
* Agencies *

DEERS
DMDC Support Office
ATTN:  Change of Address
400 Gigling Rd.
Seaside, CA 93955-6771

Monday-Friday, 0500-1700 (PT)
Tel:  1-800-538-9522
Fax:  1-831-655-8317
DEERS Address Update
Change / Update DEERS Information


Medicare Part B

*** Annual General Enrollment ***

If you didn't sign up for Part B (for which you pay monthly premiums) when you were first eligible, you can sign up during General Enrollment:

1 January - 31 March
(Late enrollment penalty may apply)

To Enroll:
Contact Social Security, Manila
Tel:  +63-2-301-2000 Ext. 9
Fax:  +63-2-708-9723
Email:  FBU.Manila@ssa.gov


Newsletters & News
USA  |  USAF  |  USMC  |  USN  |  USCG
DFAS  |  OPM
TRICARE  |  TRICARE Overseas

VA  |  VA - Facebook
VAntage Blog  |  VAnguard


Social Security Administration
United States Embassy
1201 Roxas Blvd.
Manila, Philippines 1000
- or -
Social Security Administration
Unit 8600, Box 1610
DPO AP 96515-1610

Tel:  +63-2-301-2000 Ext. 9
Fax:  +63-2-708-9723
Email:  FBU.Manila@ssa.gov
SSA Manila
SSA
Medicare


Defense Health Agency
Attn:  Program Integrity
16401 E. Centretech Pkwy.
Aurora, CO, 80011-9066

Tel:  N/A
Fax:  1-303-676-3981
FRAUDLINE
TRICARE Fraud & Abuse


TRICARE Overseas Program
International SOS, Singapore

Telephone Customer Service:
Regional Direct:  +65-6339-2676
Toll Free:  0018004418952
Email:
sin.tricare@internationalsos.com


TRICARE Overseas
TRICARE

*  *  *
Retiree Overseas Claims
Wisconsin Physicians Service (WPS)

Tel:  1-877-451-8659 (Toll Outside U.S.)
WPS Claims Address
WPS Customer Service Address


TRICARE Reimbursement Checks

U.S. Dollar vs. Thai Baht

If your claim reimbursement check is not in the correct currency you requested, YOU need to contact the TRICARE Overseas claims processor, Wisconsin Physicians Service, at its Customer Service address:

WPS - TRICARE
P.O. Box 7992
Madison, WI 53707-7992

Tel:  1-877-451-8659 (Toll Outside U.S.)


VA Health Administration Center
Foreign Medical Program (FMP)
P.O. Box 469061
Denver, CO 80246-9061

Tel:  1-303-331-7590
Fax:  1-303-331-7807
Email:  hac.fmp@med.va.gov
VA Foreign Medical Program




* Items of Interest *

Cremation & Repatriation of Ashes
Teck Hong
Siam Funeral
John Allison Monkhouse


HIV / AIDS - Anonynous Clinic
Thai Red Cross Anonymous Clinic
1871 Rama 4 Rd.
Bangkok 10330 Thailand

Tel:  02-256-4109
Fax:  02-254-7577
Anonymous Clinic


Naval Ophthalmic Support &
Training Activity (NOSTRA)
160 Main Rd.
Naval Weapons Station, Bldg. 1794
Yorktown, VA 23691-9984

Tel:  1-757-887-7600
Fax:  1-757-887-4647
Email:
NOSTRA-CustomerService@med.navy.mil
Retirees - How to Order

• Office of Personnel Management •
Federal Long Term Care Insurance

The Red Cross
American  |  Thailand


*** TRICARE for U.S. Military Retirees ***
Bangkok, Thailand


________________________________________________________________________________________________

TRICARE Overseas - International SOS, Singapore

> > > Email:  sin.tricare@internationalsos.com < < <

Telephone Regional Direct:
+65-6339-2676
- or -
Toll Free:  0018004418952

Telephone Wisconsin Physicians Service (WPS), TRICARE Claims Inquiries:
1-877-451-8659 (Toll Outside U.S.)

Web:  http://www.tricare-overseas.com


"By making the personal choice to reside outside of the United States it is our individual responsibility to study and to understand the effects of that choice, notably regarding access to health care, and to Federal/State/Local assistance."


Our Mission

1.  Our Mission.  The funded charter of the JUSMAGTHAI TRICARE office is to assist active duty personnel and their dependents.  Even though we are sometimes able to extend limited assistance (on a space-available basis) to retirees and eligible dependents of retirees residing in Thailand, we are not funded or staffed to do so.  Therefore, please direct any pertinent TRICARE inquiries to TRICARE Overseas (contact info is also at the top and bottom of this page).

2.  General*Thank You* to the Chief, JUSMAGTHAI who authorizes this webpage, and to Khun Eddy who manages its many technical aspects.  This page provides general information on TRICARE Health Benefits for U.S. military retirees and eligible dependents of retirees residing in Thailand.  This webpage primarily contains and supplements official U.S. Government (USG) sources.  If you believe information on this webpage conflicts with information provided by other official USG sources, please contact us for clarification.  If you act on unofficial information you do so at your own risk.  Again, seek clarity.  For complete TRICARE information please visit the official TRICARE website at http://www.tricare.mil/, and visit International SOS' TRICARE Overseas website at http://www.tricare-overseas.com/.

*** TRICARE NEWS + TRICARE Overseas News ***  <<< Read the Latest TRICARE News!

Rules of Engagement

Integrity, Privacy & Professionalism

1.  Foreword.  The HQ JUSMAGTHAI TRICARE office is not funded to assist the retiree community, but does so as a courtesy, duties permitting.  Please be professional, courteous, and respectful in your interaction with us.  If you have a legitimate need to seek TRICARE assistance from our office, please bring your current DoD ID card and all documents pertinent to your visit.  In most cases it's your personal responsibility to assemble and complete your own paperwork, make your own copies (TRICARE and RAO staff don't make copies), and promptly leave the office when you've been assisted--be considerate.  Limited client service hours for retirees and eligible dependents of retirees are Tuesday-Wednesday-Thursday, 0800-1100.  Please respect our schedule.  (Bldg. "J", Rm. J-202).

2.  Integrity.  An integral part of our duties and responsibilities includes being good stewards with U.S. taxpayer dollars.  Be advised and forewarned that we will not knowingly help applicants file false claims!  Any attempts to intentionally file a false claim to defraud the USG will immediately terminate assistance from our office, and your name being forwarded to the Chief, JUSMAGTHAI, TRICARE Pacific, and to HQ TRICARE.  Complete honesty is the only lawfully-acceptable method.

3.  Courtesy and Respect.  We routinely handle a large amount of Privacy Act information that is protected by law, and plainly speaking, is none of anyone else’s business.  Therefore, please show us, and any clients ahead of you in the queue, the proper respect and courtesy by not barging into our office nor interrupting when we’re assisting clients--whether or not a client is sitting in front of us.  Don't assume that because a client isn't currently sitting in front of us, that we aren't fully engaged in assistance to them.  We will assist you as soon as we are finished with the task at hand, and in queue order.  It is our professional promise that we will take every reasonable precaution possible to respect and safeguard the privacy and dignity of all clients.  Thank you in advance for your cooperation.

4.  Privacy Act and Release of Information.  Beneficiary information is protected by the Privacy Act of 1974 (amended) and medical information is further protected by The Health Insurance Portability & Accountability Act (HIPAA) of 1996.  By law, we are only authorized to release limited information.  Other release of information must be authorized by the beneficiary. For Example:  We sometimes need to share information with other agencies to help a beneficiary, but only if authorized to do so by that beneficiary.

5.  Emailing Our Office.  We welcome your emails, and due to the large volume of active duty-related emails we receive daily--and to help us efficiently use our time--we simply ask you to keep it Professional, Official, and Constructive.  Please keep your emails brief, clear, and to the point, and by all means absolutely NO rude/abusive language or anti-policy rants.

6.  Telephoning Our Office.  We welcome your calls, just please note that telephone calls go unanswered when we’re busy assisting clients.  While we prefer email contact, if you do phone, the best option is to phone our office after 1300 hours, as we are usually busy in the morning.  Also, please keep your phone calls brief, clear, and to the point, background noise to a minimum, and don't shout.  Thank You! 

7.  Retiree Mail and APO Mailboxes.  TRICARE personnel are not authorized to open retiree postal mail and/or retrieve TRICARE postal mail from retiree APO mailboxes.  On a related note, be sure to input your Street or APO Box address (as listed in DEERS) on the DD Form 2642, not the JUSMAG-TRICARE Office address.  Using your DEERS address will help you receive your reimbursement check sooner.

TRICARE Fraud Prevention

1.  TRICARE Fraud Prevention.  Care providers should not ask you to sign blank claim forms!  You should never agree to this practice because this is inconsistent with your certification on the forms.  Your signature and date on the form signifies that your personal information is correct; that you actually received the care specified on the claim from the provider identified and at the location stated; and that you authorize the U.S. Government to obtain a copy of your medical records, if necessary, to adjudicate a claim.  Also, your signature is authorizing the payment of U.S. Government funds and that you sign the claim form only for the health care services that you actually received.  Compare your EOB (Explanation of Benefits) to actual medical care and medication received.  Lastly, we request that you notify our office and also contact the Defense Health Agency, Attn:  Program Integrity, 16401 E. Centretech Parkway, Aurora, CO 80011-9066 (FRAUDLINE  |  Fax:  1-303-676-3981), anytime you believe TRICARE is being billed inappropriately.  Please help us to fully protect your benefits! 

TRICARE in Thailand - *Retiree Basics*


Your TRICARE Benefits
Your TRICARE Benefits in Thailand
TRICARE Overseas Program - International SOS
Register (Beneficiary)  |  Help - Tricare-Overseas.com
Medication:  Covered + Not Covered  |  Drugs@FDA
Important Notice - Explanation of Benefits
• • •

TRICARE Overseas Program

1.  TRICARE Overseas Program.  International SOS (not the West Region contractor) is the TRICARE Overseas Program manager and will provide the assistance you need for claims, finding a provider, authorization, and much more.  If International SOS is unable to directly answer your TRICARE questions they will refer you to the office that can.  Email TRICARE Overseas (International SOS, Singapore):  sin.tricare@internationalsos.com.

2.  Online Account Registration.  We highly encourage all eligible beneficiaries to register an account on International SOS' website.  As a registered user you’ll be able to view patient eligibility, submit claims electronically, amounts paid toward deductibles, track the status of your claim, review your claims history (amount paid and EOB), and contact customer service.

Know Your Benefits Before You Travel

3.  Traveling Abroad (from Thailand).  A number of working age U.S. military retirees are traveling abroad (from Thailand) for employment, notably to Southwest Asia, and typically under contract.  Before traveling abroad (for work or pleasure), we highly recommend you contact TRICARE Overseas to learn more about TRICARE benefits / coverage and authorized providers specific to the country(ies) you intend to visit.  Not all contract employees have medical coverage under their contract, and they also likely are not eligible for routine medical care at a military treatment facility.  Educate yourself before you travel.

TRICARE Standard Overseas & TRICARE For Life

4.  Retiree Beneficiary Education Letter.  U.S. Military Retirees and eligible Dependents of retirees residing in Thailand are entitled to TRICARE Standard Overseas (under 65 years of age) or TRICARE For Life (TFL) (age 65 and older, and have enrolled in Medicare Part B).  There are also certain criteria when a beneficiary under the age of 65 must enroll in Medicare Part B in order to retain TRICARE benefits (see our Medicare & TRICARE section).  Also see our local Frequently Asked Questions.

5.  There are no Military Treatment Facilities (MTF) in Thailand.  Payment is 100% up front to a licensed health care provider (see paragraph 10 below), and then file a claim for payment consideration with TRICARE (see our Claims section).

TRICARE Prime Overseas is Not Available to Retirees

6.  Retirees and Their Families May Not Enroll in TRICARE Prime Overseas.  Furthermore, a number of retiree beneficiaries who are enrolled in TRICARE Prime in the U.S.--but are now residing in Thailand--have not studied the higher out-of-pocket costs incurred when using TRICARE Prime's Point-of-Service Option in Thailand (for non-emergency services).  When seeking non-emergency medical care under the Point-of-Service Option, retiree beneficiaries incur an annual deductible ($300 Individual / $600 Family) and a 50% cost-share of covered services (after the deductible is met).  The annual deductible and 50% cost-share under the Point-of-Service Option is in addition to TRICARE Prime's annual enrollment fee. Whether residing in Thailand or just visiting, if you're a U.S. military retiree currently enrolled in TRICARE Prime (and choose to remain enrolled), for full details educate yourself now about using TRICARE Prime while you are outside of the U.S.  (If you’re a retiree presently enrolled in TRICARE Prime but wish to disenroll, contact the TRICARE regional contractor where you are enrolled).

Enrollment

7.  *Enrollment* is not required for TRICARE Standard Overseas or TRICARE For Life (TFL)--enrollment is automatic--there's no enrollment fee, nor is there a *TRICARE Health Benefits Card* issued to Standard or TFL beneficiaries.  However, in order to be eligible for TFL, beneficiaries must first enroll in Medicare Part B (see our Medicare & TRICARE section).

8.  Enrollment and payment of premiums is required for TRICARE Retiree Dental Program, TRICARE Retired Reserve, and TRICARE Young Adult.

Verify Eligibility

9.  Verify Eligibility.  To verify your TRICARE eligibility you can check your DEERS account in milConnect, TRICARE Overseas, or by Phone, Fax, or Mail to DSO (DEERS) in California, or visit the nearest DoD ID card issuing facility (JUSMAGTHAI is the only such facility in Thailand).  (Note:  JUSMAGTHAI is not authorized to verify TRICARE eligibility by email, phone, fax, or mail -- verification is done in-person only).

Dependent(s) Not Yet Registered in DEERS

10.  Dependent(s) Not Yet Registered in DEERS.  If you recently gained a new dependent(s) through marriage, birth, adoption, etc., but have not yet registered them in DEERS, the TRICARE Overseas claims processor WPS will deny any claims filed by (or for) that dependent while that dependent remains unregistered.  If a TRICARE claim is denied in these circumstances, the beneficiary may resubmit the claim after the dependent is registered in DEERS.  In most cases, a new dependent's DEERS registration may be backdated to the date the new dependent was legally gained (if applicable, see Claims for Same-Sex Spouses).  We emphasize this point because we wouldn't want someone delaying needed medical care due to uncertainty over the administrative process--a person's health is vastly more important.  If the DEERS system at JUSMAG is unavailable you may register your dependent(s) in DEERS by contacting the Defense Manpower Data Center Support Office (DSO) in California.

Pay 100% *Up Front*

11.  Pay 100% *Up Front* (Out-of-Pocket).  Since there are no TRICARE network providers in Thailand for retirees, retirees in Thailand first seek medical care from a licensed provider, pay the entire medical bill *up front* (out-of-pocket) upon receipt of services (outpatient and inpatient),  and then file a claim with Wisconsin Physicians Service (WPS) for payment consideration (claims address).  Reimbursement is based on TRICARE Standard Overseas guidelines--see our section on annual deductible, 25% cost-share, and annual catastrophic cap.

      a.  No Direct Billing.  Several hospitals in Thailand list *TRICARE* on their webpage as *insurance* they accept. However, that is only for active duty personnel and their eligible dependents.  It does not include retirees.  Even though these hospitals are fully aware of the coverage policy differences between active duty and retirees, they have yet to make the distinction on their webpages.  This misleading information continues to be a source of confusion and consternation to retirees who have not first reviewed TRICARE coverage for retirees in Thailand.  Over the years, various hospitals in Thailand have attempted legitimate TRICARE direct billing for inpatient care, but each attempt eventually ended in failure. Reasons why?  Primarily due to hospital billing staff not adhering to TRICARE claims filing procedures and losing a lot of money on unreimbursed claims.  Added to that are dishonest retirees who commit fraud against health care providers.

        b.  Facts and Truth.  Further compounding the confusion is medical care providers routinely--and falsely--telling retiree patients that they cannot direct bill TRICARE because our TRICARE office "won't authorize" the direct billing.  Fact: TRICARE staff have no authority in a care provider's private decision whether or not to direct bill TRICARE--each provider knows this.  The plain truth is that care providers first want *Guarantee Payment* from the U.S. Government before they will even consider direct billing TRICARE.  The U.S. Government does not provide *Guarantee Payment*.  Again, nothing prevents a health care provider from direct billing TRICARE, but they won't do so unless *Guarantee Payment* is given.

TRICARE Retiree Dental Program

12.  TRICARE Retiree Dental Program.  The TRICARE Retiree Dental Program (TRDP) is a voluntary, premium-based dental insurance plan.  TRDP offers coverage in the continental U.S. and in all overseas locations.  Please visit www.trdp.org for a complete list of benefits and program information.

        a.  Note:  "Beginning October 2013, TRICARE Retiree Dental Program (TRDP) enrollees must make their enrollment premium payments via an allotment from their retirement pay.  Enrollees, who aren’t receiving retirement pay or have reached their allowed allotments, must set up an electronic funds transfer (EFT).  If an allotment or EFT isn’t set up, individuals will lose their TRDP coverage.  Beginning July 19, 2013, Delta Dental is sending letters advising enrollees of the new requirement."

Covered Services

Covered Services

1.  Covered Services.  TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven.  However, there are special rules or limits on certain types of care, while other types of care are not covered at all. Some services or treatments require prior authorizationFor Example:  Inpatient non-emergency behavioral health care specifically requires prior authorization from TRICARE as does inpatient cancer treatment (the inpatient non-emergency behavioral health care and inpatient cancer examples are not all inclusive).  If you're uncertain as to if prior authorization is required for your situation, contact TRICARE Overseas (contact info also at the top and bottom of this page). 

Prescription Medication

2.  TRICARE Pharmacy.  TRICARE covers most prescription medications approved by the U.S. Food & Drug Administration (Drugs@FDA).  TRICARE does not cover medications that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness.  To find out if a specific medication is covered, visit the TRICARE Formulary Search Tool.

Pharmacy Home Delivery

3.  TRICARE Pharmacy Home Delivery.  TRICARE prescription drug coverage is available to all TRICARE-eligible beneficiaries who are enrolled in the Defense Enrollment Eligibility Reporting System (DEERS).  When updating DEERS with your personal information, be sure to update your address with a physical address.  If living outside of the United States, be sure to list your APO/FPO address, if you have one, as your mailing address.  Important:  Express Scripts will only ship to an APO/FPO address, and not to a Thai street address.  As well, *Home Delivery* to APO/FPO addresses is subject to local customs laws.  Be Advised:  Prescription drugs sent to APO/FPO addresses may be seized by customs authorities.  If your prescription drugs are seized, contact Express Scripts at 1-877-363-1303.  Moreover, by law, only prescriptions written by prescribers licensed in the United States, District of Columbia or a U.S. territory are considered valid.  For controlled substances, the prescriber must have and provide his or her individual DEA number.  (Note:  There are no known licensed prescribers in Thailand with a DEA number).  Lastly, prescribers cannot write prescriptions for family members.  TRICARE Pharmacy Program Handbook.

         a.  Filling Prescriptions Overseas.  You may also have prescriptions filled at host nation pharmacies, if necessary. Host nation pharmacies are considered to be non-network pharmacies, but in some cases, a host nation pharmacy may be your only option.  You may have to pay for the total amount first and then file a claim for reimbursement.  Retired service members will receive a partial reimbursement based on non-network pharmacy costs.

Annual Deductible, Catastrophic Cap & Cost-Shares

Annual Deductible

1.  Annual Deductible (TRICARE Standard and TFL Overseas) = $150 Individual / $300 Family.  Once you meet the Annual Deductible, Patient Cost-Share = 25% of Covered Services (allowable charges) up to the Catastrophic Cap of $3,000 (see paragraph 2 below).  Patient always pays 100% of non-allowable charges. 

Catastrophic Cap

2.  Catastrophic Cap = $3,000 per Family per Fiscal Year (1 Oct xx - 30 Sep xx).  The catastrophic cap limits your out-of-pocket liability on cost-shares and annual deductibles.  It is the maximum amount you are required to pay annually for Covered Services.  Once the beneficiary's deductible and 25% cost-shares reach $3,000 each fiscal year, TRICARE will begin to reimburse you 100% for TRICARE covered services (allowable charges) for the remainder of that fiscal year, as opposed to only 75% (less deductible) before the catastrophic cap is reached.  Patient always pays 100% of non-allowable charges. 

Cost-Shares

3.  Cost-Shares.  You're responsible to pay a cost share based on the type of care.  Some inpatient cost shares are subject to change each fiscal year (FY), October 1st through September 30th each year. 

Claims Filing


Claims Self-Help
Claims Address (WPS):  New  |  Tracer (Lost)
• • •
Sample DD Form 2642:  Sponsor  |  Spouse
Summary Worksheets:  (Useful, But Not Required)
Lab  |  Pharmacy  |  Services  |  Combined

Overseas Claims

1.  Claims Filing (Overseas Claims).  To help prevent *forgetting* to file a claim, TRICARE strongly recommends filing a claim as soon as possible after medical services are received.  Timely Filing Period:  1) Outpatient - Must file no later than Three (3) Years after medical services received.  2) Inpatient - Must file no later than Three (3) Years after discharge.  We receive many requests for help from beneficiaries when their claims are denied because they submitted their claims after the timely filing period, or WPS didn't receive the claim within the timely filing period.  Unless there are justifiable reasons we normally cannot help you if you exceed the timely filing limit.  TRICARE Claims Inquiries (WPS):  1-877-451-8659 (Toll Outside U.S.).

Bundling Claims

2.  Bundling Claims.  If your goal is timely reimbursement of your claim, it's not advisable to include too many different conditions or treatments in a single claim.  For example, even if you're thinking about submitting a single claim for one year's worth of monthly follow-ups for the same medical condition, it's a better choice to submit two claims instead, each covering a six month period.  Including too many treatments in a single claim greatly ups the chance that a busy claims clerk will miss something, and in-turn, you having to file an appeal (and then a grievance if the appeal is denied).  Use your best judgment.

DD Form 2642 - Claim Form

3.  DD Form 2642 (Claim Form).  Carefully read ALL instructions!  For Example:  Many claims are delayed due to the beneficiary not fully completing and/or signing and dating the DD-2642.  Other Specific Reasons for Delay:  Not including your address, not check-marking the appropriate OHI block, not providing complete prescription medication details, not including Proof of Payment, and sending claims to the West Region instead of to WPS (don't send claims to the West Region contractor!).  Also, so that WPS may process your claim quickly and correctly, TRICARE recommends that when you pay the provider directly (out-of-pocket), on top of the DD-2642 write *Payment Up Front* and the amount paid.  Lastly, a DD-2642 has two *copies*--*Processor's Copy* and *Patient's Copy*.  Submit the *Processor's Copy*, not *Patient's Copy*.

DD Form 2527 - Possible Third-Party Liability

4.  Third Party LiabilityDD Form 2527 (Statement of Personal Injury - Possible Third Party Liability).  If your claim is the result of an injury, don't forget to also include a DD-2527 with your claim.  If unsure whether to submit a DD-2527, submit it! It’s better to submit one than have WPS delay the processing of your claim until you do.  “Payment of your claims has been suspended until we receive more information.  Your claims, and any related claims that are subsequently received, will be denied if this form is not completed and returned within 35 days from the date of this letter.”

English Language Documents & Statements

5.  English Language Documents & Statements.  While beneficiaries may select providers of their choice, it is recommended that the selected providers have the ability to produce their medical documents and billing statements in English.  Documentation and billing statements that are submitted in a foreign language will require contracted translation services which will delay claims processing and payment.  For claim integrity reasons, translations by anyone other than the provider or the TRICARE translation contractor will not be accepted.  Lastly, remember to always keep a copy of each claim you submit.

Inpatient Billing Statement

6.  Inpatient Billing Statement.  As an integral part of TRICARE's ongoing fraud prevention efforts, for inpatient hospital stays TRICARE requires detailed itemized inpatient billing statements from health care providers.  For example, inpatient billing statements must show the precise date a medical service and/or medication was provided.  No longer accepted is only listing the inpatient period.  A daily record of services and/or medication is required.  What does "daily record" mean? It simply means that on the billing statement there's a date next to the service and/or medication provided.  It isn't necessary to list by day (e.g., On July 25, 2013 the following was provided...) unless of course a care provider wishes to provide an inpatient billing statement in that format.  Lastly, remember to always submit Proof of Payment with your TRICARE claim.  If you have Other Health Insurance you must first file a claim with that insurance provider before filing a claim with TRICARE.  If any pertinent questions please contact TRICARE Overseas.

Proof of Payment

7.  Proof of Payment.  Due to fraud prevention efforts, beginning September 1, 2012, beneficiaries are now required to submit proof of payment with all overseas health care and pharmacy claims (regardless of amount), including claims for care received when traveling overseas.  So that WPS may process your claim quickly and correctly, TRICARE recommends that when you pay the provider directly (out-of-pocket), on top of the DD Form 2642 write *Payment Up Front* and the amount paid (submit *Processor's Copy*, not *Patient's Copy*).  For each claim include the following:  (1) Itemized bill or invoice; (2) Diagnosis describing why the medical care is needed, and; (3) Explanation of Benefits from your other health insurance (if you have other health insurance).  Also, make sure the care provider clearly annotates *Paid* on each invoice.

       a.  As proof of payment, send any of the following items (as applicable) along with the provider's itemized invoice or bill (clearly marked as being paid), based on these guidelines:  (1) Cancelled check; (2) Credit (or debit) card receipt, or: (3) Electronic funds transfer receipt (bank-to-bank transfer, ATM slip, withdrawal slip, etc.).  For example, if you paid the provider with cash, you have to show proof of the cash withdrawal from your financial institution (e.g., ATM slip, withdrawal slip, bank-to-bank transfer, copy of your bank statement, or copy of your bank passbook).  If you withdrew funds from an ATM to fund your cash payment, we suggest you print out a record of your bank statement showing the date and amount of your ATM withdrawal.  If submitting a bank or credit card statement, or copy of bank passbook, make sure your name is clearly legible, the pertinent withdrawal transaction and amount is properly annotated (you may blank out all other entries), and your account number is blanked out (for your protection).  It's possible that you may still receive a letter from TRICARE requesting additional proof of payment in order to process your claim.  Use Common SenseWhat do you need to provide to convince a busy claims clerk that you in fact paid the claim?

       b.  Important Note:  Concerning proof of payment for overseas claims, there presently exists conflicting information between TRICARE Management Activity (TMA) (TRICARE.mil), and the operating policy of the TRICARE Overseas Program (TOP), International SOS, Singapore (TRICARE-Overseas.com).  In certain situations, TMA states there's a $1,000 threshold before proof of payment is required to be submitted with an overseas claim.  In practice, TOP wants proof of payment submitted with EACH claim, regardless of payment amount.  Clearly, common sense dictates that the agency processing your claim (TOP) is the policy to follow.  Also, if you refuse to submit proof of payment, any reimbursement due you will instead automatically be sent by TRICARE to the care provider.  When that occurs, don't expect to receive reimbursement until you submit proof of payment--in this scenario, to receive any reimbursement due you, YOU would still need to FIRST provide proof of payment to TRICARE (WPS), then the care provider must return the funds to TRICARE, and only then will TRICARE eventually send the reimbursement to you.  Refusal to submit proof of payment with your claim is counter-productive and self-defeating.

Other Health Insurance (OHI)

8.  Other Health Insurance (OHI).  Under U.S. Federal Law, retirees carrying third-party medical insurance in addition to TRICARE must always file claims with their third-party insurance company first, then TRICARE second.  Be Advised:  It is solely the patient’s responsibility to obtain any required prior authorization for medical care from their third-party insurance company.  Lastly, you must include a copy of your third-party insurance Explanation of Benefits (EOB) when you submit your TRICARE claim, else, WPS cannot process your claim.  (See DD Form 2642).

Take-Home Medication

9.  *Take-Home Medication*.  When discharged after inpatient hospitalization, beneficiaries are often prescribed *Take-Home Medication*.   When this occurs, send WPS a separate claim only for the take-home medication.  For timely payment consideration of your take-home medication claim be sure to include the following:  (1) DD Form 2642 stating in Block 8a: “Home Medication due to Hospitalization for _____________” (Block 8c:  Check “Pharmacy”); (2) Inpatient Medical Report, and; (3) Separate Itemized Bill with only the Home Medication listed (all medication details clearly stated).

File Claims by Mail

Wisconsin Physicians Service - Claims Address
WPS - Customer Service
TRICARE Overseas Program
WPS - TRICARE
P.O. Box 7985
P.O. Box 7992
Madison, WI 53707-7985
Madison, WI 53707-7992
Tel:  1-877-451-8659 (Toll Outside U.S.)
Tel:  1-877-451-8659 (Toll Outside U.S.)

10.  File Claims by Mail.  Submit claims with Proof of Payment (see paragraph 7 above) to the TRICARE Overseas claims processor, *WPS*.  If you still use a U.S. address in DEERS, mail your claim to your stateside TRICARE regional contractor.  If you're a dual-eligible beneficiary (Medicare & TRICARE), WPS is your claims processor.  Once again, it's the beneficiary's responsibility to make photocopies and mail claims.  Lastly, reimbursement checks have a 120-day expiration so be sure to deposit in a timely manner, else it's up to YOU to request a replacement check from WPS (see paragraph 13 below).

File Claims Electronically

11.  File Claims Electronically.  Once you’ve established a Beneficiary login account on the TRICARE Overseas website, and once you login, you may submit your claim(s) electronically.  For exact details, and to help ensure a smooth, trouble-free electronic claim(s) submission, please view the online tutorial.

Reimbursement Check - *Currency Error*

12.  Check in Wrong Currency.  If your claim reimbursement check is not in the correct currency you requested (THB or USD), YOU need to contact the TRICARE Overseas claims processor, WPS, to request check reissue.  For example, sometimes when you request reimbursement in *Local Currency* (i.e., Thai Baht), WPS mistakenly issues the reimbursement check in U.S. Dollars.  Naturally, WPS will not reissue a check until the current check is returned (or it expires after 120 days).  Unfortunately, this error does sometimes occur and if you absolutely must have Thai Baht just be advised that it can easily take many months to resolve.  Lastly, before you return a check to WPS for reissue we recommend you write *VOID* across the face of it and also make and keep a photocopy of it for your records.

Reimbursement Check - *Expired*

13.  Check Expired.  TRICARE reimbursement checks have a relatively short 120-day expiration date from the date of issue. If you don't deposit or cash your check before it expires, YOU will need to contact WPS to request check reissue.  Before you return a check to WPS for reissue we recommend you write *VOID* across the face of it and also make and keep a photocopy of it for your records.

Appeals & Grievances

File an Appeal

1.  Medical Appeals.  If you disagree with certain decisions made by the TRICARE Management Activity or by your TRICARE contractor regarding your benefit, you have the right to appeal that decision.  There are specific benefit issues that are appealable and the appeal process varies depending on the type of benefit issue.  For issues that can't be appealed, such as concerns with the quality of health care service you received, TRICARE provides a grievance process that allows you to submit in writing your concern or complaint.

2.  Pharmacy Appeals.  If you disagree with the decision on your pharmacy claim (e.g., if your claim is denied), or if your request for medical necessity or prior authorization is denied, you may file an appeal.  The request for reconsideration--or appeal--of your pharmacy claim, medical necessity or prior authorization decision must be in writing, signed, and postmarked or received by Express Scripts within 90 calendar days from the date of the decision, and must include a copy of the claim decision.

File a Grievance

3.  File a Grievance.  If you have a complaint about the quality of the care you received, if a provider/facility behaved inappropriately or any other non-appealable issue, you can submit a grievance.  The grievance process allows you the opportunity to report in writing any concern or complaint regarding your health care quality or service.  Any TRICARE beneficiary can file a grievance and a sponsor, parent or guardian or other representative may file on behalf of a dependent child.

4.  Overseas.  A grievance is a written complaint or concern about a non-appealable issue regarding a perceived failure by any member of the health care delivery team--including authorized providers, military providers, a TRICARE contractor, or subcontractor personnel--to provide appropriate and timely health care services, access, or quality, or to deliver the proper level of care or service.  The grievance process allows you to report in writing any concern or complaint regarding health care quality or service.  Any TRICARE civilian or military provider; TRICARE beneficiary; sponsor; or parent, guardian, or other representative of an eligible dependent child may file a grievance.  International SOS as the TRICARE Overseas Program (TOP) Contractor is responsible for investigating and resolving all grievances.  Grievances are generally resolved within 60 days of receipt.  Following resolution, International SOS will notify the party submitting the grievance that the review is complete.

5.  Pharmacy.  All grievances about a pharmacy provider, such as a network pharmacy, go directly to Express Scripts.

Medicare & TRICARE

Medicare Part B & TRICARE

1.  Medicare & TRICARE.  Age 65 is when most (not all) individuals first become eligible for premium-free Medicare Part A. In order to keep your TRICARE benefits (TRICARE For Life) when you first become eligible for premium-free Medicare Part A (due to age 65, or earlier due to disability or end-stage renal disease), you must enroll in Medicare Part B (premiums):  "TRICARE beneficiaries who live overseas and who are eligible for premium-free Medicare Part A must have Part B to remain eligible for TRICARE even though Medicare does not provide coverage overseas."  To enroll (or to confirm enrollment) in Medicare Part B, email or phone SSA Manila:

Social Security Administration - Manila
Tel:  +63-2-301-2000 Ext. 9
Social Security Administration
Fax:  +63-2-708-9723
United States Embassy
1201 Roxas Blvd.
Manila, Philippines 1000
• • •
Medicare:  Medicare.gov  |  Medicare & You

        a.  Frequently Asked QuestionSince Medicare does not provide coverage outside of the United States then why must I enroll in Medicare Part B at age 65 if I want to keep my TRICARE benefits?  Answer:  Federal law was written as such and signed into law in the FY 2001 National Defense Authorization Act (NDAA) (Public Law 106–398--Oct. 30, 2000): http://www.dod.mil/dodgc/olc/docs/2001NDAA.pdf (Section 712, p. 176).

        b.  Less Than 40 Work Credits Under Social Security.  Pertaining to Medicare Part B enrollment at age 65, in certain limited cases if you have less than the usually required 40 Social Security work credits (10 years of work) to be eligible for premium-free Medicare Part A at age 65, it's possible you may not be required by DEERS to enroll in Medicare Part B at age 65 to retain your TRICARE eligibility.  The operative word is may.  The Defense Manpower Data Center Support Office (DSO) (DEERS) is the only legally authorized agency to rule on TRICARE eligibility--not TRICARE, and not SSA.  Therefore, if at age 65 you have less than 40 Social Security work credits (10 years of work) it may be in your best interest to request a TRICARE eligibility case review and ruling from DSO (DEERS).  DSO will coordinate with SSA and then notify you of their ruling once your case review is completed.  If you request a case review and ruling from DSO, it's best that you request it well before you enter your Medicare Initial Enrollment Period (see paragraph 3 below) just in case DSO rules that you're still required to enroll in Medicare Part B to retain your TRICARE eligibility at age 65.

Information Mailed to Beneficiaries

2.  "What publications and correspondence are sent to beneficiaries to inform them that they must purchase Medicare Part B to retain TRICARE benefits?"  Medicare-related publications and correspondence that is routinely mailed to beneficiaries (you and, where applicable, your spouse or children):  (Source:  milConnect - Q&A section)

  • The Medicare & You Handbook is mailed by Medicare when the beneficiary becomes Medicare Part A eligible.
  • The Welcome to Medicare Pamphlet is mailed by Medicare three months prior to the beneficiary's Medicare effective date.
  • The Turning 65 Medicare Letter is prepared by TRICARE and mailed by the Defense Manpower Data Center (DMDC) five months prior to the month that the beneficiary turns 65.
  • The Under 65 Medicare Letter is prepared by TRICARE and mailed by DMDC after CMS (Centers for Medicare & Medicaid Services) notifies DMDC that the beneficiary is Medicare eligible.

        a.  Important Note!  In order to receive important Medicare & TRICARE information, YOU must keep your mailing address updated with the Social Security Administration, and keep your mailing address updated in DEERS (see our DEERS section).

Avoid a Break in TRICARE Coverage

3.  Avoid a Break in TRICARE Coverage.  If you aren’t receiving Social Security benefits, RRB benefits, or a federal annuity from the Office of Personnel Management, you must sign-up for Medicare Part A and Part B.  To avoid the Medicare surcharge for late enrollment, you must enroll in Part B during your Medicare Initial Enrollment Period (seven-month period that begins three months before you turn 65, or four months if your birthday is on the first of the month).  To avoid a break in TRICARE coverage be sure to enroll no later than two months before you turn 65.  If you enroll any later, your Part B effective date will be delayed and you will have a break in TRICARE coverage.

Medicare Part B Effective Date

4.  Inspect Your Medicare Card.  Once you receive your Medicare Part B card, ensure the effective date is correct and Medicare Part B enrollment is reflected in your DEERS record.  If you believe the effective date is incorrect YOU must contact Medicare.  Lastly, ensure Medicare Part B is reflected in your DEERS record before you renew your DoD ID card.  If you didn't receive your Medicare Card (or you misplaced it) please click here to learn how to request a replacement.

Late Enrollment in Medicare Part B

5.  Late Enrollment in Medicare Part B.  Since Medicare does not provide benefits for medical care received outside of the U.S., TRICARE is the primary source of health benefits.  Further, for every 12-month period beyond your Medicare Part B initial enrollment period (based on your 65th birthday, or earlier due to disability or end-stage renal disease) that you wait before you enroll, you incur a 10% penalty that's added to the monthly premium, and in this scenario, you can then only enroll in Medicare Part B during the annual general enrollment period of January-February-March (effective date of Medicare Part B then becomes 1 July of that year).  To enroll (or to confirm enrollment) in Medicare Part B email or phone SSA Manila.  For more information on Medicare Part B please visit one or more of the SSA and Medicare links in paragraph 1 above in this section.

Defense Enrollment Eligibility Reporting System (DEERS)


DEERS
Tel:  1-800-538-9522
Defense Manpower Data Center Support Office
Fax:  1-831-655-8317
ATTN:  Change of Address
400 Gigling Rd.
Seaside, CA 93955-6771
• • •
DEERS - TRICARE.mil

Your Address in DEERS

1.  Your Address in DEERS must be in the Overseas Region and must be kept updated!  DEERS has provisions to record a residential address and a mailing address.  For example, a retiree well known to our office has a U.S. address in DEERS as his residential address, and a Box-R APO box for his mailing address--he uses his Box-R address on his TRICARE claims, which is presently acceptable.  For simple address changes, you can update your DEERS address via several different methods:  In-person at JUSMAGTHAI (DEERS & DoD ID Cards); Online via DEERS or milConnect (use your DFAS myPay Log-in ID & Password); or by Phone, Fax, or Mail to DSO (DEERS) in California.

2.  Important Note!  Updating your DEERS record does not update your information with DFAS, and updating your information with DFAS does not update your DEERS record--you must separately update your DEERS and DFAS records.

DEERS Verification of TRICARE Eligibility

*** Important Reminder ***
JUSMAGTHAI TRICARE staff are not authorized access to DEERS •

3.  DEERS Verification.  As previously stated in paragraph 9 under *Retiree Basics*, to verify your TRICARE eligibility you can check your DEERS account in milConnect, TRICARE Overseas, or by Phone, Fax, or Mail to DSO (DEERS) in California, or visit the nearest DoD ID card issuing facility (JUSMAGTHAI is the only such facility in Thailand).  (Note:  JUSMAGTHAI is not authorized to verify TRICARE eligibility by email, phone, fax, or mail -- verification is done in-person only).

4.  *** Important Note! ***  TRICARE staff (worldwide) do not approve or deny--nor cannot change--a patient's TRICARE eligibility.  DEERS is the only official source for TRICARE eligibility and access to TRICARE benefits.  Therefore, if you believe your TRICARE eligibility status in DEERS may be in error, it is your personal responsibility to contact the DMDC Support Office (DSO) in California for resolution--sooner rather than later is best.  (Note:  DSO manages DEERS).

In Case of Emergency (ICE)

1.  In Case of Emergency (ICE).  We quite often think, "It will never happen to me", but, all too often it does happen to "me". Are you and your loved ones prepared to help you if you become incapacitated as the result of an accident or sudden serious illness?  Click here for a sobering article on what can happen without warning and what you can do now to prepare.  In the article is a link to this very useful form:  Emergency Personal Health Record & Contact Info Form.  This form and more comprehensive info may be found at:  http://www.ice4safety.com/.

Provider Resources


Information
Additional Assistance
Providers - Tricare-Overseas.com
Credentialing - Tricare-Overseas.com
• • •
Reimbursement Rates
• • •
Clinical Services
Register (Provider)  |  Help - Overseas


VA Foreign Medical Program (FMP)


VA Foreign Medical Program
Tel:  1-303-331-7590
VA Health Administration Center
Fax:  1-303-331-7807
Foreign Medical Program (FMP)
P.O. Box 469061
Denver, CO 80246-9061

1.  VA Foreign Medical Program (FMP).  *** Information Only ***  There is no VA Medical Facility in Thailand.  Moreover, TRICARE does not process VA FMP claims nor do we schedule FMP appointments for VA-related medical care.  Contact VA FMP and/or your servicing VA Regional Office if you believe your medical care may be partially or fully covered by the VA.

________________________________________________________________________________________________

TRICARE Overseas - International SOS, Singapore

> > > Email:  sin.tricare@internationalsos.com < < <

Telephone Regional Direct:
+65-6339-2676
- or -
Toll Free:  0018004418952

Telephone Wisconsin Physicians Service (WPS), TRICARE Claims Inquiries:
1-877-451-8659 (Toll Outside U.S.)

Web:  http://www.tricare-overseas.com


________________________________________________________________________________________________


TRICARE Staff
Street Address
Nurse Tiptida Dhatsuwanna (Thida)
HQ JUSMAGTHAI
Tel:  02-287-1036 Ext. 512
TRICARE Services, Rm. J-202
Fax:  02-287-1575
7 Sathorn Tai Rd.
Bangkok 10120 Thailand
• • •
• • •
Nurse Panisara Puangsilpa (Aoi)
APO Address
Tel:  02-287-1036 Ext. 511
HQ JUSMAGTHAI
Fax:  02-287-1575
MAGTJS-TRICARE
APO AP 96546-9998

________________________________________________________________________________________________


*** TRICARE (Thailand) - Retiree Client Service Hours ***

• Tuesday - Wednesday - Thursday •

... 0800 to 1100 ! ...

(Closed Thai & U.S. Holidays)

______________________________________________________________

• Lengthy or Complicated Issues, Please Email or Call to make an Appointment •

Bldg. "J", Room J-202 (Opposite Mailroom - Up the Stairs to 2nd Floor)

* TRICARE Pacific Health Benefits Advisor - Bangkok, Thailand *

Last Reviewed or Updated:  1 April 2014

(The appearance of hyperlinks does not constitute endorsement by the U.S. Department of Defense (DoD)
of the information, products or services contained therein.)