*** For U.S. Military Retirees in Thailand ***
(Bangkok, Thailand)

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> > > >  Novel Coronavirus (COVID-19)  < < < < TRICARE.mil:  COVID-19 Guidance  |  TRICARE-Overseas.com:  COVID-19 U.S. Embassy, Bangkok:  COVID-19 Information

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*** Keep Your DEERS Record Updated! *** It's essential that YOU keep information in DEERS up-to-date for you and your family! Health.mil:  DEERS Toolkit

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> >  How Does TRICARE Overseas Program (TOP) Select Work?  < < With TOP Select, you manage your own health care and may generally seek care from any overseas civilian provider without a referral.  However, certain services, including nonemergency inpatient admissions for substance use disorders and mental health care, require prior authorization.  Click here for more information. TRICARE Overseas Program (TOP) Select for Overseas Retirees

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*** Military Health System - Nurse Advice Line *** The Nurse Advice Line provides health care support to TRICARE beneficiaries 24/7. Nurse Advice Line Beneficiary Portal

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> > >  Official Information & Sources  < < < Official sources are reliable, credible resources based on a number of factors. If you believe information on this page conflicts with information provided by other OFFICIAL US Government sources, please contact us for clarification. • • • Unfortunately, incorrect TRICARE information in Thailand from two unofficial sources continues to persist, with the primary source declining to remove the incorrect information from multiple webpages.  Be careful!  If you act on incorrect information from a third-party source you do so at your own financial risk.

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• TRICARE Overseas • * Pacific Area - International SOS, Singapore * Email:  sin.tricare@internationalsos.com • Customer Service • Regional Direct:  +65-6339-2676 or Toll Free:  0018004418952 • Medical Assistance • Regional Direct:  +65-6338-9277 or Toll Free:  0018004417902 Web:  https://www.tricare-overseas.com • • • • TRICARE Claims Inquiries (USA) - Overseas Claims Processor • Wisconsin Physicians Service (WPS) Telephone:  1-877-451-8659 (Toll Outside U.S.) Client Service Hours:  Sunday, 7pm CT - Friday, 7pm CT (Open 24 hours in between those days/times and closed on Saturday)

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

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I.  About Us

1.  General.  *Thank You* to the Chief, JUSMAGTHAI who authorizes this webpage, and to Khun Eddy who manages its technical aspects.  This webpage provides general information on TRICARE® Health Benefits for U.S. military retirees, and eligible dependents of retirees, visiting or residing in Thailand.  This webpage primarily contains and supplements information from official U.S. Government (USG) sources, and the information on this page is not all inclusive and is always subject to change.  For more TRICARE information, please visit the TRICARE and TRICARE Overseas websites.

2.  Vehicle Entry & Parking.  Due to security enhancements, Veterans (of all categories) are no longer freely authorized to bring a vehicle into the JUSMAGTHAI compound.  If you have a valid reason to bring a vehicle into the compound, you may request an exception to policy by emailing jusmagthai@state.gov a minimum of 48 hours in advance.  Exceptions may or may not be granted based upon space availability.  On-arrival parking requests will not be granted.  Thank you for your cooperation.

3.  Our Charter.  The funded charter of the JUSMAGTHAI TRICARE office is to assist active duty personnel and their dependents assigned to the mission.  Even though we sometimes are able to extend limited assistance on a space-available basis to retirees and eligible retiree dependents residing in Thailand, we are not staffed or funded to do so.  Therefore, please direct pertinent TRICARE inquiries to TRICARE Overseas (contact info is also at the top and bottom of this page).  If you have questions about the status of an overseas claim already filed, you may contact the overseas claims processor directly (WPS, USA 1-877-451-8659).

4.  Office Location.  JUSMAGTHAI is located in central Bangkok at the southeast corner of Sathorn Rd. and Sathorn Soi 1 (one block south of Rama IV Road and the MRT Lumpini Station - Exit 2).  We are in Building "D", Room D-110 (ground floor).  Turn left after entering the main gate on Sathorn Rd.  To request entry, press the intercom button to the left of the door.

5.  Contacting Us.  For faster service, retirees should contact TRICARE Overseas.  If you do have an inquiry for our office, we prefer email contact (please note our new email address).  If phoning, please do so after 1300 hours as mornings are very busy (especially Mondays and the first day after a long holiday weekend), and no matter the time, phone calls go unanswered when we’re assisting clients. Please keep your inquiries official, professional, brief, and to the point; absolutely NO rude/abusive language or anti-policy rants.  Before contacting us, review this webpage and our Frequently Asked Questions. The answers to most TRICARE general questions from retirees are found on and via this webpage.

6.  Information Accuracy.  Official sources are reliable, credible resources based on a number of factors.  If you believe information on this page conflicts with information provided by other OFFICIAL USG sources, please contact us for clarification.  Unfortunately, incorrect TRICARE information in Thailand from two unofficial sources has persisted for years, with the primary source of the incorrect information declining to remove it from multiple webpages.  Be careful!  If you act on incorrect information from a third-party source you do so at your own financial risk.  Once again, if you're unsure about any TRICARE information that you've read or heard, especially if it originated from an UNOFFICIAL source, please seek clarity.

• TRICARE News & Updates •

• TRICARE News Center  |  TRICARE Multimedia Center  |  TRICARE Overseas Newsletters

• Facebook  |  Twitter  |  YouTube

• Email Updates  |  eCorrespondence
  

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II.  Rules of Engagement

• Integrity, Privacy & Professionalism •

1.  Foreword.  The JUSMAGTHAI TRICARE office is not funded to assist the retiree community, but we gladly do so as a courtesy, mission 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 staff does not make copies), and promptly leave the office when you've been assisted.

2.  Integrity.  An integral part of our mission is safeguarding U.S. taxpayer dollars.  Be advised that we will not knowingly help beneficiaries file false claims!  Any attempt to intentionally defraud the USG will immediately terminate assistance from our office and your name being forwarded to the Chief, JUSMAGTHAI, TRICARE Pacific, and to the Defense Health Agency for criminal review.  Complete honesty is the only lawful method.  See our section on Fraud Prevention.

3.  Courtesy and Respect.  Please show us and any clients ahead of you in the queue the proper respect and courtesy by not interrupting, even when a client isn't physically sitting in front of us.  We will assist you as soon as we complete the task at hand, and in queue order.  It is our professional promise that we take every reasonable precaution to respect and safeguard the privacy and dignity of all clients.  Thank you for your cooperation!

4.  Privacy Act and Release of Information.  We routinely handle a large amount of private information that is protected by law.  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.

5.  Retiree Mailing Address.  Input your Street or P.O. Box address (as listed in DEERS) on the DD Form 2642, not the JUSMAGTHAI TRICARE office address.  Use your DEERS address to receive your reimbursement paper check sooner.  Better yet, sign up online for TRICARE Overseas' Direct Deposit service and elect to receive your Explanation of Benefits (EOB) electronically.

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III.  Defense Enrollment Eligibility Reporting System (DEERS)

• DEERS • * Defense Manpower Data Center Support Office (DSO) *     Call the DMDC Support Office (DSO):     Phone:  (800) 538-9552     Fax:  (800) 336-4416 (Primary)     Fax:  (502) 335-9980 (Alternate)     Address:     DMDC/DEERS Support Office     400 Gigling Rd     Seaside, CA 93955-6771     Hours of Operation:     5:00 am - 5:00 pm (Pacific Time), Monday-Friday     We are closed on all federal holidays TRICARE & DEERS - milConnect Change / Update DEERS Information - milConnect > You may need to use a VPN to access milConnect < DEERS - TRICARE.mil DEERS Required Documents - TRICARE.mil

• JUSMAGTHAI - DEERS / DoD ID Cards • *** LOCATION *** Building "D", Room D-109 • Hours of Operation • **** BY APPOINTMENT ONLY **** To make an appointment, please visit: https://idco.dmdc.osd.mil/idco/locator (Location:  Bangkok Thailand) *** Closed U.S. & Thai Holidays *** Email (General Inquiries):  jusmagthai@state.gov Joint U.S. Military Advisory Group, Thailand (JUSMAGTHAI)

*** Administrative Note *** The Defense Manpower Data Center (DMDC) Support Office (DSO) manages DEERS.  Unless otherwise stated on this webpage, "contact DEERS" means to contact DSO in California.

• Keep Your DEERS Record Updated! •

*** Defense Manpower Data Center (DMDC) - milConnect *** Updating and Correcting DEERS Data To access your DEERS information in milConnect (or TRICARE-Overseas.com) first requires site registration.

1.  Why must I keep my information in DEERS up-to-date?  It is essential to keep information in the Defense Enrollment Eligibility Reporting System (DEERS) current for you and your family.  Failure to update DEERS to accurately reflect the sponsor’s or family member’s residential address and/or the ineligibility of a former dependent could be considered fraud and a basis for administrative, disciplinary and/or other appropriate action.  Also see:  Life Events.

2.  Your Social Security number (SSN) and the SSNs of each of your covered family members (if eligible to be issued an SSN by Social Security) should be included in DEERS for TRICARE coverage to be reflected accurately.  To register your family members in DEERS, you must visit your local ID card office.  The only DoD ID Card/DEERS office in Thailand is located at JUSMAGTHAI in central Bangkok (southeast corner of Sathorn Rd. and Sathorn Soi 1).  The JUSMAGTHAI DEERS operating hours for retirees are currently *** BY APPOINTMENT ONLY *** (see information box above).  No Walk-ins Accepted Until Further Notice.

• Your Address in DEERS •

3.  Whenever you move, near or far, the first thing you should do after you move is update DEERS with your new address, phone number and other personal information.  Your TRICARE eligibility doesn't change when you move, but it may change your health plan options.

4. For TRICARE beneficiaries residing in Thailand, to avoid a delay in TRICARE claims processing for overseas treatment, 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 (such as a P.O. Box) – retirees may use a street or a P.O. Box mailing address on their TRICARE claims.  For simple address changes, you can update your DEERS address via several different methods: Online via ID Card Office Online, contact DEERS, or in-person at JUSMAGTHAI *** BY APPOINTMENT ONLY *** (see information box above).  No Walk-ins Accepted Until Further Notice.

• DEERS Verification of TRICARE Eligibility •

*** Important Notice *** JUSMAGTHAI TRICARE staff is not authorized access to DEERS!

5.  DEERS Verification.  To verify your TRICARE eligibility you can check your DEERS account in milConnect or TRICARE Overseas, contact DEERS, or visit the nearest DoD ID card issuing facility (JUSMAGTHAI is the only such facility in Thailand).

• Note:  JUSMAGTHAI DEERS is not authorized to verify TRICARE eligibility by email, phone, fax or mail.  Verification is done in-person, only.  *** JUSMAGTHAI BY APPOINTMENT ONLY ***  (No Walk-ins Accepted Until Further Notice.)

• Register Your Dependents in DEERS •

6.  Register Your Dependents 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 (please also see paragraph 7 below).  If a TRICARE claim is denied in these circumstances, the beneficiary may resubmit the claim after the dependent is registered in DEERS.  In certain 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).  Even when the DEERS system at JUSMAGTHAI is sometimes unavailable you may still register your dependent(s) in DEERS.

7.  Getting TRICARE for Your Child.  You need to register your child in DEERS within one year (365 days) of his or her birth or adoption.  On day 366, your child won’t be able to receive benefits until you register them in DEERS.

• Updating DEERS & DFAS Records •

8.  Individually Update DEERS & DFAS Records.  Updating your DEERS record does not automatically update your DFAS information, and updating your information with DFAS does not update your DEERS record.  YOU must separately update your DEERS and DFAS records.  (Note:  If your address on record in DEERS differs from your address on record with DFAS, DFAS will eventually catch the discrepancy and force a DFAS record update to use the same address you have on record in DEERS.)

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IV.  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.  Anytime you believe TRICARE is being billed inappropriately, we request that you notify our office and also contact the Defense Health Agency (address below).  Please help us to fully protect your benefits!

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

2.  Fraud Notice - Read Carefully.  Federal Laws (18 U.S.C. 287 and 1001) provide for criminal penalties for knowingly submitting or making any false, fictitious or fraudulent statement or claim in any matter within the jurisdiction of any department or agency of the United States.  Examples of fraud include situations in which ineligible persons knowingly use an unauthorized Identification Card in filing of a TRICARE/CHAMPUS claim; or where providers submit claims for treatment, supplies or equipment not rendered to, or used for TRICARE DoD/CHAMPUS beneficiaries; or where a participating provider bills the beneficiary/patient (or sponsor) for amounts over the TRICARE/CHAMPUS-determined allowable charge; or where a beneficiary/patient (or sponsor) fails to disclose other medical benefits or health insurance coverage.

3.  TRICARE Fraud Examples (prohibited by 32 CFR, §199.9):

• Waiving of Deductibles/Cost-Shares.

• Patients not paying Deductibles/Cost-Shares.

• Offering financial inducement to encourage receipt of health care service, such as Membership fees and dues.

• Billings that involve persistent over-charging and over-utilization of services.

• Billing for services NOT provided.

• Improper billing practices.  Billing more than usual and customary charges.

• Patterns of services not medically necessary.

• Failing to promptly refund the U.S. government.
  

4.  Possible Penalties:

• Exclusion/suspension from TRICARE.

• Loss of TRICARE benefit.

• Defense Criminal Investigative Service (DCIS) Investigations and Interviews.

• Prosecution.

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V.  TRICARE Reform (FY 2017 NDAA)

1.  The Fiscal Year (FY) 2017 National Defense Authorization Act (NDAA) was signed into law by then-President Obama on December 23, 2016.  The FY 2017 NDAA mandates Reform of TRICARE and the Military Health System.

2.  Significant TRICARE program changes have been phased in starting in CY 2018 (transition year). The first change to affect U.S. military retirees that were covered by TRICARE Standard is that TRICARE Select replaced TRICARE Standard on January 1, 2018.  Retired families are also now categorized as Beneficiary Group A or Group B based upon when the sponsor joined uniformed service.  Group A and Group B have different enrollment fees and out-of-pocket costs.  TRICARE Select enrollment fees for most Group A retired families began January 1, 2021.

3.  TRICARE Changes Fact Sheet (et al.):

• January 1, 2018:  TRICARE Select replaced TRICARE Standard.  Conversion from Standard to Select was automatic. Annual enrollment is now required if you are a covered beneficiary and elect to participate in TRICARE Select (beneficiaries must enroll in a TRICARE plan to be covered for civilian care).  Beneficiaries eligible for and/or enrolled in TRICARE coverage as of December 31, 2017, were automatically enrolled in their respective TRICARE plans on January 1, 2018; TRICARE Standard beneficiaries were automatically enrolled in TRICARE Select.  No action is required by beneficiaries.  See:  Enrollment and Disenrollment.

• January 1, 2018:  Costs for TRICARE benefits have changed from a fiscal year (October - September) period to a calendar year (January - December) period to align with the annual enrollment period.

• January 1, 2018:  Enrollment fee for TRICARE Select Group B retired families begins.

• CY 2018 / CY 2019 / CY 2020:  No enrollment fee for TRICARE Select Group A retired families (fee begins CY 2021).

• November 12 - 10 December 10, 2018:  New annual TRICARE Open Season begins.  Beneficiaries can choose to enroll in or change their TRICARE Select or TRICARE Prime (stateside) coverage during the annual open enrollment period. Learn more on this page here.

• November 12 - 10 December 10, 2018:  Federal Benefits Open Season begins for OPM's Federal Employees Dental & Vision Insurance Program (FEDVIP) for U.S. military retirees.  Retirees have the opportunity to review their plan choices and make changes to their FEDVIP coverage for the upcoming benefit year.  Learn more on this page here.

• December 31, 2018:  TRICARE Retiree Dental Program (TRDP) ends.

• January 1, 2019:  Dental and Vision plans are available through FEDVIP.

• January 1, 2021:  TRICARE Select enrollment fee begins for Group A retired families.  In later years, the enrollment fee will be indexed to retired pay COLA.  In the Group A retired category, the enrollment fee shall not apply to Chapter 61 retirees or being a dependent of such a member, and survivors whose military sponsors died on active duty.  Your TRICARE Select enrollment fees will apply towards your catastrophic cap.

• January 1, 2021:  TRICARE Select annual catastrophic cap on out-of-pocket expenses for Group A retired families increases to $3,500.  In later years, the catastrophic cap will be indexed to retired pay COLA.

4.  TRICARE publishes additional updates here when they become available.  You may also sign up for email updates and eCorrespondence about changes to your TRICARE coverage.

5.  JUSMAGTHAI TRICARE Office Notes:

• It's essential that YOU always keep information in DEERS up-to-date for you and your family!

• You can best help yourself by always seeking information only from OFFICIAL TRICARE sources.  With that being said, please direct all questions to TRICARE Overseas.  (If you reside in the U.S., or are otherwise enrolled in TRICARE Prime, please direct questions to your TRICARE Regional Contractor.)
  

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VI.  TRICARE in Thailand - *Retiree Basics*

*** What is a TRICARE-Authorized Provider? *** Pertaining to health care providers in Thailand as they relate to retired category TRICARE beneficiaries, you'll sometimes see or hear the terms "TRICARE-authorized", "TRICARE-approved", "TRICARE-qualified" or "TRICARE-certified" provider.  Being that there are no TRICARE network providers for retirees in Thailand, local health care providers do not undergo any type of retired category TRICARE accreditation or certification program.  It simply means that a health care provider in Thailand is known by TRICARE to be licensed by the Royal Thai Government and the provider has not been blacklisted by TRICARE. DD Form 2642 - TRICARE Claim Form

• Your TRICARE Benefits • What is TRICARE? - Overview  |  New to TRICARE TRICARE Select Overseas  |  TRICARE For Life (TFL) Retiring from Active Duty  |  Retirees & Families TRICARE Open Season  |  Dental & Vision  |  Former Spouses Covered Services  |  Costs  |  Life Events Immunizations  |  Flu Vaccine  |  COVID-19 Centers for Disease Control & Prevention:  Flu  |  COVID-19 TRICARE Retired Reserve  |  TRICARE Young Adult TRICARE Pharmacy  |  Express Scripts Medication:  Covered + Not Covered  |  Drugs@FDA Proof of Coverage  |  Other Health Insurance (OHI) Claims Filing Information  |  Explanation of Benefits (EOB)

• Your TRICARE Benefits in Thailand • TRICARE Overseas Program - International SOS Register (Beneficiary)  |  Help - Tricare-Overseas.com Retiree Beneficiary Education Letter - Thailand Frequently Asked Questions (FAQs) - Thailand Emergency Contact Card - Thailand Important Notice - Explanation of Benefits Proof of Payment • • • TRICARE Fraud Prevention  |  Report Fraud & Abuse Patient Rights and Responsibilities Proof of TRICARE Coverage • • •

• Forms • DD Form 2642 - TRICARE Claim Form DD Form 2527 - Possible Third Party Liability DD Form 2870 - Authorization to Disclose Information DD Form 3403-3 - TRICARE Select Enroll, Disenroll, Change TRICARE Pharmacy - Home Delivery Order Form Physiotherapy Report Form Overseas Estate Notification Other TRICARE Forms  |  TRICARE Overseas Forms

• Publications • Handbook:  TRICARE Overseas Program Handbook:  TRICARE For Life Handbook:  Pharmacy • • • TRICARE Publications (Search) • • • Defense Health Agency (DHA) Reference Center Frequently Asked Questions (FAQs) - TRICARE.mil

• Know Your Benefits Before You Travel •

1.  Traveling to Thailand.  If you're reading this in the U.S. as part of your pre-visit or pre-move to Thailand, excellent!  While most TRICARE retiree beneficiaries study and understand how TRICARE works in Thailand before making the personal choice to visit (tourism or "snowbird") or relocate here, unfortunately, many do not.  By reading and studying this webpage before you travel or before you need medical care, you have made an informative decision.  Also, before you travel overseas contact your current TRICARE Region regarding what travel rules may apply.  For example, TRICARE Prime beneficiaries need to learn and understand how Prime works outside of the U.S. (see the TRICARE Prime section of this webpage).

• Three key things to remember:

• There is no U.S. Military Treatment Facility (MTF) or Department of Veterans Affairs (VA) Medical Facility in Thailand.

• If you require medical care, make sure it's from a licensed health care provider.

• Be prepared to pay 100% up front (out-of-pocket) and file your own claim with TRICARE.

>>> U.S. State Department:  Medical Emergencies  |  Your Health Abroad  |  Travel Medical Insurance Providers.

2.  The #1 Frequently Asked Question:  Do Thailand providers accept TRICARE?  If by "accept TRICARE" you mean that the provider will provide medical services and then file claims on your behalf without requiring payment up front, Thailand providers typically do not.  TRICARE cannot compel foreign providers – nor for that fact CONUS non-network providers – to file claims on behalf of TRICARE beneficiaries.  Normally, payment is 100% up front to a licensed health care provider (see paragraph 14 below), and then you file a claim for payment consideration with TRICARE (see our Claims section).

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 leisure), 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 ineligible for routine medical care at a military treatment facility.  Educate yourself before you travel.

4.  TOP Beneficiaries Traveling in the United States.  All TRICARE Overseas Program (TOP) beneficiaries traveling in the United States are encouraged to seek care from a U.S. Military Treatment Facility, if one is located nearby.  If this is not possible, then TOP beneficiaries should seek care from a TRICARE Approved Provider in the United States.  (For information pertaining to Emergency Care, Urgent Care, Routine Care, Claims Filing, and Contacting TOP, please visit the TRICARE Overseas link at the beginning of this paragraph.)

• TRICARE Overseas Program (TOP) •

*** Referrals & Prior Authorization *** "Referrals are not required but you may need prior authorization from the Overseas Contractor for some types of services."

5.  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 (Pacific Area - International SOS, Singapore):  sin.tricare@internationalsos.com.

6.  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, authorize TRICARE Overseas to disclose information to family members, 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.

• Password Tip.  You have two login choices:  1) DMDC login, or; 2) TRICARE-Overseas.com login.  If you're not using a DMDC login, and you're having trouble creating a TRICARE-Overseas.com login password, or resetting an expired password, please read the following:  Your TRICARE-Overseas.com account password must be 15 characters long, with at least 2 upper case letters, 2 lower case letters, 2 numbers, and 2 special characters (the only special characters permitted are # and $).

• Secure Messaging via TRICARE Overseas Portal.  Generally, TRICARE Overseas will respond to a beneficiary's secure message in 14 calendar days.  If you desire a timelier response, consider emailing or phoning TRICARE Overseas.

• TRICARE Prime Overseas - Not Available to Retirees •

7.  Retirees and Their Families May Not Enroll in TRICARE Prime Overseas.  Furthermore, retiree beneficiaries that are enrolled in TRICARE Prime in the U.S. often do not study the higher out-of-pocket costs incurred when using TRICARE Prime's Point-of-Service Option outside of the U.S. (for non-emergency services).  When seeking non-emergency medical care under the Point-of-Service Option, retiree beneficiaries typically incur an annual deductible ($300 Individual / $600 Family) and a 50% cost-share of covered services (after the deductible is met) (see Cost Terms).  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.)

• TRICARE Select Overseas & TRICARE For Life •

8.  Retiree Beneficiary Education Letter.  U.S. Military Retirees and eligible Dependents of retirees residing in Thailand are entitled to TRICARE Select 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 eligibility.  Read below for additional TRICARE For Life information.

• TRICARE For Life is Medicare wraparound coverage for TRICARE beneficiaries who have premium-free Medicare Part A and are enrolled in Medicare Part B, regardless of age or place of residence.  Enrollment for TRICARE For Life is not required, but you must pay Medicare Part B premiums.  Learn more on this page:  Medicare & TRICARE  |  Frequently Asked Questions.

• How TRICARE For Life Works Overseas.  Medicare does not provide coverage outside the United States, U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands), and ships in U.S. territorial waters.  Therefore, TFL is your primary payer for health care received in all other overseas locations. TFL generally provides the same coverage as TRICARE Select Overseas.  Learn more on this page:  File Claims.

• JUSMAGTHAI TRICARE Office Note:  Because Medicare does not provide coverage outside the U.S., some TRICARE For Life (TFL) beneficiaries in Thailand mistakenly believe their TRICARE Health Plan is "TRICARE Select Overseas". Although covered health care costs incurred outside the U.S. are reimbursed at the TRICARE Select Overseas rate, the actual Health Plan for those beneficiaries is still TRICARE For Life.

• Enrollment •

*** TRICARE Select Enrollment & Fees *** Enrollment is required for Group A and Group B retired beneficiaries. You’ll pay a monthly TRICARE Select enrollment fee to maintain your TRICARE Select coverage. TRICARE.mil  |  TRICARE-Overseas.com

*** DEERS Registration *** You must be registered in DEERS to get your TRICARE benefit.

9.  Enrollment is required for TRICARE Select Overseas.  Enrollment is required if you are a covered beneficiary and elect to participate in TRICARE Select.  The enrollment fee is based on Beneficiary Group A or B.  Beneficiaries must enroll in a TRICARE plan to be covered for civilian care.

• Group A retired families must pay an annual TRICARE Select enrollment fee beginning CY 2021.  Group B retired families must pay an annual TRICARE Select enrollment fee beginning CY 2018.  In the Group A retired category, the enrollment fee shall not apply to Chapter 61 retirees or being a dependent of such a member, and survivors whose military sponsors died on active duty.  Retired beneficiaries with any Medicare coverage are not eligible to enroll in TRICARE Select.

• Your regional contractor will process your enrollment, disenrollment or change request to be effective on the date requested or the date of event (e.g., initial eligibility, marriage, birth) as appropriate.  If your regional contractor receives your enrollment request within 90 days of loss of other TRICARE or healthcare coverage, your TRICARE Select Overseas or TRICARE Prime (stateside) coverage starts on the day after the loss of your other coverage.  You'll be notified by your regional contractor when your enrollment is processed and then you can log in to milConnect to download your enrollment card.  You should confirm the enrollment or change before obtaining care by calling your Regional Contractor or by viewing milConnect.

• I'm a Group A Retiree; What Happens if I Don’t Take Action?  If you didn’t set up your monthly enrollment fee payment by December 31, 2020, you were disenrolled from TRICARE Select.  If you didn't request reinstatement from your regional contractor no later than June 30, 2021 (special first-year extended grace period), you are now only able to receive care from a military hospital or clinic, if space is available, and you will be responsible for all civilian health care costs.  (See next paragraph immediately below.)

• Starting January 1, 2019, eligible beneficiaries will only be able to enroll in TRICARE Select Overseas, or TRICARE Prime (stateside), or change plans during the annual enrollment open season, or for up to 90 days following a Qualifying Life Event.

10.  Enrollment and premiums also required for:  Federal Dental & Vision | TRICARE Retired Reserve | TRICARE Young Adult.

11.  Enrollment is not required for TRICARE For Life (TFL) – eligibility is automatic as long as you are registered in DEERS and DEERS shows you as being eligible.  That said, if you are entitled to premium-free Medicare Part A, you must have Medicare Part B to remain TRICARE-eligible (under TFL) (see our Medicare & TRICARE section on this page).  A *TRICARE Health Benefits Card* is not issued to TFL beneficiaries.

• Disenrollment •

12.  Disenrollment.  How you disenroll depends on which health plan option you're using.  Note:  Certain events will cause you to be disenrolled.

• Enrollees may disenroll from any TRICARE plan at any time.  Enrollees who voluntarily disenroll from TRICARE Select cannot re-enroll in a TRICARE plan unless a Qualifying Life Event occurs or until the next annual open enrollment period.  If you voluntarily disenroll from TRICARE Select (or TRICARE Prime) or do not pay your enrollment fee, you will only remain eligible to receive covered care at a military hospital or clinic on a space available basis (there is no Military Treatment Facility in Thailand).  You may re-enroll during the next open enrollment period or within 90 days of a Qualifying Life Event. You have 90 days from the life event to enroll and your coverage will start on the date of the event (e.g., marriage, birth).

• Open Season •

13.  TRICARE Open Season.  During this period, eligible beneficiaries can enroll in or change their TRICARE Select Overseas or TRICARE Prime (stateside) coverage, or choose to do nothing and remain enrolled in their current TRICARE Select Overseas or TRICARE Prime (stateside) coverage for the next calendar year.  Prior to each annual open enrollment season, the Defense Health Agency will share known changes coming to the plans for the next calendar year and dates these changes will take effect.

• TRICARE Open Season is the annual period when you can enroll in or change your health care coverage for the next year.  It occurs each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December.  Any enrollment changes you make will go into effect on January 1, 2024.  Open season applies to anyone enrolled in or eligible for a TRICARE Prime option or TRICARE Select.  This timeframe coincides with the Federal Benefits Open Season.

• If you aren't already in a plan and don't enroll in a plan, you'll only be eligible for care at a military hospital or clinic if space is available.  (Note:  There are no U.S. Military Treatment Facilities (MTF) in Thailand and TRICARE Prime enrollment is unavailable to retirees residing outside of the U.S.)
  

• Payment - 100% Up Front •

*** No Network Providers for Retirees *** "When seeking care from an overseas host nation provider or a stateside non- network provider, be prepared to pay up front for services and file a claim with International SOS for reimbursement in the overseas region where you live."

14.  Pay 100% *Up Front* (Out-of-Pocket).  TRICARE use by retirees in Thailand historically has been and still is to "Pay 100% Up Front” (out-of-pocket) for medical care.  Being that there are no TRICARE network providers in Thailand for retirees, eligible retirees in Thailand normally 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 medical claim with International SOS (TRICARE Overseas Program) for payment consideration (processed by Wisconsin Physicians Service (WPS)).  Reimbursement is based on covered health plan costs.

     14.1.  No Network Providers with Direct Billing for Retirees.  There is no universal or contractual direct billing for retiree beneficiaries in Thailand and TRICARE cannot compel foreign providers to file claims on behalf of TRICARE beneficiaries. Moreover, even though several hospitals in Thailand list *TRICARE* on their webpage as *insurance* they accept, this historically has been for active duty personnel and their eligible dependents.  Before you assume it includes retirees it would be sensible to ask the provider before treatment.

• Note:  The "Thailand Providers" list on the TRICARE Overseas website under "TOP Remote" is for active duty service members and their eligible family members.  TOP Prime Remote Overseas is not available to retiree beneficiaries and the aforementioned TOP Remote provider list is not applicable to retirees.  If a listed care provider chooses to also extend inpatient direct billing to retirees, it's coincidental (not contractual) and it's their private decision to make.

• A confusing list of hospitals published by an UNOFFICIAL source in Thailand that they say "may" direct bill TRICARE, is misleading and contains factually incorrect information.  Our office is not involved with speculative third-party lists. For reasons stated above and below, no direct billing list exists for retiree beneficiaries in Thailand.

      14.2.  Fact & Truth.  Some health care providers falsely tell retiree patients that our local TRICARE office "won't authorize" direct billing or that TRICARE will not send claim payments to them.  FACT:  TRICARE staff has no authority in a care provider's private decision to direct bill TRICARE – each provider knows this.  TRUTH:  Care providers normally first want *Guarantee Payment* from the U.S. Government before they'll consider direct billing TRICARE.  The U.S. Government does not provide *Guarantee Payment* for retiree beneficiaries.  Again, nothing prevents a health care provider from direct billing TRICARE, but they typically won't do so.

     14.3.  Legal Consequences for Non-Payment.  If a patient refuses to pay or enter into a formal payment agreement for services received, it's well within a health care provider's legal right to take legal action against the non-payer.  Non-payment is a legal matter between patient and care provider, and does NOT involve TRICARE or the U.S. Government.  Obstinately refusing to pay can lead to arrest and other court-ordered action.  Paying for services received is the only sensible choice.

       14.4.  JUSMAGTHAI TRICARE Office - Additional Notes:

• The availability of inpatient direct billing from local care providers is not automatic, and availability cannot be counted upon.  Direct billing is a care provider case-by-case private offering that can end at any time.  A care provider that may be trialing or offering direct billing today may abruptly end that service tomorrow.  Direct billing TRICARE is strictly a health care provider's private decision to make.  The decision does NOT involve, nor require, TRICARE approval.

• Over the years, various hospitals in Thailand have attempted legitimate TRICARE direct billing for retiree inpatient care (case-by-case basis) only for most attempts to eventually end.  Why?  Primarily due to care providers not adhering to TRICARE claims filing procedures and incurring financial losses.  Added to that were retirees that defrauded (and still try to defraud) health care providers.  As a result, numerous care providers stopped offering direct billing to retirees.

• ALL local direct billing nearly ended when it came under close scrutiny due to an increasing number of undue problems caused by certain retirees.  Due to those problems, we stopped publishing detailed information about local direct billing and is the reason why we no longer openly discuss it.  We certainly don’t want the few local care providers that courteously still offer retiree inpatient direct billing (case-by-case) to completely end the availability.

• The remaining limited number of known care providers that may still offer direct billing (case-by-case) first require that a TRICARE-eligible patient have a valid Thai residential address in DEERS (at least 30 days old), and they typically request your SSN.  Local care providers may legally also photocopy a military ID card for filing a TRICARE claim (see last paragraph in linked DoD news article).  These are fraud prevention policies of individual care providers.  They do not involve TRICARE.  Retirees that refuse to comply with individual care provider rules pay 100% up front.  Period.

• Every now and then a retiree will try to pressure a local care provider into "pre-approving" TRICARE direct billing as a hedge against "potential" future emergency medical care.  Being that a retiree’s TRICARE eligibility can for several reasons change, it’s financially unwise for a care provider to offer “pre-approval” for TRICARE direct billing, and no smart provider is going to do so.  DEERS is the ONLY official source for up-to-date TRICARE eligibility.

• ALL retirees must act appropriately to help prevent a resurgence of past problems when the minority nearly ruined it for all U.S. military retiree beneficiaries in Thailand.   We thank the overwhelming majority of U.S. military retirees (and eligible family members) that continue to cooperate and conduct themselves professionally.
  

• Service Branches Determine TRICARE Eligibility •

*** 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.

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

• Note:  If you believe your TRICARE eligibility status in DEERS may be in error, it is your personal responsibility to contact DSO for resolution – the sooner the better.

• Survivors of Retired Service Members •

16.  Survivors.  If a sponsor dies after retiring from active duty (either regular or a medical retirement), surviving family members remain eligible for TRICARE with the same health plan options and costs they had before their sponsor passed away.  Surviving spouses remain eligible for TRICARE unless they remarry and children remain eligible until they age out or lose eligibility for TRICARE for other reasons.  Also see:  Death in the Family and Medical Bills of Deceased Sponsor.

• Federal Dental & Vision Insurance Program (FEDVIP) •

*** FEDVIP Dental & Vision Coverage Started January 1, 2019 *** The TRICARE Retiree Dental Program (TDRP) ended December 31, 2018.

17.  Federal Dental & Vision Insurance Program (FEDVIP).  Eligibility for FEDVIP, offered by the U.S. Office of Personnel Management (OPM), has expanded to include certain retired uniformed service members and active duty family members. Also see:  FEDVIP Dental and Vision Coverage.

• The annual Federal Benefits Open Season gives retirees the opportunity to review their plan choices and make changes to their FEDVIP coverage for the upcoming benefit year.  It occurs each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December.  This timeframe coincides with the TRICARE Open Season.

• If you were enrolled in TRDP, you were not automatically enrolled in a FEDVIP dental plan.  To have dental coverage you must take action to enroll.

• JUSMAGTHAI TRICARE Office Note:  Please kindly remember that FEDVIP is an OPM-managed program and to direct your dental and vision benefits questions to FEDVIP.  TRICARE has no involvement with FEDVIP administration.

• My Military Health Records •

18.  My Military Health Records.  You should keep copies of your medical documentation, records, and health care history information for your own reference.  Also see:  Request Archived Health Records.

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VII.  Annual Deductible / Cost-Shares / Catastrophic Cap

*** TRICARE Health Plan Costs *** Patient Always Pays 100% of Non-Allowed Charges! Find Your Health Plan Costs Cost Terms (Review Your Health Plan Costs Each Calendar Year)

• Beneficiary Groups A & B •

1.  Beneficiary Groups.  Starting January 1, 2018, you will fall into one of two categories based on when your sponsor became affiliated with the Uniformed Services, either through enlistment or appointment.  Group A and Group B have different enrollment fees and out-of-pocket costs.

• Group A:  If your sponsor’s initial enlistment or appointment occurred before January 1, 2018.

• Group B:  If your sponsor’s initial enlistment or appointment occurred on or after January 1, 2018.

• Annual Deductible / Cost-Shares / Catastrophic Cap •

2.  Annual Deductible.  Cost-sharing begins after you meet your annual deductible each calendar year.

3.  Cost-Shares.  You'll pay a copay or cost-share based on the type of care.  Some inpatient copays and cost-shares will change each calendar year.

4.  Catastrophic Cap.  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.  After you reach your catastrophic cap, you won’t have to pay anything more in most cases, but there are some exceptions.

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VIII.  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 authorization.  For 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).  Certain services below are specifically mentioned in this section due to high topical interest.  If you're uncertain if prior authorization is required for your situation, contact TRICARE Overseas (contact info is also at the top and bottom of this page).

• Services - Common Topics •

2.  Mental Health Care.  Mental health problems can affect your thoughts, mood and behavior.  For general information of what's covered and what's not, please visit:  Covered Treatments and Exclusions.  If you believe you may need mental health care, contact TRICARE Overseas for current coverage information and if prior authorization or a referral is required.

• Emergency Mental Health Care.  You have an emergency if the patient:  Is at immediate risk of serious harm to self or others as a result of mental disorder; Needs immediate continuous skilled observation at the acute level of care (based on a psychiatric evaluation).  If you have a mental health emergency in Thailand, have someone take you to the nearest emergency room.  You may of course dial 191 (police), 1669 (ambulance), or contact your local hospital's emergency service, but going directly to the nearest emergency room is your best course of action.  You don't need prior authorization. If admitted, call TRICARE Overseas (regional contractor) within 24 hours or the next business day. Admissions must be reported within 72 hours.  If you need emergency mental health care, seek help immediately!

• Non-Emergency Mental Health Care.  Plans differ as to if a referral and prior authorization is required.  Follow your plan's rules for getting non-emergency mental health care.  Behavioral Health Care Services Fact Sheet.

• Do you need prescription drugs for a mental health condition?  You must be under the care of a provider who can prescribe drugs and manage your dosage.  Some types of mental health providers can prescribe drugs, but others cannot.  >> Learn More.

3.  Physical Therapy and Occupational Therapy.  Important Note:  These two common services are not automatically covered. These two services may or may not be deemed by TRICARE to be medically necessary and considered proven for your specific case.  Before starting a Physical Therapy or Occupational Therapy regimen we recommend you contact TRICARE Overseas for specific limitations to the Physical Therapy or Occupational Therapy benefit.

• Note:  Claim filing details unique to Physical Therapy are further discussed on this webpage in our Claims section.

4.  Substance Use Disorder Treatment.  (Click on link to learn what treatment is covered).

5.  Ambulance Services.  (Click on link to learn more).

6.  Air Evacuation.  (Click on link to learn more).

7.  Health Promotion and Disease Prevention Examinations.  TRICARE covers Health Promotion and Disease Prevention (HP&DP) exams for beneficiaries age 6 and older.

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IX.  Prescription Medication

• Prescription Medication •

*** Periodically Review the TRICARE Formulary *** TRICARE covers most prescription medications approved by the U.S. Food and Drug Administration (USFDA).  It's prudent to periodically review the TRICARE Formulary to make sure your prescription medication is still covered. One example of a medication being withdrawn (for patient safety reasons) by the USFDA is Ranitidine (Brand Name Zantac).

1.  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:  TRICARE Formulary.

2.  Filling Prescriptions Overseas.  You may have prescriptions filled at host nation pharmacies.  Host nation pharmacies are considered to be non-network pharmacies, but in some cases, a host nation pharmacy may be your only option.  You will have to pay for the total amount first and then file a pharmacy claim for reimbursement (see Section X below).

• Over-the-counter (OTC) medicine purchases overseas are not a covered benefit.

• There are no U.S. military pharmacies in Thailand.

• JUSMAGTHAI TRICARE Office Note:  A beneficiary with a prescription written by a Thai government-licensed health care provider may purchase prescription medication from a local pharmacy and then file a TRICARE pharmacy claim for reimbursement consideration.

• Pharmacy Home Delivery •

*** TRICARE Mail Order Pharmacy (TMOP) *** TRICARE will only mail prescription medication to a U.S. address!

3.  TRICARE Pharmacy Home Delivery.  TRICARE prescription drug coverage is available to all TRICARE-eligible beneficiaries who are enrolled in 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.  Express Scripts will only ship to an APO/FPO address and not to a Thai address.  Further, *Home Delivery* to APO/FPO addresses is subject to local customs laws.  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. Prescribers cannot write prescriptions for family members.  TRICARE Pharmacy Program Handbook.

• Important Note:  Neither TRICARE nor the VA Mail Order Pharmacy will ship medication to a foreign address!

• Attention:  If you’re assigned to the U.S. Embassy and don’t have an APO address, you should use the embassy's official Washington, D.C. address.  Contact the JUSMAGTHAI TRICARE office for more information.

• Note:  U.S. law forbids U.S.-licensed civilian medical providers publicly practicing outside the U.S. from having a Drug Enforcement Administration (DEA) number.  This is the reason why U.S. military retirees outside of the U.S. cannot obtain a prescription for U.S. controlled substances.

4.  JUSMAGTHAI TRICARE Office Note:  Pertaining to beneficiaries that ask family or friends in the U.S. to forward medication to Thailand, prescription medication is at risk of being seized by Thai Customs authorities.  It is illegal to import prescription medication without a Thai import license and individuals ordinarily cannot obtain said license.  In most cases it is also illegal for individuals to mail prescription medication via the U.S. Postal Service (Controlled Substances and Drugs).  Only entities that are registered with the Drug Enforcement Administration are permitted to send drugs through the U.S. Postal Service.  If bringing medication into Thailand the supply limit is 30 days.  Bringing Medication into Thailand (Royal Thai Embassy, Washington, D.C.).

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X.  Claim Filing (Pharmacy Claims)

*** TRICARE Claims - Preparation & Filing is Easy! *** Pharmacy Claims DD Form 2642 - TRICARE Claim Form

*** COVID-19 Vaccine Note *** COVID-19 vaccines approved and authorized for use in the host nation will be covered by TRICARE, even if they are not U.S. FDA approved. (Source:  Regional Medical Director Asia Pacific, TRICARE Overseas Program.)

1.  File a Pharmacy Claim.  At a non-network pharmacy, you’ll pay the full price of your medication up front and file a claim for reimbursement.  Retired service members will receive a partial reimbursement based on non-network pharmacy costs. Reimbursements are subject to deductibles, out-of-network cost-share, TRICARE formulary status, and applicable copayments.  All deductibles must be met before any reimbursement can be made.  You must submit proof of payment with all overseas pharmacy claims.

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XI.  Claim Filing (Medical Claims)

*** TRICARE Claims - Preparation & Filing is Easy! *** Medical Claims DD Form 2642 - TRICARE Claim Form Medical Claims Checklist & Helpful Hints Guide - Thailand

*** COVID-19 Tests *** TRICARE.mil:  COVID Testing

• Medical Claims Self-Help • Medical Claim Filing Tips How to File a TRICARE Medical Claim - Thailand • • • Sample DD Form 2642:  Sponsor  |  Spouse • • • DD Form 2642 - TRICARE Claim Form DD Form 2527 - Possible Third Party Liability	Medical Claims Address (WPS):  New  |  Tracer (Lost) Other Health Insurance (OHI) Proof of Payment How to Sign Up for Direct Deposit Recoupment of Overpayments • • • Summary Worksheets:  (Useful, But Not Required) Lab  |  Pharmacy  |  Services  |  Combined

• Other Health Insurance (OHI) •

1.  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.  Also see:  TRICARE Overseas OHI Questionnaire and DD Form 2642.

• TRICARE For Life (TFL) Beneficiaries:  Even though Medicare is a federal entitlement, TRICARE still pays last after Medicare and OHI.  However, being that Medicare does not provide coverage outside of the U.S. and its territories, in all other OCONUS areas TFL is the first payer.  Therefore, for care received in Thailand file a TRICARE medical claim using the same TOP medical claims address used by TRICARE Select Overseas beneficiaries. Learn more on this page:  Medicare and TRICARE  |  File Claims.

• Overseas Medical Claims •

2.  Claims Filing (Overseas Medical 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 - File no later than Three (3) Years after medical services received.  2) Inpatient - File no later than Three (3) Years after discharge date.  We receive 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, TRICARE will normally deny a claim if the timely filing limit is exceeded.  TRICARE Claims Inquiries (WPS):  1-877-451-8659 (Toll Outside U.S.).  (WPS is contracted by International SOS to manage medical claims processing for the TRICARE Overseas Program.)

• Filing Claims with Your New DoD Benefits Number (DBN).  The Department of Defense (DoD) is removing Social Security Numbers (SSN) from uniformed services identification (ID) cards, as part of the continued effort to protect the privacy and security of TRICARE’s over 9 million beneficiaries.  With removal of SSNs, two new numbers are printed on newly-issued DoD ID cards – a 10-digit DoD ID Number and an 11-digit DoD Benefits Number (DBN).  The 10-digit DoD ID Number replaces the SSN.  If you have DoD benefits, (e.g., health care, commissary privileges, exchange privileges), an 11-digit DBN is printed on the back of the ID card (above the bar code).  The 11-digit DBN is a unique number that ensures your records are clearly aligned with your treatments.  Health care, pharmacy and dental claims can be submitted using the sponsor’s SSN or DBN, or the beneficiary’s DBN (eligible former spouses should use their own SSN or DBN, not the sponsor’s).  Claims cannot be processed using the 10-digit DoD ID Number.  DoD is also replacing ID cards issued to retirees and family members with a new, more secure card that will incorporate an updated design and security features to deter counterfeiting and fraud.

• Note:  Current ID cards remain valid through their expiration dates.  You do not need to make a special trip to update or renew your ID card until it is 30 days from expiration.  The replacement process is expected to take several years, until all current DoD ID cards are replaced as they come up for renewal.  Until all cards are updated, you can use either your SSN or DBN to submit claims and verify TRICARE eligibility.  See:  Removal of Social Security Numbers from ID Cards. Also see:  Next Generation Uniformed Services ID Card.

• Your Guide to Duplicate Claims Submissions.  When you submit a claim to the TRICARE Overseas Program (TOP) claims processor, it can take up to 30 days from the date it was received for the claim to be processed.  If you want to check the status of a claim wait at least 21 days and then contact either TRICARE Overseas (Pacific Area) or WPS (Tel: 1-877-451-8659 (Toll Outside U.S.)).  Claims customer service representatives can tell you when the claim was received, where it is in the process and when you should expect to receive reimbursement.  If you choose to resubmit a claim (due to mail loss of the original claim, for example), wait at least 45 days from when you submitted the first claim before submitting a duplicate.  Clearly note on the paperwork "Second Submission" to help ensure your claim is identified as a resubmission, which will help expedite claims processing.

• 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 (street or P.O. Box), not check-marking the appropriate OHI block, not providing complete prescription medication details, not providing complete Physiotherapy 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.  If you haven't already signed up for direct deposit service, TRICARE also recommends that if/when you check "No" in the *Payment in US Currency* box in Block 13, in large letters also write *Thai Baht* so as to avoid a potential reimbursement check currency error.

• Proof of Payment •

*** Important Note *** TRICARE Overseas requires *Proof of Payment* submitted with EACH claim, regardless of payment amount.

4.  Proof of Payment for Overseas Claims.  Proof of payment is needed for TRICARE to protect the money you spend on health care.  Due to fraud prevention efforts, beginning September 1, 2012, beneficiaries are 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 *Patient Paid in Full* and the amount paid in local currency.  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 ensure the care provider clearly annotates *Paid* on each invoice.  Claims over $1,000 require additional proof of payment.

• Proof of Payment for Bundled Claims.  If you are bundling more than one claim on a single claim form you must submit proof of payment for each service.  Each individual claim will be reviewed as if it was submitted separately.  Any items that do not have proof of payment will be returned to you for further documentation.

• Proof of Payment Examples.  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, but did not retain the ATM slip, 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 Sense:  What do you need to provide to prove to a busy claim adjudicator that you in fact paid the claim?

• Refusal to Submit Proof of Payment.  If you or someone you know has received a claim reimbursement without submitting proof of payment, consider yourself lucky, but don't expect that luck to carry forward each time.  Every now and then a retiree beneficiary will stubbornly refuse to submit proof of payment with their claim and then ignore TRICARE's follow-up request to submit proof of payment.  If you refuse to submit proof of payment, any reimbursement due you will instead automatically be sent by TRICARE to the care provider.  When this 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 and ignoring TRICARE's follow-up request to do so is counter-productive and self-defeating.

• 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 submitted.

• 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, 2022 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 third-party insurance provider before filing a claim with TRICARE.  If any pertinent questions please contact TRICARE Overseas.

• Take-Home Medication •

7.  *Take-Home Medication*.  When discharged after inpatient hospitalization, beneficiaries are often prescribed *Take-Home Medication* (aka *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).

• Separate Itemized Billing Statement Required for *Take-Home Medication*.  As stated in paragraph 7 immediately above, in order for TRICARE to reimburse *Take-Home Medication*, the take-home medication must be separately invoiced, and not included on the inpatient billing statement, nor can any other items be included on the take-home medication itemized bill.  If not separately invoiced, the take-home medication will not be reimbursed.  Once again, during inpatient discharge you must obtain a separate itemized bill for *Take-Home Medication*.

• Physiotherapy (Physical Therapy) •

8.  Physical Therapy.  While *Physical Therapy* is the more commonly known street name, and is also the name used on the TRICARE.mil website, in medical jargon it's *Physiotherapy*; or *PT* for short.  In order to ensure that any claimed physiotherapy is medically necessary (not all physiotherapy is medically necessary), TRICARE Overseas requires certain specific details.  (In practice, we recommend you contact TRICARE Overseas for specific limitations to the Physical Therapy benefit before you start a Physical Therapy regimen).  The Physiotherapy Report Form, when properly completed, provides TRICARE with the required information to process your claim.  If your care provider uses a similar form that provides the same details you may instead submit their form with your TRICARE claim in lieu of the TRICARE Overseas form.  If you didn't bring the TRICARE Overseas Physiotherapy Report Form to your care provider to complete, the best solution is to ask your care provider to download/print it by clicking on the link above.  If for whatever reason a physiotherapy report form is not completed, ensure your care provider includes the required details in a Medical Certificate or Report, else, the processing of your claim will be delayed until you submit the required details to TRICARE.

• Note:  *Occupational Therapy* is different from Physical Therapy and is briefly discussed on our webpage here.

• DD Form 2527 - Possible Third-Party Liability •

9.  Third-Party Liability.  If your claim is the result of an injury, include DD Form 2527 with your claim.  If unsure whether to submit DD-2527, submit it!  It’s better to submit it than for WPS to 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.”

• Bundling Claims •

10.  Bundling Claims.  If your goal is timely reimbursement of your claim, submit separate claim forms for each unique patient encounter/date of service.  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 requesting reconsideration (followed by filing an appeal, and then a grievance if the appeal is denied).  Use your best judgment.  (Also see paragraph 4 above about submitting Proof of Payment with bundled claims.)

• File Claims Electronically •

11.  File Claims Electronically.  THE FASTEST WAY TO GET MONEY BACK is to file your claim online and sign up for direct deposit (see Section XII below).  Once you’ve established a Beneficiary login account by registering on the TRICARE Overseas portal, and once you log in, you may submit your claim(s) electronically (proof of payment is still required).  For details on the filing method, and to help ensure a smooth, trouble-free electronic claim(s) submission, please review the TRICARE Overseas Beneficiary Portal Message Center Tutorial.

• Suggestion:  After electronic claim submission, wait a couple of business days and then contact the TRICARE Overseas Program claims processor, Wisconsin Physicians Service (WPS) | Tel:  1-877-451-8659 (Toll Outside U.S.), or International SOS, Singapore to make sure there were no obvious claim errors noted during claim intake.  If you don't check, you may not learn about a potential claim error until many weeks later (and incur a lengthy processing delay).

• File Claims by Mail •

• TRICARE Overseas Claims Processor • * Wisconsin Physicians Service (WPS) *     Claims Address:     TRICARE Overseas Program     P.O. Box 7985     Madison, WI 53707-7985     Phone Number & Hours:     Phone:  1-877-451-8659 (Toll Outside U.S.)     Hours:  Sunday, 7pm CT thru Friday, 7pm CT     (Closed U.S. Holidays)     Customer Service Address:     WPS - TRICARE     P.O. Box 7992     Madison, WI 53707-7992

12.  File Claims by Mail.  Submit claims with Proof of Payment (see paragraph 4 above) to the TRICARE Overseas claims processor, WPS, at the above claims address.  For care received overseas, including in U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands), submit claims to the TRICARE Overseas Program claims processor (WPS), regardless of your home region.  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 claim check from WPS (see the Expired Check section below under Claim Reimbursement).  Better yet, sign up for claim reimbursement via TRICARE Overseas' Direct Deposit service (more information is available on our webpage here).

• TRICARE For Life (TFL) Beneficiaries:  In the U.S. and its territories TFL pays after Medicare; in all other OCONUS areas TFL is the first payer.  For care received in Thailand, use the same TOP claims address (above) used by TRICARE Select Overseas beneficiaries (P.O. Box 7985).

• Suggestion:  If you mail your claim using regular international mail, wait 2-3 weeks and then contact the TRICARE Overseas Program claims processor (above) or International SOS, Singapore to make sure your claim was received and there were no obvious claim errors noted during claim intake.  If you don't check early in the process, you may not learn about a potential claim error until many additional weeks later (and incur a lengthy processing delay).  For claims mailed via registered or express mail, wait a couple of business days after tracking shows your claim was delivered to WPS before inquiring.

• Medical Bills of Deceased Sponsor or Dependent •

*** Claim Filing - Deceased's Medical Bills *** Please first contact the JUSMAGTHAI TRICARE office before filing a claim!

13.  Medical Bills of Deceased Sponsor.  Our sincere condolence for your loss.  Let us help you file a medical claim.  Claim processing in this situation can easily be delayed for a number of reasons, therefore, it's best to contact the JUSMAGTHAI TRICARE office BEFORE filing a claim.

14.  The TRICARE Overseas claims processor, WPS, normally delays claim processing until it's proven who paid the unreimbursed medical expenses of the deceased beneficiary.  While the person who paid for end-of-life unreimbursed medical expenses is likely to be the Primary Next-of-Kin (PNOK), this isn't always the case.  This is the primary reason why WPS delays claim processing until it can be proven exactly who paid those bills.  When an individual uses a credit card to make payment it's typically easy to prove exactly who paid.  In situations where cash was used or a bank transfer was made, it may not be clear who paid.  As well, if other existing unreimbursed medical expenses were paid by the then-living beneficiary, the same now deceased beneficiary clearly cannot be reimbursed.  In these situations, WPS typically requests the deceased beneficiary's NOK or representative to obtain a court judgement essentially stating that a specific individual (or the Estate) is entitled to any TRICARE claim reimbursements.  Also see the Overseas Estate Notification form.

• Historical Note:  In a case years ago, claim reimbursement was issued to the PNOK (widow) but it was later proven that the decedent's daughter had in fact paid the medical expenses.  Unfortunately, the widow refused to return the funds to TRICARE or remit to the daughter.  At that point it became a civil matter between daughter and widow.  There was nothing TRICARE legally could do except to revise claims policy to delay processing of future claims involving deceased beneficiaries.

• Important Reminder:  Local hospitals typically will not release a decedent's body until the hospital invoices' outstanding balance is paid in full.  Further, TRICARE will NOT reimburse a claim for hospital bills that have been paid with funds unlawfully withdrawn or transferred from a decedent's bank account, or have been paid with an unlawfully used credit card, debit card or paper check.  Plan accordingly.

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XII.  Claim Reimbursement

• Direct Deposit Service •

1.  Claim Reimbursement via Direct Deposit.  Beneficiaries registered on TRICARE Overseas' secure claims portal can sign up to receive payment for their TOP Claims via automated direct deposit.  Once signed up, you will receive payments in USD currency (only) to your U.S. bank account through an Automated Clearing House (ACH).  It's quick, safe and convenient.  Visit the secure claims portal (TRICARE Overseas website) today to sign up!  Contact your TOP Regional Call Center and press option #2 if you have questions or need assistance.  Click here to learn how to register for Automated Direct Deposit.

• JUSMAGTHAI TRICARE Office Note #1:  U.S. financial institutions participating in the U.S. Domestic ACH system have a valid 9-digit numeric American Banking Association (ABA) routing number that's needed for automated direct deposit sign-up (SWIFT codes for international accounts cannot be used).  We highly encourage you to take advantage of Automated Direct Deposit.  If you do not have a U.S. bank account, or have not yet signed up for claim reimbursement via direct deposit, you can still receive reimbursement via paper check in USD or Thai Baht (the currency choice made by the beneficiary in Block 13 on the DD-2642 claim form).  Please contact TRICARE Overseas for assistance.

• JUSMAGTHAI TRICARE Office Note #2:  TRICARE claim reimbursement via direct deposit to a Bangkok Bank account is no longer available.  Policy vs. Practice:  By policy, beneficiaries should not have set up their TRICARE claim reimbursements to be direct deposited to a non-U.S. bank like Bangkok Bank.  In practice, previous direct deposit for claim reimbursement to a Bangkok Bank account was successful because the Defense Health Agency did not sort through 27,000 U.S. ABA routing numbers and block the ABA routing numbers assigned to some foreign banks.  In short, that has changed due to a change in U.S. anti-money laundering rules.  If you do not receive your TRICARE claim reimbursement via direct deposit to a Bangkok Bank account as expected, this rule change may be the reason why.  If any questions, please see Note #1 above.

• Paper Check •

2.  Reimbursement by Paper Check.  You have two options for TRICARE claim reimbursement via paper check:  1) A "WPS TRICARE" check payable in US Dollars (USD), or; 2) A "Citibank, N.A." (Thailand) check payable in Thai Baht (THB).

• JUSMAGTHAI TRICARE Office Note:  If you absolutely want to have claim reimbursement via paper check, please be advised that neither the "WPS TRICARE" check in USD, or the "Citibank, N.A." (Thailand) check in THB, prints a person's middle name on the check.  This can be problematic due to Thai banks typically wanting to see the account holder's full name as depicted in their passport during account sign-up.  Therefore, before requesting TRICARE claim reimbursement via paper check, it's prudent that you first review your Thai bank's check cashing/deposit rules.  Final Note:  The "WPS TRICARE" check in USD typically will include your middle initial when you include your middle initial on the DD-2642 claim form.  However, the "Citibank, N.A." (Thailand) check in THB will have first and last name, only. The Defense Health Agency is aware of this Thai banking issue but there is no identified solution for TRICARE's part of the process – bank account holder's need to sort this check cashing/deposit issue with their respective Thai bank.

• Paper Check - Error / Expired / Lost / Reissue •

3.  Reimbursement Check Problems.  If your TRICARE claim reimbursement paper check is not in the currency you requested (THB or USD); payee name is incorrect or misspelled; check has expired (120-day expiration date from the date of issue); was lost in the mail, etc., YOU need to contact the TRICARE Overseas claims processor (WPS) to request check reissue.  WPS is unable to reissue a check until the current check is returned to WPS or it expires after 120 days.  Check reissue typically takes many months to resolve, so for example, if you absolutely want a check in Thai Baht instead of USD, it's not a timely fix. Lastly, before you return a check to WPS for reissue we recommend you write *VOID* across the face of it and keep a copy for your records.  (Direct Deposit:  To avoid the hassle of currency errors when you desire reimbursement in USD, TRICARE Overseas now offers a Direct Deposit option for claim reimbursement in USD – see paragraph 1 above).

• Reimbursement Mistakenly Sent to Care Provider •

4.  Provider Mistakenly Paid.  Every now and then TRICARE mistakenly sends a claim reimbursement due a beneficiary to the care provider instead.  When this occurs the care provider typically tries to contact the beneficiary to inform them of the error, and also notifies TRICARE.  This is one of the reasons why it's extremely important that YOU ensure your care provider and WPS (TRICARE Overseas claim processor) have your current contact information (the same applies to keeping your DEERS record updated).  Also, the care provider will first have to remit the reimbursement back to TRICARE before TRICARE will reimburse you.  Due to the high volume of claims processed by WPS errors of various types sometimes do occur (also see our Appeals & Grievances section on this webpage).  In order to receive a claim reimbursement due you when this type of payment error happens, please remain calm and be cooperative to help resolve the matter.  Thank You!

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XIII.  Appeals & Grievances

• File an Appeal •

1.  Filing an Appeal.  Beneficiaries who disagree with certain benefit-related decisions made by the Defense Health Agency (DHA) or by a TRICARE contractor have the right to appeal those decisions.  The appeals process varies depending on whether the denial of benefits involves a medical necessity determination, factual determination, provider authorization, provider sanction, and/or a dual-eligible determination.  Beneficiaries will be notified of the appeals process they should follow at the same time they receive a written decision.  All initial determination and appeal denials explain how, where, and by when to file the next level of appeal.  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, 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 file a grievance.  The grievance process allows 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 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.  The TRICARE Overseas Program Contractor (International SOS) 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.

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XIV.  Medicare & TRICARE

• Medicare Part B & TRICARE •

*** Defense Manpower Data Center (DMDC) - milConnect *** Life Events That Impact Your Benefits - Medicare TRICARE and Medicare - Under Age 65 TRICARE and Medicare - Turning Age 65

*** Social Security Disability Insurance (SSDI) Beneficiaries *** Reminder:  Social Security Disability Insurance beneficiaries become eligible for Medicare beginning the 25th month of receiving disability payments.  In this situation, if you're an SSDI beneficiary and wish to remain TRICARE-eligible, you must enroll in, and continue to pay, the monthly Medicare Part B premium.

*** Medicare Enrollment Coverage Changes Effective January 1, 2023 *** "Medicare Part B coverage becomes effective the month after enrollment for individuals enrolling in the last three months of their Initial Enrollment Period or in the General Enrollment Period, thereby reducing any potential gaps in coverage." When Does My Medicare Coverage Start?

1.  Medicare & TRICARE.  Age 65 is when most individuals (sponsor or dependent) first become eligible for premium-free Medicare Part A (hospital insurance).  In order to keep your TRICARE benefits (TRICARE For Life) when you first become eligible for premium-free Medicare Part A (based on your 65th birthday or earlier due to certain disabilities, end-stage renal disease at any age, Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's disease), or mesothelioma) 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."

• Frequently Asked Question:  Since 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:  Public law is written as such in the FY 2001 National Defense Authorization Act (NDAA) (Public Law 106–398—Oct. 30, 2000) (Section 712, p. 176).

• You become eligible for Medicare Part A at age 65 if you or your spouse paid into Social Security for at least 40 quarters (at least ten years of work).  To avoid a break in TRICARE coverage enroll in Medicare Part B no later than two months before you turn 65 (see paragraph 4 below in this section).

2.  Beneficiaries Who Don't Qualify for Medicare Part A.  Pertaining to Medicare Part B enrollment at age 65, in certain limited cases you may not be required to enroll in Medicare Part B at age 65 to retain your TRICARE eligibility.  The operative word being may.  One such scenario is having less than the required 40 Social Security work credits (10 years of work).  In two contrasting actual examples concerning two retirees that each did not have the required number of Social Security work credits (nor did their respective spouse), one was required to enroll in Medicare Part B at age 65 to remain TRICARE eligible, the other was not.  The difference?  Even though the first retiree did not have the required number of work credits (quarters of coverage), he did pay Medicare taxes for the required quarters of coverage while employed to be eligible for premium-free Medicare Part A.  (This topic is explained in further detail at:  Original Medicare (Part A and B) Eligibility and Enrollment).

• TRICARE Beneficiaries:  If you are not entitled to premium-free Medicare Part A when you turn 65 under your own Social Security number (SSN), you must file for benefits under your spouse’s (this includes divorced or deceased spouses) SSN if he or she is 62 or older.  If your spouse is not yet 62, and you anticipate that he or she will be eligible for premium-free Medicare Part A at age 65, you should sign up for Medicare Part B when first eligible at age 65 to avoid paying a late-enrollment premium surcharge.  You should then file for Part A benefits under your spouse’s record two months before he or she turns 62.  If neither spouse will be eligible for premium-free Medicare Part A, neither will need Medicare Part B to remain TRICARE-eligible.  Source:  TRICARE For Life Handbook.

3.  TRICARE Eligibility Determination.  Not all individual situations are straightforward or clear as to when (or possibly if) you or your spouse is required to enroll in Medicare Part B to retain TRICARE benefits.  Begin by carefully reviewing the related TRICARE-Medicare publications linked on the TRICARE website.  If you do have TRICARE eligibility questions that are related to Medicare enrollment, contact DEERS.  The service branches through DEERS are the only legally authorized agencies 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) and you're unsure as to whether or not you're required to enroll in Medicare Part B to remain TRICARE-eligible, 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, it's best to request it well before you enter your Medicare Initial Enrollment Period (see paragraph 4 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.

• Avoid a Break in TRICARE Coverage •

4.  Retired Service Members and Families.  Since Medicare does not provide benefits for medical care received outside of the U.S., TRICARE is the primary source of health benefits.  You become eligible for Medicare Part A at age 65 if you or your spouse paid into Social Security for at least 40 quarters (at least ten years of work).  You must have Medicare Part A and B in order to have TRICARE coverage when you are 65.  Or you must have proof of your ineligibility for Medicare.

• Initial Enrollment Period (Medicare 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, 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 - Enrollment •

5.  In certain situations you may apply online for Medicare Part B, or you may have to email or phone SSA Manila to start the Medicare Part B enrollment process (or to confirm enrollment).  Local Handout (Bilingual):  TRICARE & Medicare Part B.

• "Residents of Puerto Rico or foreign countries will not receive Part B automatically.  They must elect this benefit."
  
  

• Social Security Administration - Manila •     Federal Benefits Unit (FBU) - Manila:     Web:  Social Security Administration - Manila     Phone:  +63-2-5301-2000 Option 3 (after language)     Fax:  +63-2-8708-9714     Online:  Inquiries for the Federal Benefits Unit     (Online Inquiry is the preferred contact method)         Phone Hours:     Tues & Thurs | 8:00 am - 11:00 am (Manila Time)     Closed U.S. & Philippine Holidays     Address:     U.S. Embassy - Manila     Social Security Administration     1201 Roxas Boulevard     Manila, Philippines 0930 SSA:  Medicare Benefits  |  Medicare Booklet Medicare:  Medicare.gov  |  Medicare & You Handbook

>>> JUSMAGTHAI TRICARE Office Note:  To set straight incorrect information published in the December 2015 JUSMAGTHAI RAO newsletter stating that "... registering for MEDICARE Part B are handled by the DEERS office.", the JUSMAGTHAI DEERS office does NOT handle Medicare Part B enrollment.  No DEERS office does.  The Social Security Administration manages Medicare Part B enrollment.  What DEERS offices worldwide can do is to verify if Medicare Part B enrollment is recorded in your DEERS record after you enroll in Medicare Part B.  When the member enrolls in Medicare Part B, Medicare [normally] notifies DEERS that Part B has been obtained.  If Medicare does not automatically notify DEERS, you can present your official Medicare Part A/B card or Medicare enrollment confirmation letter to DEERS office staff and they in-turn can use it to update your DEERS record.  Again, Medicare Part B enrollment is managed by the Social Security Administration.

• Medicare Part B - Late Enrollment •

6.  Late Enrollment in Medicare Part B.  For every 12-month period beyond your Medicare Part B Initial Enrollment Period (based on your 65th birthday, or earlier due to certain disabilities, end-stage renal disease at any age, Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's disease), or mesothelioma) that you wait before you enroll, you incur a 10% surcharge that's added to the monthly premium (for life).  In this scenario, you can then only enroll in Medicare Part B during the annual General Enrollment Period of January-February-March (When Does Medicare Coverage Start?).  To enroll or confirm enrollment in Medicare Part B, contact FBU Manila (SSA).

• Information Mailed to Beneficiaries •

7.  "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 - FAQs 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 3 months prior to the beneficiary's Medicare effective date.

• The Turning 65 Medicare *Postcard* or *Email* is prepared by TRICARE and mailed by DMDC 5 months prior to the month that the beneficiary turns 65.

• The Under 65 Medicare *Postcard* or *Email* is prepared by TRICARE and mailed by DMDC after CMS (Centers for Medicare & Medicaid Services) notifies DMDC that the beneficiary is Medicare eligible.

8.  When you read your Medicare notification letter from TRICARE, take the time needed to fully understand it.  The same applies to the Medicare & You Handbook.  Each one contains important TRICARE and Medicare benefits details.

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

• Address Change - SSA / Medicare •

***Submit SSA / Medicare Change of Address *** Please complete the FBU Manila online inquiry form: Inquiries for the Federal Benefits Unit (FBU Manila) "A person with a U.S. address who is outside the U.S. for 90 days must use an address within the foreign country.  A client may use any address in Thailand including a Thai PO Box if they prefer."

• Medicare Part B - Effective Date •

10.  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, see:  How do I get a replacement Medicare card?

• Note:  Social Security Numbers (SSNs) have been removed from all Medicare cards.  A new Medicare Beneficiary Identifier (MBI) replaced the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.  New Medicare Cards:  CMS.gov  |  Medicare.gov.

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XV.  Provider Resources

• Information • Providers - Tricare-Overseas.com Rates and Reimbursement TRICARE Service Centers (Pacific) • • • • Clinical Services • Health Care Quality & Safety

• Additional Assistance • Provider Education Material - Tricare-Overseas TRICARE Provider Education Letter CMS-1500 - Health Insurance Claim Form TRICARE Hospitalization Summary - Worksheet Register (Provider)  |  Help - Overseas TRICARE Area Office-Pacific - TAO-P (Japan)

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XVI.  TRICARE and the Affordable Care Act (ACA)

*** 2017 Tax Cut and Jobs Act *** The ACA "Individual Mandate" that required basic health insurance coverage or pay a tax penalty has been repealed effective January 1, 2019.

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XVII.  Thailand Visas & Immigration

*** Courtesy Notice *** The Royal Thai Government (RTG) requires health insurance coverage for certain Non-Immigrant Visas.  The RTG also continues to make short-notice changes to Immigration and Entry requirements/procedures. Royal Thai Embassy, Washington, D.C. Thai General Insurance Association (TGIA)

1.  Pertaining to the Royal Thai Government's Foreign Insurance Certificate (aka Overseas Insurance Certificate) that they say may be used when applying for certain Thai Non-Immigrant Visas, the U.S. Defense Health Agency (DHA) has ruled that it cannot ethically sign the certificate due to there being no contractual TRICARE Overseas direct billing for U.S. military retiree beneficiaries.  In short, DHA cannot guarantee to the Royal Thai Government that a TRICARE retiree beneficiary (and applicable family members) would indeed pay their medical bills.

2.  Although DHA cannot ethically sign the aforementioned Thai "Foreign/Overseas Insurance Certificate", the TRICARE Area Office-Pacific (TAO-P) may sign a TRICARE coverage explanation letter upon request.  Just be advised that the coverage explanation letter is not proof of TRICARE coverage (click here for information on how to get proof of TRICARE coverage).  As always, it's at the RTG's sole discretion whether or not to accept the TRICARE letters (or any other health insurance letters for that matter).  Lastly, direct all questions about the TRICARE coverage explanation letter to TAO-P (the JUSMAGTHAI TRICARE office is not involved with letter issuance).

3.  Thai *Visas* are issued by the Royal Thai Ministry of Foreign Affairs.  *Extensions of Stay* (and in certain instances a 90-Day Non-Immigrant "O" Visa based on retirement) are issued by local Royal Thai Police Immigration Bureau offices (Ministry of Interior).  Direct your questions to the applicable Royal Thai Government agency.

• Local Note:  There is no official Thai Immigration procedure known as "Renewing a Visa" or "Visa Renewal".  The Thai Immigration ink stamp placed in a passport reads "Extension of Stay Permitted Up To <Date>".  An "Extension of Stay" may be renewed, a Visa cannot.  Even though Thai Immigration often uses the translated English term "Visa Renewal", it is still incorrect terminology and the source of much confusion to expats unfamiliar with the difference.

4.  JUSMAGTHAI and U.S. Embassy staff diligently worked the health insurance coverage issue with the Royal Thai Government (RTG) on behalf of U.S. military retirees to request that the RTG accept TRICARE via blanket authorization. Unfortunately, the Royal Thai Government will not give blanket authorization for TRICARE even though TRICARE is recognized as being far superior to locally available health insurance products.

5.  TRICARE staff isn't qualified or authorized to answer Thai Visa and Thai Immigration questions, and is not involved with Royal Thai Government application decisions.  Again, this information is provided strictly as a COURTESY.

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• TRICARE Overseas • * Pacific Area - International SOS, Singapore * Email:  sin.tricare@internationalsos.com • Customer Service • Regional Direct:  +65-6339-2676 or Toll Free:  0018004418952 • Medical Assistance • Regional Direct:  +65-6338-9277 or Toll Free:  0018004417902 Web:  https://www.tricare-overseas.com • • • • TRICARE Claims Inquiries (USA) - Overseas Claims Processor • Wisconsin Physicians Service (WPS) Telephone:  1-877-451-8659 (Toll Outside U.S.) Client Service Hours:  Sunday, 7pm CT - Friday, 7pm CT (Open 24 hours in between those days/times and closed on Saturday)

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• JUSMAGTHAI - TRICARE Staff • Tel:  02-287-1036 Ext. 511 Fax:  02-287-1575 ______________________ • Retired Service Members in Thailand • Email:  tricarert@jusmagthai.org * * * • Assigned to Mission Thailand • Email:  tricareth@jusmagthai.org	• Street Address • HQ JUSMAGTHAI TRICARE Services, Rm. D-110 7 Sathorn Tai Rd. Bangkok 10120 Thailand ______________________ • U.S. Diplomatic Pouch Address • JUSMAGTHAI ATTN:  TRICARE Office 7200 Bangkok Place Washington, D.C. 20521-7200 (Postage Required)

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*** TRICARE Office (Thailand) - Retiree Walk-In Service Hours *** > > >  Tuesday - Wednesday - Thursday < < < Time:  0800-1100 ! ______________________________________________________________ • Lengthy or Complicated Issues:  Please Email or Call to make an Appointment • ______________________________________________________________ *** Closed U.S. & Thai Holidays *** (Also closed when Mission duties take us away from the office.) ______________________________________________________________ Building "D", Room D-110 (Turn Left After Entering the Main Gate) (To Request Entry - Press the Intercom Button to the Left of the Door) * TRICARE Pacific Health Benefits Advisor - Bangkok, Thailand * Reviewed & Updated:  15 May 2023 (The appearance of hyperlinks does not constitute endorsement by the U.S. Department of Defense (DoD) of the information, products or services contained therein.)

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