Coverage

- Please be aware that private hospitals in Panama have the discretion to accept or reject different types of insurance. If your VA-FMP, Tricare, or CHAMPVA coverage is not accepted by a private hospital, you may incur out-of-pocket expenses for medical services.

 

 IMPORTANT for dependents: - When visiting any Hospital in the Republic of Panama  for medical services using TRICARE Select or TRICARE for Life, it's essential to have a photocopy of the sponsor's ID card and a know their Social Security Number (SSN). Failing to provide this information could lead to the hospital staff being unable to confirm your eligibility for medical services, resulting in the necessity to pay for your services upfront in cash. Being well-prepared with the required documentation can help ensure a smoother healthcare experience and avoid any unnecessary delays.

 

– It's important for retirees to be aware that TRICARE Prime does not offer coverage overseas. If you're planning to relocate to Panama, it's recommended to get in touch with TRICARE before the move and switch your coverage from TRICARE Prime to TRICARE Select. This advice also extends to any family members who will be relocating with you. By making this transition, you can ensure that you have the appropriate healthcare coverage that aligns with your international move.

 

– CRITICAL!!!: As of January 2021, all TRICARE Select beneficiaries who are not under Tricare for Life must establish a monthly premium allotment either for their family or for themselves individually. Failing to set up this allotment with Tricare could result in the loss of Tricare medical coverage for you and your family. To ensure continuous coverage, it's advised to contact TRICARE at 800-444-5445 and set up the necessary allotment. This step is critical to maintaining your medical coverage.

 

NOTE:  It's important to consider your healthcare coverage when moving to Panama. If you don't have TRICARE Select or TRICARE for Life and instead have VA-FMP (Foreign Medical Program), and your family isn't covered by CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), you have the option of using BLUE CROSS - BLUE SHIELD International (BCBS-I). However, it's essential to verify your eligibility before proceeding. Before your move to Panama, it's recommended that you inquire with the BCBS-I insurance company to ensure they provide coverage for you and your family while living overseas, specifically in Panama. This step is crucial to guarantee that you'll have adequate healthcare coverage during your time in Panama. By being proactive and making the necessary inquiries, you can help ensure the well-being of you and your family in a new country.

 

Retired and non-retired veterans overseas, with a VA awarded disability of 0% to 100%, are covered under the VA Foreign Medical Program (FMP).  The veteran must register with VA-FMP.      https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp

- For veterans who do not possess a VA ID, the process involves visiting a VA hospital or clinic during their return to the United States. It's essential to take a copy of your DD214 for verification purposes while requesting a VA ID. It's important to note that while the VA ID is not mandatory for accessing medical services abroad, specifically for those with VA awarded service-connected disabilities, a different protocol applies. Overseas, the only requirement is the VA-FMP benefit letter, which comprehensively outlines the awarded disabilities. This documentation is sufficient for individuals to receive the necessary medical services related to their service-connected disabilities while overseas.

NOTE: If a veteran does not have service-connected VA awarded disabilities, they will not be eligible for VA-FMP (Veterans Affairs Foreign Medical Program) medical coverage while overseas. In order to determine eligibility and potentially claim service-connected disabilities, it is recommended that individuals seek guidance and assistance from their nearest Veterans Claims Assistant (VCA). These knowledgeable professionals can provide valuable support in navigating the process of claiming service-connected disabilities and understanding the benefits available through VA-FMP.

 

- CHAMPVA, the Civilian Health and Medical Program of the Department of Veterans Affairs, provides medical coverage for dependents of veterans designated as 100% Total and Permanently disabled by the VA. Through CHAMPVA, these eligible family members gain access to vital medical services and necessary medications, ensuring that the support and care provided to veterans extend seamlessly to their dependents. This provision serves as a recognition of the sacrifices and contributions made not just by the veterans, but also by their loved ones who stand beside them.  https://www.va.gov/COMMUNITYCARE/programs/dependents/champva/champva_eligibility.asp

To continue to receive CHAMPVA benefits after age 65, your spouse or surviving spouse must meet the following conditions:

* Turned 65 on or after 5 June 2001, your spouse or surviving spouse must be enrolled in Medicare Part A and Part B to remain eligible for CHAMPVA.

* If your spouse or surviving spouse turned 65 before 5 June 2001, and has Medicare Part A and Part B, they must keep Medicare Part A and Part B to be eligible for CHAMPVA.

* If your spouse or surviving spouse turned 65 or older before 5 June 2001, were eligible for CHAMPVA and do not have Medicare Part B coverage, then they remain eligible for CHAMPVA without having to have Medicare Part B coverage.

 

The 100% T&P non-retired veteran and his dependents are also authorized DOD ID Cards for entry into military installations. They will have access to commissaries, PX/BX and MWR. 

 

Dependents of retired and non-retired 100% T&P veterans are entitled to Chapter 35, Dependents Educational Assistance (DEA), to be used towards a degree in VA certified colleges and universities.

 

TRICARE Select, TRICARE for Life and CHAMPVA beneficiaries are responsible for the 25% co-pay for medical services and medications.

– TRICARE Select, TRICARE for Life (TFL) and CHAMPVA can be used for medical services and medications.  The  25% co-pay is required. 

 

 – The VA Foreign Medical Program (FMP) can be used for VA awarded disabilities from 0% to 100%. VA awarded disabilities are covered overseas if listed on the VA-FMP letter.     http://www.va.gov/PURCHASEDCARE/programs/veterans/fmp/index.asp

 

- Non-service connected disabilities that are not listed on the VA-FMP benefit letter are typically not covered by VA-FMP when overseas. However, there could be exceptions to this rule. In cases where a veteran needs medical care for non-service connected disabilities overseas, they are required to request approval from VA-FMP before receiving the medical treatment. Once the veteran obtains the VA-FMP approval letter for the treatment of these non-service connected disabilities overseas it is recommended to provide a copy of the VA-FMP approval letter to the hospital, as this is necessary for the hospital to initiate a verification call to VA-FMP and ensure the coverage for the treatment. This process emphasizes the need for proper authorization and communication between the veteran, VA-FMP, and the medical facility to ensure that the necessary approvals are in place for the coverage of non-service connected disabilities. It's always a good practice to follow the specific procedures outlined by VA-FMP and the medical facilities to ensure a smooth and hassle-free process for medical treatment overseas.

 

– Always remember, when it comes to veterans overseas, they will receive medical care and medications for VA-awarded disabilities listed on the VA-FMP (Foreign Medical Program) benefit letter. It's important to note that the VA ID is not a requirement for receiving medical services while overseas. Instead, the VA-FMP benefit letter, along with an additional form of identification, is necessary for verifying eligibility for these services. This ensures that eligible veterans can access the medical care they deserve, even when living abroad.

 

– In the United States, all veterans are entitled to medical care at any VA hospital, service-connected or not. Co-payments may apply.

 

Create your va.gov online account to view your VA disability list, compensation payments, claim decision letters, apply for VA compensation, request copies of your DD-214, military personnel and medical files and many other services.    https://www.va.gov/

 

FOR MILITARY RETIREES ONLY:
TRICARE Prime (TP) does not provide coverage overseas. Ensure you are enrolled in TRICARE Select Overseas (TSO). Call the TRICARE customer service 215-942-8393 or 877-451-8659. You must disenroll from TRICARE Prime to be placed on TSO.

 

Use your online TRICARE overseas account to manage and view your Explanation of Benefits (EOBs) and upload reimbursement claims directly to the TRICARE claims department. You have 3 years to submit a claim from overseas. Create your online TRICARE account at:

 http://www.tricare-overseas.com/beneficiaries

 

If you are receiving retired military pay, and do not have an online DFAS MyPay account, go to https://mypay.dfas.mil/mypay.aspx and create your account. At this site you can manage changes to your account, download the 1099-R and 1095-B for tax time, designate beneficiaries for Arrears of Pay (AOP), Survivor Benefit Plan (SBP) and other options.

 

If you have questions or require assistance, please contact one of the Veterans Claims Assistant (VCA). Click on “VCA” on the Main Menu for details.

 

NOTE:

By law, MEDICARE Part-B does NOT provide coverage overseas.

VERY IMPORTANT !–>  Retirees/widows/widowers: You CANNOT cancel MEDICARE Part-B at any time or you will drop out of TRICARE for Life or CHAMPVA and not be insured.

 

For retired veterans and their spouses, ensure you sign up for MEDICARE Part-B six to three months prior to your 65th birthday. You will drop out of TRICARE and not be medically insured if you do not have MEDICARE Part-B at age 65.  Manage this most important life event very carefully and don't miss it.  Permanent penalties apply if you register in MEDICARE Part-B after age 65. 

 

Medicare Part-B is Mandatory by Law to continue TRICARE coverage, even if it does not provide coverage outside of the US.

 

To keep TRICARE coverage, when military retirees and their spouses turn age 65, they must enroll in Medicare Part-B and pay the standard Part-B monthly premium.

https://www.tricare.mil/LifeEvents/Medicare/Retiree_and_Family

https://www.tricare.mil/Plans/HealthPlans/TFL/TFL_O.aspx

 

Even though Medicare does not provide coverage outside of the US, Public Law 106-398, October 30, 2000, mandates Medicare Part-B enrollment if you wish to remain eligible for TRICARE for Life (TFL) at age 65 and beyond.

 

Apply for Medicare Part-B six to three months before your 65th birthday to avoid a break in TRICARE for Life coverage.

 

By taking a few simple steps, you can make sure you have your TRICARE benefits at age 65 and beyond.

 

Four months before your 65th birthday, you should receive a postcard from the Defense Manpower Data Center (DMDC), the office that supports the Defense Enrollment Eligibility Reporting System (DEERS), with information about keeping TRICARE coverage at age 65 and beyond.

 

If you do not receive a postcard from DMDC, call them at (800) 538-9552.

 

You must have Medicare Part A and Medicare Part B to be eligible for TRICARE For Life, even if you live overseas and it does not provide coverage.

 

TRICARE For Life is the Medicare wrap-around coverage for TRICARE beneficiaries who are entitled to Medicare Part A and have Medicare Part B regardless of where you live.

 

The Medicare initial enrollment period is seven months. If you miss your initial enrollment period, your next chance to sign up for Medicare Part B is during the general enrollment period, Jan. 1 – March 31. Your coverage will begin July 1st, and your monthly premium for Part B may go up 10 percent for each 12-month period that you could have had Part B, but didn’t sign up for it. Also, there will be a lapse in your TRICARE coverage until Part B is effective.

 

Overseas, your nearest US Embassy Federal Benefits Unit (FBU) can also assist with Medicare Part-B enrollment. Oftentimes when you tell the Embassy officer that you are retired military, or the spouse/survivor of a retired military service member, the embassy officer may say that you do not need Medicare Part-B overseas, they are INCORRECT. US Embassies overseas make this mistake and the beneficiary will be penalized by the SSA for enrolling late in Medicare Part-B to maintain TRICARE for Life.

 

** Another way to enroll:

- If you are a military retiree, age 65, and already receiving SS retirement benefits, please enroll by completing Form CMS-40B.

- If you are a retiree, age 65, and have not applied for SS retirement benefits yet, please enroll in Medicare Part-B by completing Form CMS-40B or online at https://www.ssa.gov/benefits/medicare

- If you are a spouse or survivor of a retiree, aged 65, please enroll in Medicare Part-B by completing Form CMS-40B

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

- You can also apply for Medicare Part-B using your online SS account

Important: when applying for Medicare Part-B and have not applied for SS retirement benefits yet, the Social Security Administration (SSA) will contact you for further information. Provide a valid phone number, and area code, where you can be contacted.

 

REMEMBER: If you are enrolling in Medicare Part-B to keep your TRICARE for Life benefits, you must answer “YES” when the Social Security representative asks if you want to enroll in Medicare Part-B.

 

**For survivors (widow/widower), on Form CMS-40B, include the following in “Remarks”:

1) Your Deceased spouse’s Name and Social Security Number (SSN) if you do not have your own SSN

2) The word “TRICARE”

3) Indicate if you are receiving benefits from the Department of Veterans Affairs (VA). Write “VA Survivors Pension”

4) Write “Interpreter” and the language you require, if you need translation assistance for the follow-up telephone interview 

 

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Veterans Claims Assistant (VCAs) are available to provide guidance and assistance. Click “VCA” on the main menu for details.