US Military and FED retiree medical insurance questions

[Lynn S]

I am retired from the Navy Reserve and eligible for Tri-care, but the processing is reported to be a year behind.
I am also retired from civil service.
My wife is Thai and we plan on relocating to Chiang Mai near her family by the end of the year.
Chiang Mai Ram is listed as accepting Tri-Care Overseas.

Question: will I need my civilian insurance? should I drop it to a minimal insurance plan?
 

[Sheryl]

I think it depends on your overall financial situation.

 

Tri-Care reimburses after the fact, there is usually not direct billing. So you have to front the costs.  If this would be difficult, you might want to maintain private insurance. But perhaps with a large deductible (how large depending in what you can afford).

 

As a general indication, really major hospitalization in private hospital can run 3-5 million baht. An average hospitalization, more like 400-500k baht. Outpatient care is usually quiet affordable.

 

If you are now in the US, your US civilian insurance likely does not cover you abroad - check the policy wording carefully. I have yet to find any US policy that provides cover for people living outside the US.

 

If hospitalized, request to pay the bill on a daily or every other day basis, that will enable you to submit for reimbursement in stages, Don't wait for the final bill.

[Langsuan Man]

2 hours ago, Lynn S said:

I am retired from the Navy Reserve and eligible for Tri-care, but the processing is reported to be a year behind.
I am also retired from civil service

Question: will I need my civilian insurance? should I drop it to a minimal insurance plan?

 

Depends upon your insurance, Blue Cross / Blue shield will cover you overseas at select hospitals direct billing or will just reimburse you after you have paid, minus your deductible 

 

You also need to consider Medicare into your planning, especially when you get to the magic age where TRI-Care forces you to pay for Medicare Part B 

[Sheryl]

1 hour ago, Langsuan Man said:

Depends upon your insurance, Blue Cross / Blue shield will cover you overseas at select hospitals direct billing or will just reimburse you after you have paid, minus your deductible 

 

 

Are you sure that is true if living overseas (as opposed to emergency care while travelling)?

[Langsuan Man]

19 hours ago, Sheryl said:

 

Are you sure that is true if living overseas (as opposed to emergency care while travelling)?

Once again it all depends upon your definition of "traveling" or "living". 

 

I live here for 6 months of the year and 6 months in the US and BC/BS has paid both ways, reimbursement and direct billing.  And since they are receiving both my monthly payments from my pension plus the government's contribution they have never questioned my "status" 

 

May also have to do the the fact that I am in the FEP (federal employee program)

[lopburi3]

As retired Civil Service he should be eligible for several nationwide/international insurance plans from Government - FEP/Blue Cross/Blue Shield is one of them and and is also available to family (but would require survivor benefits after death to pay).  These plans are nationwide and for overseas full time (used by State Department and such who work overseas).  This plan has limited number of hospitals with direct pay for inpatient but in most cases you would pay and file claim and that would be true for all outpatient.  

[marcusarelus]

On 3/18/2019 at 11:06 AM, Sheryl said:

I think it depends on your overall financial situation.

 

Tri-Care reimburses after the fact, there is usually not direct billing. So you have to front the costs.  If this would be difficult, you might want to maintain private insurance. But perhaps with a large deductible (how large depending in what you can afford).

 

As a general indication, really major hospitalization in private hospital can run 3-5 million baht. An average hospitalization, more like 400-500k baht. Outpatient care is usually quiet affordable.

 

If you are now in the US, your US civilian insurance likely does not cover you abroad - check the policy wording carefully. I have yet to find any US policy that provides cover for people living outside the US.

 

If hospitalized, request to pay the bill on a daily or every other day basis, that will enable you to submit for reimbursement in stages, Don't wait for the final bill.

Check with the hospital some direct bill for FMP.  I emailed the Hospital rep and sent her my paperwork and worked out direct billing.  JUSMAGTHAI has the information.  

[Lynn S]

Thanks for all the info.  Most of it is very useful.
In the past I have submitted claims to my private insurance (GEHA) for services in Thailand and they did pretty good at reimbursement.  Chiang Mai RAM advertises they will assist with paperwork and submit direct to Tri-Care Overseas.  The more I research Tri-Care Overseas, the better it looks.  I will switch to that as soon as I can. I should be able to switch to a lower priced private insurance just to take care of loose ends.

[Lynn S]

On 3/17/2019 at 9:36 PM, Langsuan Man said:

Depends upon your insurance, Blue Cross / Blue shield will cover you overseas at select hospitals direct billing or will just reimburse you after you have paid, minus your deductible 

 

You also need to consider Medicare into your planning, especially when you get to the magic age where TRI-Care forces you to pay for Medicare Part B 

Looks like I need to do more reading!

[lopburi3]

Medicare is not required if you continue to use GEHA or FEP/Blue and such as those plans already provide as good coverage - and are usable worldwide - but having medicare may eliminate some fees (probably not enough to justify extra cost IMHO).  Indeed it does require research.

[Langsuan Man]

3 hours ago, lopburi3 said:

Medicare is not required if you continue to use GEHA or FEP/Blue and such as those plans already provide as good coverage - and are usable worldwide - but having medicare may eliminate some fees (probably not enough to justify extra cost IMHO).  Indeed it does require research.

Cost of Medicare Part B for 2019:  $135.50 per month (taken out of Social Security) + Medicare deductibles

Cost of FEP/Blue for 2019:      $224.46 per month (taken out of your retirement) + no deductibles if on Medicare and use BC as "supplemental"

 

The above are for single payers, not families