VA Health Care for Expat Veterans

[Utley]

Expat Veterans - Bringing awareness to the fact that Veterans who live outside of the U.S. are excluded from receiving VA Medical Care.

 

 

An open letter to:

Secretary David Shulkin M.D.

Department of Veterans Affairs

810 Vermont Avenue NW

Washington DC 20420-0002

 

There has been much talk recently about privatizing elements of the Department of Veterans Affairs to have a system where veterans can choose to either receive health care from VA medical facilities or private medical facilities.  When this change is fully or partially implemented, please do not exclude veterans who live outside of the U.S. from the program.

 

I am a Vietnam Veteran living in Thailand (while still a registered voter in the 8th district of Brevard County, Florida) and I am currently prohibited from receiving VA medical care locally as the VA has no medical facilities in Thailand.  If the VA changes their policy and allows veterans to receive medical care from private medical facilities, there is no logical, ethical or moral reason to exclude those of us who live outside of the U.S.  The private medical facilities in Thailand charge substantially less (about ½) than those in the U.S. while the quality of the medical care that they provide is equal to and often better than that found in the U.S.

 

Many Vietnam Veterans have Hepatitis C, for instance, but they can’t get treatment from the VA unless they leave their Thai families and return to the U.S.  That just isn’t right!  We fought hard for our country.  To deny us medical care because we live outside of the U.S. is akin to breaking the contract made with us when we raised our right hands and took the oath to protect and uphold the Constitution of the United States.  Please do not leave us behind.

 

#VietnamVeterans #VAHealthCare #CongressmanPhilRoe #SenatorJohnnyIsakson #SecretaryDavidShulkin

[Sheryl]

They are not excluded, they can and do receive care at VA facilities - but they have to travel to the US for it.

 

Same story for everyone covered under Medicare.

[Utley]

31 minutes ago, Sheryl said:

They are not excluded, they can and do receive care at VA facilities - but they have to travel to the US for it.

 

Same story for everyone covered under Medicare.

Do you think that is the way it should be?  Do you really think that someone should have to travel over 8,000 miles to receive medical care owed to them?

[Utley]

Due to the overcrowded conditions at many VA medical facilities in the U.S. and the long queues associated, there is a pilot program that allows veterans to opt to use private medical facilities.  If veterans in the U.S. can use private medical facilities, why can't  expat veterans do likewise?

[Thanyaburi Mac]

Some vets here do go to private Thai facilities, pay upfront, and successfully claim reimbursement from the VA.  

 

Would be nice if Medicare was similar.

 

Mac

[Utley]

That only works if the medical treatment is related to a VA approved, service related disability; reimbursement is through the FMP.  

 

The VA has never recognized Hep C as a military service related disability but the Vets state-side can receive free treatment at any VA Health facility.  Its the non-service related health care problems such as that I'm talking about.  Free or low cost to veterans in the U.S., not available to expat veterans.

 

Yes, it would be nice for Medicare too.  After all, it was our tax dollars.

[dddave]

On 1/24/2017 at 9:22 PM, Utley said:

there is a pilot program that allows veterans to opt to use private medical facilities.

From what I understand, this program is targeted at US resident veterans who live at inconvenient distances from their treatment facilities, especially in the case of ongoing treatments such as kidney dialysis, physical therapy and various types of counselling.  

[Utley]

2 hours ago, dddave said:

From what I understand, this program is targeted at US resident veterans who live at inconvenient distances from their treatment facilities, especially in the case of ongoing treatments such as kidney dialysis, physical therapy and various types of counselling.  

Yes, but why the restriction to U.S. based veterans?  Why not all veterans worldwide?

[wpcoe]

My cynical political view is that a newer generation is taking control of these policies and view such "entitlements" as merely drags on the federal budget.  There's no logical, rational reason why certain hospitals in Bangkok couldn't be certified by the VA and Medicare to administer health care to U.S. veterans and retirees, but to the young'uns in power, why bother?

 

Just like careers-for-a-lifetime and defined benefit pension plans, the New World Order is that such policies would merely be a drain on resources and certainly sacrifice-able.   Harrumph. </rant off>

[Langsuan Man]

Who is standing at the airports in the US forcing "veterans" to retire in Thailand ?

 

Did the OP move to Thailand and then they suddenly changed the rules ?

 

Did the OP not take into account that moving to a foreign country would entail the loss of certain benefits ?

 

The military guys who retired here understood that they would have to enroll in Tricare,  pay a large deductible, and in many cases outlay cash for their treatment and then make a claim  (not to mention being forced to pay for Medicare Part 
B that they can't use overseas)

 

Seems to me someone failed the due diligence test before retiring here 

 

 

[Utley]

17 minutes ago, Langsuan Man said:

Who is standing at the airports in the US forcing "veterans" to retire in Thailand ?

 

Did the OP move to Thailand and then they suddenly changed the rules ?

 

Did the OP not take into account that moving to a foreign country would entail the loss of certain benefits ?

 

The military guys who retired here understood that they would have to enroll in Tricare,  pay a large deductible, and in many cases outlay cash for their treatment and then make a claim  (not to mention being forced to pay for Medicare Part 
B that they can't use overseas)

 

Seems to me someone failed the due diligence test before retiring here 

 

 

Just because that is the way it is doesn't mean that is the way it has to be.  Congress made the rules and Congress can change the rules.

[Utley]

9 hours ago, wpcoe said:

My cynical political view is that a newer generation is taking control of these policies and view such "entitlements" as merely drags on the federal budget.  There's no logical, rational reason why certain hospitals in Bangkok couldn't be certified by the VA and Medicare to administer health care to U.S. veterans and retirees, but to the young'uns in power, why bother?

 

Just like careers-for-a-lifetime and defined benefit pension plans, the New World Order is that such policies would merely be a drain on resources and certainly sacrifice-able.   Harrumph. </rant off>

If you think about it, American citizens should be encouraged to retire overseas where health care is less expensive than the U.S.  Using medicare and veterans health care overseas would use less of our tax dollars than using those same services in the U.S.  Encouraging retirement overseas might actually help balance the budget!

[SaintLouisBlues]

2 minutes ago, Utley said:

If you think about it, American citizens should be encouraged to retire overseas where health care is less expensive than the U.S.  Using medicare and veterans health care overseas would use less of our tax dollars than using those same services in the U.S.  Encouraging retirement overseas might actually help balance the budget!

Exactly, it should clear up the $587.33 billion deficit in a matter of ... weeks?

[Utley]

9 minutes ago, SaintLouisBlues said:

Exactly, it should clear up the $587.33 billion deficit in a matter of ... weeks?

To that I cannot attest but I do know one thing; if we do nothing then nothing will change.  I encourage you to go to Expat Veterans to get the names and addresses (and sometimes emails) of those in Congress that can effect change.  I know it is a long shot, but what better do you have to do with your time today?

[SaintLouisBlues]

8 minutes ago, Utley said:

I know it is a long shot, but what better do you have to do with your time today?

The usual - reading uninformed posters on TV who are clearly living on Fantasy Island

[Utley]

2 minutes ago, SaintLouisBlues said:

The usual - reading uninformed posters on TV who are clearly living on Fantasy Island

Why in the world must you be so bitter?

[SaintLouisBlues]

Just now, Utley said:

Why in the world must you be so bitter?

Bitter - you clearly haven't read my other posts about how much fun I'm having this week

[Utley]

3 minutes ago, SaintLouisBlues said:

Bitter - you clearly haven't read my other posts about how much fun I'm having this week

You are correct; I don't recall having ever read one of your posts.

[Sheryl]

On 1/25/2017 at 1:48 PM, Utley said:

.....Yes, it would be nice for Medicare too.  After all, it was our tax dollars.

 

What I find particularly egregious, regarding Medicare, is that expats living abroad and paying out of pocket for health insurance are fined if they do nto also purchase Medicare Part B, which they canot use while living abroad. A substantial fine that is life long.

 

Expats living abroad are exempted from the fine if they have health insurance through an employer, which few medicare eligible people would have, but there is no exemption for those who have insurance they buy themselves.

 

No this is both illogical and outrageous.... either we should have options to use Medicare overseas or we should be exempted from purchasing Part B unless/until such a time as we move back to the US.

[Utley]

31 minutes ago, Sheryl said:

 

What I find particularly egregious, regarding Medicare, is that expats living abroad and paying out of pocket for health insurance are fined if they do nto also purchase Medicare Part B, which they canot use while living abroad. A substantial fine that is life long.

 

Expats living abroad are exempted from the fine if they have health insurance through an employer, which few medicare eligible people would have, but there is no exemption for those who have insurance they buy themselves.

 

No this is both illogical and outrageous.... either we should have options to use Medicare overseas or we should be exempted from purchasing Part B unless/until such a time as we move back to the US.

Are you sure about the fine?  I have been receiving SS for several years and have always opted out of "Part B" Medicare.  I have never been fined nor have I ever read that Part B was mandatory for expats (I do not maintain a U.S. residence).

[WaywardWind]

53 minutes ago, Sheryl said:

 

What I find particularly egregious, regarding Medicare, is that expats living abroad and paying out of pocket for health insurance are fined if they do nto also purchase Medicare Part B, which they canot use while living abroad. A substantial fine that is life long.

 

Expats living abroad are exempted from the fine if they have health insurance through an employer, which few medicare eligible people would have, but there is no exemption for those who have insurance they buy themselves.

 

No this is both illogical and outrageous.... either we should have options to use Medicare overseas or we should be exempted from purchasing Part B unless/until such a time as we move back to the US.

Expats can opt out of Medicare Part B.

 

You either do so in person at a Social Security office while in the US, or file a form CMS-1763 with a special office in Jamaica, NY.

 

I went through this last year when I turned 65.

 

The form can be downloaded at https://secure.ssa.gov/apps10/poms/images/Other/G-CMS-1763.pdf

 

The address to which I mailed the form was Social Security Administration, Northeastern Program Service Center

155-10 Jamaica Ave, Jamaica,  NY 11432-3898.

 

 

[Sheryl]

Yes, you can opt out. Nothing to do with being an expat, anyone can opt out.

 

But if you ever later need to enroll you will be fined 10% for each year that you had opted out and this will be applied for the rest of your life or as long as you are enrolled.

 

Example: Opt out for 10 years and then need to return to the US for medical care and enroll then. Your premium will have a 100% fine tacked on i.e. will be double what it should be for your income and will remain so permanently.

 

Clearly expats who have other health insurance covering them in the country where they reside should be exempted from this, but only those whose insurance comes from an employer are.

[WaywardWind]

28 minutes ago, Sheryl said:

Yes, you can opt out. Nothing to do with being an expat, anyone can opt out.

 

But if you ever later need to enroll you will be fined 10% for each year that you had opted out and this will be applied for the rest of your life or as long as you are enrolled.

 

Example: Opt out for 10 years and then need to return to the US for medical care and enroll then. Your premium will have a 100% fine tacked on i.e. will be double what it should be for your income and will remain so permanently.

 

Clearly expats who have other health insurance covering them in the country where they reside should be exempted from this, but only those whose insurance comes from an employer are.

Yes, but should really be considered by those who have no intention of ever returning to the US to reside.

[Sheryl]

Even if not planning to return to reside, one might wish to be able to return to get medical care.  That would be my only reason, but I'd like to have the option.

[wpcoe]

I believe that it's not only Medicare Plan B that has the penalty for late enrollment.  My sister made a mistake when choosing options and forgot to select the option that covers prescriptions (Plan D?) and while she was still 65 realized her mistake and was assessed a penalty (10%?) for "late enrollment."   That penalty will be applied for the rest of her life.

[dddave]

On 1/28/2017 at 11:46 AM, WaywardWind said:

You either do so in person at a Social Security office while in the US, or file a form CMS-1763 with a special office in Jamaica, NY.

 

I also opted out of "B" in person at an SS office in Boston a few months ago.  Nothing in "B" I wont get from the VA.

Just gotta come up with the airfare.

[WaywardWind]

6 minutes ago, dddave said:

I also opted out of "B" in person at an SS office in Boston a few months ago.  Nothing in "B" I wont get from the VA.

Just gotta come up with the airfare.

There is a small VA operation in Manila but you are right  - it is off to the US for anything serious.

[dddave]

Just now, WaywardWind said:

There is a small VA operation in Manila but you are right  - it is off to the US for anything serious.

I checked on the Manila option last year and was told it was for Philippine nationals who had served in the US military only...no expats need apply.

[WaywardWind]

10 minutes ago, dddave said:

I checked on the Manila option last year and was told it was for Philippine nationals who had served in the US military only...no expats need apply.

Hmmmm...not according to the VA website:

 

https://www.va.gov/directory/guide/facility.asp?ID=682

 

Not a big deal as it only a clinic, so services would be minimal. Anything that doesn't require lengthy hospital stays, I would just deal with here in Thailand.

[Utley]

2 hours ago, dddave said:

I also opted out of "B" in person at an SS office in Boston a few months ago.  Nothing in "B" I wont get from the VA.

Just gotta come up with the airfare.

That is my point exactly; why should an expat veteran have to leave his home and family to return to the U.S. for medical treatment from the VA.  It just doesn't make any sense.  Medical care in Thailand, even from private hospitals, is less expensive to the U.S. taxpayer than medical care from a VA facility in the U.S.  And there is less hardship on the veteran and his family when receiving medical care locally.  So I say, lets put a stop to this madness and get the rules changed.  I know it is a long shot, but the time has never been better with the new Trump administration now taking over.  They want to drain the swamp, how about starting with changing the archaic rules that prevents expat veterans from receiving medical care locally.

 

If you want to help and try to get the rules changed, please go to  Expat Veterans - Bringing awareness to the fact that Veterans who live outside of the U.S. are excluded from receiving VA Medical Care.