SEMBACH, Germany -- The winter holiday season is quickly approaching and with that comes visits by relatives, family and friends. The last thing on their mind as they plan their trips is getting sick and having to seek medical care while overseas. However, it is something that everyone should take into consideration before traveling abroad.
As a general rule, visiting relatives and friends who are not TRICARE beneficiaries are not eligible to receive healthcare from military medical treatment facilities.
Those visitors coming to Europe are encouraged to have private health insurance, or travelers insurance, if they seek medical care from a host-nation provider.
According to Regional Health Command Europe officials, they should expect to pay up front and then file with their insurance company to get reimbursed. If they don't have insurance, they could end up paying out of pocket and may not be reimbursed for their expenses.
For military retirees, whether they are TRICARE for Life back home, TRICARE Select or TRICARE Prime, the rules are still the same when they come overseas. They may be able to receive space-available care at the military medical treatment facility, or they can go off base and see any provider they like, as they do not require a prior authorization for most inpatient and outpatient services. However, there will be the standard copays/cost-shares and deductibles associated with their plan, according to the TRICARE website (www.TRICARE.mil)
TRICARE recommends that all eligible beneficiaries traveling to Europe contact International SoS customer service for assistance in finding a provider and understanding their benefits and potential out-of-pocket costs.
While not a complete and detailed explanation of benefits, the information in the paragraphs below provides an overall summary of who, where and how visitors to Europe can receive healthcare during their travels abroad.
ACTIVE DUTY SERVICE MEMBERS AND THEIR FAMILIES
Visiting active duty military and their family members enrolled in TRICARE Prime will need to request authorization from ISOS when seeking care outside of a medical treatment facility for urgent medical needs. Urgent medical concerns are those that cannot wait for your primary care provider, such as allergic reactions, cold or flu symptoms not managed with self-care, persistent diarrhea, sprains and strains and more.
In addition to providing the authorization for care, ISOS can also provide healthcare finder assistance. In some cases, they may be able to coordinate cashless, claimless billing, which means no up-front, out-of-pocket costs and the medical facility will file the claim for the patient. When possible, it is best to utilize a TRICARE network provider or facility. However, patients should be aware that many European medical facilities do not file claims, and to be safe, they should be prepared to pay up front.
Emergency care, for the potential loss of life, limb, or eyesight, works a little differently. When seeking medical attention for any of these situations, patients should seek care first and call ISOS once they are stable, typically no later than three business days from the date of emergency.
After patients call ISOS, they should make sure to write down the care authorization number in a safe place. This number will be associated with their TRICARE claim for reimbursement.
When paying out of pocket for care, patients should make sure to keep copies of all medical records, discharge paperwork and receipts. Once home, they should visit their nearest TRICARE office for assistance with submitting claims for reimbursement and documents for translation.
For routine care, active duty and their families should wait until they have returned home and can see their primary care manager.
FRIENDS AND FAMILY VISITORS WHO ARE NOT TRICARE BENEFICIARIES
The U.S. Department of State recommends travelers learn what medical services their health insurance will cover overseas. If their health insurance policy provides coverage outside the United States, travelers should carry both an insurance policy identity card and a claim form.
Although some health insurance companies pay "customary and reasonable" hospital costs abroad, very few pay for medical evacuation back to the United States. Medical evacuation can cost more than $50,000, depending on the location and medical condition.
For Medicare patients in general, healthcare they get while traveling outside the United States is not covered by Medicare. In rare cases, Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis received in a foreign country. Visit Medicare.gov for more information.
Medicare eligible adults may wish to contact Medicare, the American Association of Retired Persons or a travel agent for information about foreign medical care coverage with private Medicare supplement plans.
Many private health insurance policies do not cover care outside the United States so patients may be required to pay some, or all, of their bill up front and file a claim to try and get reimbursed upon their return to the United States.
Veterans enrolled in the Veterans Affairs Foreign Medical Program and traveling overseas, may receive covered healthcare for service-connected disabilities in civilian medical clinics and military medical treatment facilities (space-available basis), but they will need to be prepared to show proof of enrollment. Some hospitals in foreign countries may not recognize the program and may still require up-front payment.
SUMMARY
Only TRICARE beneficiaries are eligible for care at military medical treatment facilities. All others should seek medical care from a host-nation provider. Due to fluctuating availability of appointments and specialty services, there are times when even eligible beneficiaries may need to receive care on the local economy.
RESOURCES:
VA FOREIGN MEDICAL PROGRAM
https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp
TRICARE
https://www.tricare.mil/
INTERNATIONAL SOS MEDICAL ASSISTANCE 24/7
Toll Free from Germany: 0800-589-1599
From the United States: 1-877-678-1207
NURSE ADVICE LINE
Toll free from Germany 0800-825-1600
Appointment Line 06371-9464-5762 (LRMC), Nurse Advice Line option
From the United States 1-800-TRICARE
For phone numbers from other countries, please visit https://rhce.amedd.army.mil/Families/nurse_advice_line.h
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