TRICARE for Retired U.S. Military in the Philippines

TRICARE Health Care Coverage

Since arriving in the Philippines over two years ago, and aside from the normal “getting old” symptoms, I’ve been fortunate that my health remains good and that aside from some very minor things, I’ve never had to rely on the use of my TRICARE Overseas Program benefits. TRICARE is the health care coverage afforded to all retired U.S. military folks around the world, and more specifically, here in the Philippines. In addition to scouring the TRICARE website for relevant information should I ever need to avail of a doctor’s or hospital’s services, I’ve visited many blogs and forums in order to make sense of some of the TRICARE particulars.There seems to be a lot of convoluted information, mis-information, and simply a lack of a single-expert source for help with this program’s complexities. And I see many others continually looking for answers to their own questions that may pertain to their own situation.

I’m happy to say, I have recently been contacted by a Mr. Doug Sullivan, R.N., who is now in Makati here in the Philippines, and whose primary objective here is to help TRICARE, and potentially other managed health care recipients, with making sense of their coverage and helping those who need health care claim assistance. He has worked in the Managed Care Industry for almost 20 years, directly assisting patients and medical doctors and teaching them to understand the way complex Health Plans coverages work so they can utilize their benefits. He looks forward to doing this same service for TRICARE patients.

With his permission, here is an excerpt from his most recent correspondence to me:

First let me tell you a little about myself. I am an RN and Certified Case Manager. I’ve spent the last 20 years working for Managed Care, HMO’s PPO’s and EPO’s. They all have their unique and common rules but one thing is for sure, They’re all confusing to the patient and often times to the MD’s staff. So while I was working for these Managed Care Plans,one of my roles was to help the patient (we called them members) to navigate their benefits covered under their plan they where enrolled with. This usually came to us as a request from their PCP Primary Care Physician or directly from the member, just depending on the type of plan they had. Then I would analyze the request and determine if this was covered as a “medical necessity” and what supporting medical records would I need to review to make this decision. Obviously this was only for the NON-Emergent type of treatment. Emergency services in most cases, but not all, would be automatically approved. 
Now I’m here in the Philippines and in some ways doing the same thing. TriCare Overseas Program is the HMO for vets here. It is in most cases even more confusing to the members and the MD’s office staff. Knowing what benefits are covered and what’s not, what doctors are approved and who’s not, what labs and x-rays are covered and when their not, can be like walking through a mine field.
The best offense is a good defense has always been my approach. Many of us know what type of medical conditions that we have suffered from in the past and planning for the medical care and treatment that will be needed is vitally important. This takes a deliberate and strategic effort to research the MD’s,hospitals and ancillary facilities that will be needed for your treatment. That would start with a Certified/Approved provider search on the TriCare Overseas Program website here http://tricare-overseas.com/ProviderSearch/Beneficiary_PhilippineDemonstration_ProvSearch.aspx This will give you a start. The unique complexities that will undoubtably arise with some members takes a focused analysis to find the best solution. I will be here and available to do this for Vets on a case by case basis. 
My company http://www.americanhealthcareservicesinc.net is rapidly contracting and networking with Certified/Approved TriCare MD’s,Hospitals and ancillary services. Soon I will be setting up free seminars to help vets find good local MD’s in Makati,Manilla,Cavite,Quezon City,Pampanga,Subic,Olongapo and Zambales. Other cities as we expand our network. My company is a medical billing company. I get paid by the MD to do their billing.
Need help with Tricare?

Need help with Tricare?

Like I said I’ve done this for a long time and I really feel that people deserve some assistance to understand health insurance and I enjoy helping people. I plan on forming a network for vets to refer to when they need help.  My phone number here is 63 905 603-8781 so feel free to call me for any questions. 
So, for all those TRICARE eligible’s in country, know that Doug Sullivan is here to help in any way he can. There is no charge for his service and as he mentioned, he is paid through his company by the doctors and facilities that utilized his services. Please visit his company website for additional information, or for more immediate needs, you can contact him at his number above.
 
 

16 thoughts on “TRICARE for Retired U.S. Military in the Philippines

  1. Really good information to know because TRICARE is the only insurance I have and I sure don’t know as much as I should about it. I really hope that he can make his way down to our area for a free seminar shortly. I believe it will be well attended.

    • A trip to Samar would be nice, but we would be lucky should he come this far. You can visit his website for more information and use his contact page if you have specific questions.

  2. Need information for retired dependent. Is it the same as the sponsor while we are in the Philippines?

  3. I personally use TRICARE. Its not rocket science! I had an emergency and ended up in a Certified but not Approved hospital. Filed the paperwork got reimbursed. A few emails a few phone calls and it was really pretty easy. I use an Approved Hospital The Medical City In Pasig. There they have folks who walk you thought the process and even make the appointments for you. As it is with any insurance TRICARE is no different.

    • Hey Curtis, from what I understand, those folks who use TRICARE at an approved facility have little problems as those staffs are more familiar with the particulars of TRICARE. For many of us who live outside the reaches of the large metro areas (the province), and must rely on small hospitals and clinics for our care, TRICARE and the procedures thereof are not very well understood by doctors, nurses, staff etc. Anything Mr. Doug Sullivan can do to help those who are not very knowledgable about the process is welcomed.

  4. We are Tricare for Life recipient, and my wife is going thru all kinds of medical issues in Metro Manila particularly Quezon City area hospitals. I have some receipts that we already paid up front. How do we go about getting reimbursed from Tricare for all these medical expenses? Thank you to all!

    • Noel, You might get quicker and more precise information about TRICARE reimbursements if you were to visit facebook and search TRICARE Overseas. There are several people there who have shared information about filing claims. Here is another link that might help: Tricare Overseas Portal

  5. good info to know thanks have been here for almost 6 years now in the philippines and have found filing a claim under an emergency situation by having to go to an unapproved hospital for emergency treatment and then transferring to an approved hospital my claim was denied for the emergency room visit which cost me 250.00 us dollars but yet page 13 in the overseas handbook gives precise instructions and yet i still get denied then the rates set for the actual surgery were only covered up to 20% percent of the charges in which i also had to pay up front

  6. Hi, I’m U.S Military retired here in Thailand. If an emergency happens, where could I go there in the Phillipines If I dont have the money to pay upfront?

    • If you are registered with Tricare, there are a few hospitals that are in the network. Check the latest information on the TriCare Philippines Provider list by clicking here. Or, or you can check with the VA in Manila if you are VA eligible.

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