Okay, I know that I need some kind of medical insurance to cover a doctor out in town. There is one kind of doctor I will be needing that can't be served on base. I saw Adam's post about different kinds of insurances overseas. That was a great start.

From your earlier posts, you said you ARE under Tricare in the EFM program. If this is the case, DoD medical is available to you & they will cover all allowable expenses. If they can't accommodate you on base, you will be given a referral to health care off base and that too is covered by Tricare. You might have to pay out of pocket & submit for reimbursement (I do this, as a retiree) but it's still covered.

This is for ALLOWABLE expenses. Some things are not allowable, such as cosmetic surgery, glasses, etc. You were talking previously about cochlear implants. I don't know if that's allowable or not. If it is, Tricare will cover it, whether it be on base or off base (probably off base). If Tricare doesn't cover cochlear implants, you're on your own & have to start shopping around. I previously recommended Thailand, which is a global destination for high-quality, affordable medical treatment. Specifically, Bumrungrad Hospital, but there are many others as well. It is a 5-star facility. Medical treatment at Bumrungrad costs about 20% of what it would cost in the States, and it's one of the more expensive hospitals in Bangkok. The Thai royal family goes there, Arab sheiks, business leaders, etc. It is world-class. They speak all languages at Bumrungrad. They also accept Tricare.

As far as other medical insurance, I have a philosophical look about this. I don't have secondary insurance simply for the fact that if I did, then the 2 insurance companies would always be bickering about which one has to pay. Each would want me to submit my claim to the other, making claims harder to fulfill. The first question Tricare always asks is if I have another insurance policy. I can proudly say "No!" then they shut up & take care of me. Any policy that would cover cochlear implants would be hugely expensive; it would probably be cheaper to go to Thailand & pay out of pocket.

Final comment: You are discussing this same topic on like 3-4 different discussion threads. I recommend you pick a single discussion & stick with it, otherwise the conversation gets scattered all over JB. I'm not sure if you're hoping you'll get different answers each time you post, but in fact you can get more relevant & accurate information if you keep all your posts in a single discussion. Did you pass your EFM screening? Are you in Okinawa now?

They were all different questions so I posted them under different subject headings but since they are all related, I'll keep them in this post from here on out. I can see where my posts are confusing. If if helps any, I'm feeling a bit confused too. Let's see if I make any sense...

First, we were sent through this whirlwind of EFMP. Part of our confusion is we WERE an active duty marine family and now we are DoD and things are just not very clear. So we do all this stuff and people are saying tons of stuff. The biggest thing was the person in charge was saying this was her first civilian EFMP person to process out of our duty station. Oh great. It's a learning curve for someone else too. Well then my husband emails me today and says that person was never supposed to be in charge because she was for the ARMY only. I don't understand exactly what this means if we don't do EFMP at all or if it's just this person is not supposed to do it. My husband gets the impression we don't do EFMP. Okay, well his email says to me that CPAC (whoever that is...he still uses the acronyms even if I don't understand them) is just supposed to tell us what is available and we decide if we want their care. So that sounds loopy to me and I need a bit more understanding than that. It just seems like anybody we talk to here doesn't really know what they are talking about. I thought it would be helpful to find out from someone over there how it all works. Otherwise my husband just goes half cocked assuming stuff because he is as utterly confused as I am.

As far as the Cochlear Implant thing goes, I fully expect that is going to have to be something I research myself but first I have to have a full understanding of the basic process. I already have a clinic lined up. I just have to figure out how everything works so I can ask the right questions.

I'm not under Tricare. I'm not sure where that was posted. We aren't active duty. I see that Lester serves DoD but I don't know how it all works and my husband seems to get the impression none of it is guaranteed because military get first service. I can certainly understand that but how prevalent is that really?

I have a lot of questions floating around. I'm happy to keep them here. If my questions seem conflicting, it is because I get conflicting information every day. Just dealing with my own HMO wanting to charge us $0.73 a page for 5 years of medical records on 5 family members is ridiculous enough.

I'm not in Okinawa yet. I'm wanting to get there. I'm just trying to make sure our bases are covered before we get there so there are no surprises we aren't willing to handle.

Here's another one.  Hubby is looking up federal insurances for overseas and he is seeing we pay out of pocket and they pay what they deem appropriate for the service. ANybody deal with this and if so, how often are they left stuck with remaining charges the insurance didn't reimburse them for?  

What do you mean "now we are DoD". I took that to mean military. Is one of you a school teacher? Federal employee? Is anyone in your family active duty military? That info would help. Also, what duty station are you at now?

You're right, this sounds hugely confusing (like many other aspects of moving overseas). Good luck & I hope you get it sorted out to your satisfaction.

He was in the marine corps. He got out, went out to civilian world and then got a job as a federal employee (DoD). He isn't active duty military anymore. Currently we are on Ft. Detrick in Maryland. I'm a school teacher. I work for a deaf school. I probably won't work when we move. At least not initially.

It's interesting you would go to Thailand for medical. I would think that having to pay for airline out of pocket would offset any savings particularly if your Tricare is paying for the medical part itself regardless of where you go.

Well, I used to live in Thailand so Bumrungrad is where I went for my care. For people paying out of pocket, even with airfare & hotel you will save money on expensive procedures. I had heard once that Bumrungrad even gives miles on Thai Air so your hospital bills count towards a free vacation. Since you mentioned insurance, I was thinking your treatment might not be covered & I expect your procedure would be pretty expensive; that's why I mentioned it. If you already have coverage that would pay for the procedure, then better to do it in Japan.

Here's an example: A hip replacement in the States for uninsured would cost like $40,000.  At Bumrungrad, it's about $11,000 which includes the prosthetic, doctor's fee, medications & 7 days in the hospital.  Even with airfare, Thailand comes out much cheaper. Also, if you're ensured in the States, you would still have to pay deductible & co-pay which exceeds the cost of your air tickets.

I'm not trying to sell you on Thailand, but for others reading it might be an alternative for care in the future.

My procedure was very expensive. I don't know exactly how much because I only paid a $200 copay. It was at least 60k. I have already had the procedure done. Now I have to go for regular mappings. That means they have to hook it up to a computer ad program it. It's a pretty sophisticated peice of equipment in my head that corresponds with an outer piece that I wear on my ear. Here my copay each time I go is the same as going to any specialist-$30.

I think what I am looking for is a DoD employee who is not a teacher and who is not a retired military or a dependent of one. I need to ask questions about accessing medical (not just for my cochlear but for basic colds, etc as well). I need to ask questions about insurance and so forth.