Pilot Health Insurance Enhancement for DOD Civilian Employees in Japan

The contract for the pilot was awarded to International SOS Government Services, Inc., for $4.2 million.

Of note, International SOS currently holds the contract with the Defense Health Agency to operate the TRICARE Overseas Program. TOP is the DOD health care program for active duty uniformed service members, retirees, their families, and certain other beneficiaries who reside outside the U.S. in more than 200 countries.

Current federal law and DOD policy prioritize access to health care in military hospitals and clinics for active duty service members and their families and other TRICARE Prime beneficiaries. When a military hospital or clinic has appointment availability, those appointments may be released as space-available to non-TRICARE enrolled personnel supporting the DOD mission, including DOD Education Activity teachers, DOD civilian employees, and contractor personnel. Emergency medical services are always available for anyone with base access on a cost reimbursable basis (billed against their health insurance) and subject to both capability and capacity at the facility. All DOD personnel, including DOD civilian employees, contractor personnel, and their authorized dependents, are eligible to have prescriptions filled at military hospitals and clinics. Prescriptions must be from a licensed U.S. provider and be written in English. Military pharmacies may take up to three days to fill such prescriptions.

International SOS staff will assist eligible civilian employees with health care navigation, to include provider finding services. International SOS will also establish direct billing agreements with FEHB plans, which will result in improved reimbursement processes for the civilian employees. These services will reduce the burden on civilian employees to pay up front for care and locate a provider on their own.

During the transition period, International SOS will establish a centralized toll-free number to a call center. Once a call center is active on Jan. 1, 2025, it will be staffed 24/7 with bilingual staff to guide requestors through the process and help them determine what they need. The call center will also contact provider offices, book appointments, and (when necessary) issue payment guarantees up front.

The pilot is available to DOD civilian employees with assignments in Japan. The employee must have medical insurance through the FEHB Program that includes overseas coverage in Japan to be eligible. The pilot does not extend to dependents.

Yes. NAF employees are eligible for this program but must work through their insurance carrier, Aetna International. NAF employees may use the same toll-free number to contact the International SOS call center.

Yes, if they are enrolled in one of the insurance plans that offers overseas coverage in Japan through the FEHB Program.

Yes, you’re eligible, but you must first enroll in a participating FEHB health plan with overseas coverage in Japan during the Federal Benefits Open Season starting Nov. 11, 2024.

This pilot program was directed by the Undersecretary of Defense for Personnel and Readiness as a result of a yearlong effort to identify and address gaps in accessing medical care for DOD civilians stationed in Japan.