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» Foreign Medical Program (FMP)
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Foreign Medical Program Benefits and Claims Information
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Foreign Medical Program Benefits and Claims Information
Unlike typical health benefit/insurance plans, where the range of benefits is standard among all enrolled beneficiaries/subscribers, FMP benefits are limited to services that are medically necessary to treat a VA-rated, service-connected disability, or for a condition that is associated with and held to be aggravating a service-connected disability. Supporting medical documentation is always required.
General Exclusions
- Late charges on unpaid bills
- Check-cashing fees
- Postage and other costs associated with services unrelated to treatment
- Treatment, services and supplies that are determined not medically necessary or are submitted from prohibited countries
- Services, treatment or prescriptions unrelated to the service-connected disability
- Services, treatment procedures or supplies for which the Veteran has no legal obligation to pay
- Services, treatment or supplies received in or from the United States, District of Columbia, Commonwealth of Puerto Rico or the U.S. Territories: Virgin Islands, Guam, American Samoa and the Northern Mariana Islands
- Services furnished or billed by a provider or facility barred from FMP participation (VHA IVC will notify Veterans prior to barring a provider)
- Services that are not accepted by the VA or U.S. medical community
- Services as part of a grant, study or research program
Health Benefit Exclusions
This list is not all inclusive. FMP does not cover:
- Any service, procedure, treatment, drug or device that is experimental or investigational
- Adult day care
- Assisted living
- Custodial care
- Companion services
- Dental care (unless service-connected)
- Durable medical equipment with deluxe/luxury features
- Exercise programs and health club memberships
- Family planning services and sterilization
- Nursing homes
- Non-acute institutional care, such as long-term inpatient psychiatric and nursing home care
- Nonmedical home care (aid and attendance)
- Physical therapy not under the supervision of a licensed physician
- Procedures, services or supplies related to gender transformations
FMP Claims Information
In order to speed up your claim processing, have your provider submit the claim in English. Claim information submitted in a language other than English will require translation; your claim processing is then delayed.
Fact Sheet: How to File a FMP Claim FMP Claim Cover Sheet, VA Form 10-7959f-2
FMP has an updated Claim Cover Sheet dated March 2016
