Free Medical Care in Mexico for U.S. Disabled Veterans
If you have a U.S. Department of Veterans Affairs service-connected
disability rating you may be hesitant about moving to a foreign country
and losing the free treatment and prescription medications that are
Don Adams is a disabled Viet Nam veteran now living and writing
If that's a major concern affecting your decision to move to Mexico,
we have good news! A little known government program will pay the bills
for treatment of your service-connected medical problems.
According to Glenn Johnson, the Public Affairs Officer for the VA's
Foreign Medical Program, over 19,000 vets in 133 countries are
currently registered and receiving payment for treatment of their
Foreign Medical Program (FMP)
The Foreign Medical Program (FMP) was established in 1973 as an
addendum to Public Law 85-857. The current budget of seven million
dollars is provided through congressional appropriation as a part of
the general VA budget and the program is managed through the VA Health
Administration Center in Denver, Colorado.
Under the Foreign Medical Program Don is able to receive
treatment in Mexico, thus eliminating frequent exhausting trips
to the VA hospital in Texas.
What does all this mean for you? Not much unless you know about it.
We found out about the program several years ago during a conversation
with our friend Bill O'Brien, a former Vice-Commander of the American
Legion Department of Mexico. We recently e-mailed Department Service
Officer David Lord and he replied that he is also aware of the program
and uses it himself.
His email-address is not included in this article due to the huge
volunteer workload he already has. Your questions should be answered
directly by FMP employees and we'll provide names, telephone numbers,
email-addresses, and website information as you read on. Please respect
David's time and wait until you get to Mexico to enlist his aid if you
You may, as we did, discover that many of the Veterans Service
Officers employed by service organizations, county and state
governments, and other entities north of the border have not heard of
the FMP. Mr. Johnson of the FMP told us that they conduct an extensive
information outreach program in order to get word of this benefit out
to those folks. After his excellent responses to our questions we
believe his efforts will benefit all of us in the future.
The Information for Overseas Disabled Veterans
Here are a few of the pieces of information he shared with us or
directed us to. In order to qualify for benefits under the FMP you must
have at least a 10% service-connected disability rating from the VA.
The program is designed to pay 100% of all charges for medical care
associated with VA rated service-connected disabilities or for care for
anyone who is participating in a 38 USC Chapter 31 rehabilitation
program while living or traveling outside the U.S.
However, there are some restrictions. For obvious reasons claims for
medical care rendered in Democratic Kampuchea (formerly Cambodia),
North Korea, Iraq, or Cuba will not be accepted.
Two other countries, Canada and the Philippines, because they have
approved medical facilities available to U.S. veterans, are not
included in the FMP.
For Care in Canada:
If you're a DV in the United States seeking care in Canada you should
VAM&RO Center (136FC)
North Hartland Road
White River Junction, Vermont 05009-0001
Telephone: (802) 295-9363, Extension 5620
Fax: (802) 296-5174
If you're already in Canada you can contact any one of the 32
Veterans' Affairs Canada district offices to ask for assistance. Call
toll free (888) 996-2242 for information.
For Care in the Philippines
Those living or visiting in the Philippines can get information from:
Embassy of the United States of America
(U.S. Embassy Annex Building)
VA Outpatient Clinic (358/00)
2201 Roxas Blvd.
Pasay City 1300
Republic of the Philippines
Telephone: 011 (632) 833-4566, 523-1001 or 523-1224
Fax: 011 (632) 838-4566
Or you may need to contact:
VA Regional Office
1131 Roxas Blvd.
Telephone: 011 (632) 521-7521
Registration and Authorization for Other Countries
Pre-registration in the FMP is not required but since there are some
documents you have to produce we advise contacting the FMP office which
will have jurisdiction over your foreign geographic location and make
sure you get into their system as soon as possible. A simple one page
registration form asking for only seven pieces of information (name,
SS#, VA claim/file #, physical address, mailing address, telephone #,
fax #) and your signature can be downloaded from
http://www.va.gov/hac/fmp/fmp.asp#ques. Fax the completed form to the
appropriate office for your area and if you qualify for care under the
program an FMP Benefits Authorization form will be sent to you.
Speed Up the Process
Here's a hint that may speed up your authorization process. The online
and printed information sheets indicate that if you do not have a copy
of your VA Rating Letter that the HAC/FMP folks will order one from
your servicing VARO. In Don's case they requested that he send one to
them directly. Luckily we actually had a copy on hand. Play it safe and
go ahead and include a copy in your request, whether faxed or
If you're in any area other than Canada or the Philippines you need
VA Health Administration Center
Foreign Medical Program (FMP)
PO Box 65021
Denver, Colorado 80206-9021
Toll-free telephone: (800) 733-8387
Fax: (303) 331-7803
One of the FMP Program Support Assistants informed us that they
cannot accept e-mail with attachments so either cut and paste any
requested documents into the text field of your message, fax them, or
use surface mail.
The telephone number given above will connect you with the Health
Administration Center. If you want to speak directly to one of the FMP
personnel you can call (303) 331-7590 between the hours of 9:00 AM and
6:30 PM Eastern Time. Don has talked with two of the ladies, Jackie
Heath, a Program Support Assistant, and Nancy Martinez, the Program
Support Specialist and is satisfied with the good service they provide.
The two other Support Assistants on the front line are Rose Goodgion
and Nickki Pohlson.
Folks, no matter how you've been treated in the past by the VA, and
you all have stories you can tell, these ladies will deliver help
immediately and professionally.
Since we believe that both the attitude and efficiency of any
organization are determined by the example set at the highest levels we
want to tell you that the Director of the HAC, and therefore the Big
Dog of the FMP, is a career Civil Service employee, Mr. Ralph Charlip.
The Supervisor of Suspense Unit II and the immediate head of the FMP,
among other responsibilities, is Mr. William Folds.
Okay, the big question right now is—how does this deal
The FMP permits you to choose your own healthcare providers, with the
stipulation that you choose licensed practitioners who can deliver
services and medications deemed acceptable as standard therapy
Like many chemotherapy patients, there have been times when
Don has lost all of his hair. (Photo by David McLaughlin)
So, after you receive your authorization you need to find a
competent doctor who will treat your condition. That part is obvious.
However, you may not have enough spare change to pay for those
services. The FMP pays the bills after the services are provided but if
you don't have the funds to pay up front you still have an option. At
present we owe our local healthcare providers in excess of US $11,000
for chemotherapy treatments.
How and why?
Don had been traveling each month from Chapala to the VA North Texas
Regional Medical Center in Dallas for well over a year and a half
before tiring of the trips and the expense, so we began to search for a
local alternative. Teresa recommended that we talk with a local GP, Dr.
Juan José Lastra Berriozábal to see if he could help
arrange for treatment in Guadalajara.
Dr. Lastra referred us to Dr. Gilberto Rosas Espinosa, an oncologist
practicing in Guadalajara. He requested medical records, which we had
as the VA Healthcare Center in Dallas made a copy when requested at
discharge. As an example of their efficiency up there, the copies were
printed out on the spot when asked for and the entire process took less
than 20 minutes.
Dr. Rosas also requested all X-rays, CT Scans, and other visual
diagnostic films. We simply faxed a request to Dallas that they send
the items to Dr. Rosas and he had them within a few days. Again, kudos
to Director Alan Harper, Mr. Miller in the X-ray library, and all the
good folks working for the benefit of their client veterans in the VA
North Texas Regional Medical Center.
According to the information on
http://www.myhealthevet.va.gov/MHV.portal sometime during 2005 veterans
who register with that program will be able to access their VA medical
records from anywhere in the world via the internet. This may be a real
time saver for many of you who need to provide accurate information to
your doctor in any location outside the U.S. so plan on keeping up with
developments in this program. We suggest that you go ahead and register
Once the oncologist in Mexico had all the medical records in hand he
recommended changing the medication to be administered. Since the type
being used in Dallas was not producing positive results we agreed. This
is something you need to weigh and remember; the VA medical treatment
system is bound by a number of policies which may not work to your
advantage in many cases. One policy is that many drugs are purchased
from the lowest bidder. This sometimes means that they may not be able
to provide the most effective treatment option for a given
Under the guidelines of the FMP your treating physician is not bound
by those regulations. He or she may prescribe any treatment regimen or
drug therapy as long as it is recognized by the VA and/or the U.S.
medical community and the U.S. Food and Drug Administration and
approved for treatment of your service-connected disability. In short,
this means the FMP won't pay for experimental or alternative therapies
or drugs. If you have a concern about whether a prescribed drug is
acceptable go to the FDA website at http://www.fda.gov to find a list
of approved medications.
As a taxpayer you may be pleased to discover that medical treatment
in Mexico is far less expensive than that provided in the U.S. For
example, one of the IV drugs used in Dallas costs the VA about $4,000
per unit. In Mexico, a drug of the same family, only more effective in
controlling lung cancer, added in with all the other costs of one
treatment, came to a total of less than $2,800 per session. That's the
doctor, all medications, and all affiliated procedures and
A CT Scan that costs $150 in Guadalajara was $1,500 for a friend in
California. X-rays are usually in the $35 to $45 range. A recent CBI
(complete blood index), including both liver and kidney function tests
cost less than $150.
And in addition to being less expensive, in this case the doctor
comes to our home to administer the IV therapy.
On occasion he may be two or three hours late but there's a reason;
one that we both understand and appreciate. If the patient he's
treating prior to visiting us has any type of problem with any aspect
of the treatment he's receiving, the doctor stays with them. We figure
the same will apply for us.
Dr. Rosas and Don discuss the selection of medications and
solutions used for his treatment as the IV hanging from the
ceiling fan drips into Don's arm.
Yes, you read that correctly; the doctor stays at the house during
treatment. Our usual routine is that we either prepare a simple lunch
or call one of our local take-out establishments and have things laid
out when he arrives. We exchange pleasantries and abrazos (big
hugs and pats on the back), and then get down to business.
Before Dr. Rosas arrives we loop a wire clothes hanger over one
blade of the living room ceiling fan to provide a hook from which the
doctor can hang the IV bag. When he's ready, Don makes himself
comfortable in an easy chair and Dr. Rosas makes the connection and
begins the drip. During treatment we visit, at some point moving to the
dining table to eat, and generally make the best of what some consider
a bad situation. On occasion Dr. Lastra will accompany Dr. Rosas and we
sit around and gossip like little spinsters.
Teresa came home one afternoon while we were gathered around the
table eating sushi while the IV bag was hanging from the chandelier and
said later we looked like a bunch of old boys hanging out in the
garage. Neither of the doctors wears a tie, so everyone is pretty
casual looking, but the change in drugs has caused a significant
decrease in the size of the primary tumor and there's definitely
nothing casual about that!
At some point we're going to have to pay the doctors for their services
but so far neither of them has hit the panic button.
For specific details on how to arrange payments go to
http://www.va.gov/hac/factsheet/fspages/FactSheet01-30.pdf to download
VA Fact Sheet 01-30, How to File a Claim. There are no official forms
to fill out at this point but you need to carefully read the
requirements and provide the information requested. FMP claims
processors will review the documents you submit and assign the
appropriate ICD9 billing codes so both you and the service provider are
relieved of yet another burden. Dr. Rosas is still patiently waiting
because we failed to provide the information needed by the FMP to
process and pay the claim and it was denied. We're in the process of
doing things correctly now.
When the check does arrive it will be made out to Dr. Rosas, or in
your case, your doctor or hospital. According to Ms Heath if you pay
for your medical services and then submit a claim you must attach a
paid receipt in order to have the check issued in your name or the
check will be automatically issued to the service provider.
You may also wonder what to do if your bill is given to you in a
foreign language. Send it in. The FMP has a number of contracted
translators who will take care of the language and currency
differences. Your charges will be paid at the currency exchange rate in
effect on the day(s) services were provided, not the date the claim is
processed. Ms Heath told me that the current time span for claims
processing is from 21 to 30 days plus one week for translation. If your
medical service provider is fluent enough in English to prepare your
bill, you will save the time required by the translation process.
Keep in mind that the FMP does not accept previously translated
bills or receipts. If your provider(s) cannot issue the paperwork in
English originally, don't waste your time and money having translations
Once you've cleared those hurdles, only one remains. When the claim
is finally authorized for payment, a request to issue a U.S. Treasury
Department check is sent to Austin, Texas. At present it takes from 7
to 14 days before the check is mailed out via the U.S. mail.
Mr. Johnson reported that the normal time period for payment, from
start to finish can, depending upon the FMP workload, take up to 90
days for completion. When you or the care provider receives the check,
the entire cycle is complete. If you have any questions about the
status of the claim or the payment you can call one of the FMP Support
Assistants for information after you've allowed time for the procedure
to run its normal course. Keep in mind that the processing time will
depend upon the volume of claims submitted at any given time. There are
only four claims processors employed in the FMP so on occasion you may
need to be more patient than at other times.
Denial of Claims
And in case you're wondering, according to Glenn Johnson the most
common reasons that claims are denied are:
- The veteran is seeking payment for medical treatment not
related to the service-connected disability.
- There is insufficient documentation of the medical
- The veteran or provider fails to itemize items on the bill
submitted for payment. Refer to the previously mentioned VA Fact
Sheet 01-30 for the specific information required by the FMP.
More Helpful Information
Here are a few more miscellaneous items that you may find interesting
The FMP will pay for a prosthetic device related to your
service-connected disability if you require one. If the cost is less
than $300 you do not need pre-authorization for the purchase. If the
cost of the device exceeds this amount you should contact the
appropriate office for approval prior to purchase.
They will also pay for USDA approved prescription drugs for
treatment of your service-connected disability or complications arising
from it. Mr. Johnson says pharmacy claims from those who require
medication on a regular basis constitute the greatest number received
from program participants. Because of international laws prohibiting
the practice, the VA does not offer a pharmacy mail service to those
residing outside the U.S. If you need prescription drugs, they must be
available within your country of residence, and again, must be on the
FDA approved list.
Otherwise eligible veterans cannot receive payment for stays in
nursing homes or other long-term care facilities, or for day care in a
And this is included just because we think it's interesting. The
three countries with the highest number of claims submissions are
Germany, Panama, and Australia.
Remember, FMP personnel are the only ones who can give you
definitive answers to your eligibility and claims questions. For
additional information you can access the website at
http://www.va.gov/hac and select Foreign Medical Program from the
Other VA Information for Overseas Veterans
All of the information given to this point relates only to the FMP. If
you're living outside the U.S. and have questions about any other
matters related to the VA, VA benefits for other programs, or survivor
benefits, or any other concerns you need to contact one of the
Veterans living in Mexico, South and Central America, and the
Caribbean should get in touch with:
Department of Veterans Affairs Regional Office (362/21)
6900 Almeda Road
Houston, Texas 77030-4200
Fax: (713) 794-3818
Regardless of where your records are at present, when you move to
Mexico you need to have your file moved to the Houston VARO.
Veterans living in all other countries will contact:
VA Regional Office
1000 Liberty Avenue
Pittsburgh, Pennsylvania 15222
Fax: (412) 395-6057
E-mail: email@example.com or
VA Regional Office
1120 Vermont Avenue, NW
Washington, D.C. 20421
Fax: (202) 418-3213
Note: Although this email address is widely published, it was not
working at the time of publication.
More Overseas Information Websites
Check out http://www.vba.va.gov/foreign/forinqu.htm for direct links to
all overseas locations.
For more information about treatment in all overseas locations look
This article should be used only as a guide to assist you in
contacting official sources who will provide you with accurate and up
to date information and procedural guidelines.
Finally, we will feel that our goal has been realized if you pass
this information on to all of your U.S. military veteran friends and
their families. You can never know who might benefit from your
interest. And, please contact Don at firstname.lastname@example.org to report on
your experiences with the FMP.
Co-author of this article and editor of Don Adam's book Head
For Mexico, the Renegade Guide is his wife, Teresa
Authors' note: This article is based on our personal
experience, on information found on the websites listed as well as a
few related others, on telephone calls to Ms Martinez and Ms Heath, and
on e-mail communications with Ms Martinez, Mr. Folds, and Mr. Johnson.
Any mistakes or errors are ours and we accept full responsibility for
the accuracy of the article content.
The information contained herein is presented as a guide to help you
locate people and organizations which will provide official information
specific to the individual person and situation, and should not be
interpreted as the definitive word in regard to any program of the U.S.
Veterans Administration or any of its entities.
Don Adams and Teresa Kendrick, co-authors
of this article are Lakeside residents and authors. For more
information about Head For Mexico The Renegade Guide, go to
Don's website: http://www.headformexico.com . You can read more about
Teresa's book, Mexico's Lake Chapala and Ajijic, The Insider's
Guide to the Northshore for International Travelers at
June 2, 2004 Update: The results of Don's June 1 MRI show a
very rare remission. The catcher's mitt-sized tumor in his lungs (that
was growing larger four months ago) has completely disappeared in the
four cycles of chemo here in Mexico, using the chemotherapy drug
suggested by his doctor here.
This remission is completely unexpected and it is very rare for a
"second line" of treatment to be so effective—rare enough that
Doctor Rosas is writing Don's case up for publication. Next month Don
will begin taking three or four months of small maintenance doses of
chemo. If the small doses keep the tumor at bay, he will be eligible
for a new oral drug that has been working well with the type of cancer
he is fighting.
Needless to say, after two exhausting years of travel to Texas and
discouraging treatment, Don, Teresa and all of their friends are