Does the Foreign Medical Program (FMP) cover all my medical care overseas, or do I need other insurance too?

The Foreign Medical Program (FMP) is run by the VA's Health Administration Center and reimburses treatment only for conditions that are service connected (rated by the VA, including conditions rated at 0%). It does not cover non-service-connected illnesses, routine primary care unrelated to a rated condition, dental care in most cases, or preventive services like annual physicals unless tied to a service-connected diagnosis. Because of this limited scope, veterans living outside the United States generally need a separate source of coverage for everything else.

Most veterans living abroad handle this in one of a few ways. Many enroll in the host country's national health system if they are legal residents, since many countries allow long-term residents or citizens to buy into public insurance at reasonable cost. Others purchase private international health insurance policies designed for expatriates, which can be pricier but offer broader networks and sometimes emergency evacuation coverage. Some veterans maintain U.S.-based coverage such as Medicare (though Medicare generally does not pay for care received outside the U.S., so this mainly matters if they return periodically) or a private U.S. plan with limited overseas benefits. A smaller number choose to fly back to the U.S. periodically for both VA and non-VA care, but this is logistically and financially demanding and is not a substitute for having local coverage for day-to-day and emergency needs.

It's worth noting that FMP is reimbursement-based, not a direct-pay insurance card in most countries — veterans typically pay providers first and submit claims for reimbursement, so having a supplemental plan or savings cushion for upfront costs matters. Claims are filed with the FMP office in Denver, and veterans should keep detailed medical records and receipts, since documentation requirements are strict. Coverage rules and country-specific logistics (some countries have expanded direct billing arrangements) can change, so checking current guidance directly with FMP is important before assuming coverage details.

A veteran in this situation should contact the VA's Foreign Medical Program office directly (or check the FMP page on va.gov) to confirm exactly which of their service-connected conditions are covered and what documentation is required, while separately researching local or private health insurance options to cover non-service-connected care.