VA Foreign Medical Program: What It Pays

The VA Foreign Medical Program pays medically necessary care you receive outside the United States for a VA-rated service-connected disability, and for a condition VA decides is tied to that disability and makes it worse. You have 2 years from the date of care, or from the hospital discharge if you were admitted, to file the claim. A nursing-home stay, the flight to the clinic, and an illness that is not connected to your rating stay on your own bill.

As of November 2026, that split is the whole cash-flow decision. The program can reimburse a service-connected knee, a related prescription that is approved by the Food and Drug Administration, or an emergency visit for that same condition. It will not pay care that is unrelated to the rating, and it is not a substitute for local coverage. A retirement stay, including one built around the Thailand retirement visa requirements, still needs a separate way to pay for everything the rating does not cover. Visa rules get you in the country. Paying for the care the rating skips is an expat health insurance decision of its own.

Does the VA pay for medical care abroad?

Yes, when the care is outside the United States and it treats a VA-rated service-connected disability, or a condition VA holds to be associated with that disability and to make it worse. The Foreign Medical Program page, updated October 8, 2026, uses a clear example: if post-traumatic stress disorder is service-connected, VA may cover care for depression that is not itself service-connected, because that depression can aggravate the rated condition. The third path is care you receive while you are in Veteran Readiness and Employment.

You do not need a referral, and you do not need prior approval, for ordinary care under this program. You can see any licensed provider in the country where you live or travel. A March 30, 2026 VA News article also states that you do not need to be enrolled in VA health care to be eligible.

Who qualifies, including a 0% rating

VHA Directive 1521, dated March 25, 2024, says a veteran must be rated for a service-connected disability from 0% to 100% to participate. A 0% rating is inside that range. The same directive draws a hard line on the other end: a 100% rating that exists only because of permanent and total disability, or because VA rated you unemployable, does not by itself make unrelated care eligible. Payment follows the conditions that are actually rated service-connected.

The legal hooks named in that directive are 38 U.S.C. 1724 and 38 C.F.R. 17.35. A September 10, 2026 Federal Register notice describes the program as fee-for-service, meaning VA pays covered bills rather than handing you a local insurance card.

Situation	What FMP does	What you still handle
Office visit, hospital stay, emergency or urgent care, physical therapy, or skilled nursing for a rated service-connected condition	Can pay if the care is medically necessary and happens outside the United States	Get the benefits letter, and file within 2 years if you paid the clinic yourself
A condition VA decides aggravates the rated disability	Can pay, as with depression tied to service-connected PTSD on VA's own example	Ask before you assume the link; the letter lists rated conditions, not every related illness
Care you need while in Veteran Readiness and Employment, including some care that is not service-connected	Can pay	The case manager must refer you before the visit, with the treatment plan, enrollment dates, and a signature
FDA-approved medicine, or prescribed equipment, for a covered condition	Can reimburse a local pharmacy or supplier	US mail-order drugs are not covered, and the medicine must be FDA approved
Routine care, a nursing home, travel, or care inside the United States, a territory, the District of Columbia, or Puerto Rico	Does not pay	A separate plan, or your own cash

Which bills does FMP refuse?

The getting-care page, updated April 30, 2026, refuses anything that is not related to the service-connected disability, with the narrow exceptions above. It also refuses long-term care in a nursing home, assisted living, a mental health facility, or an adult day health center. Skilled nursing is a different item on the covered list: licensed medical care for medicines, wound care, and recovery. A room in a nursing home is not that visit.

Travel, postage, late fees, and check-cashing charges are out. So is care in a US state, a territory, the District of Columbia, or Puerto Rico, even if you live abroad the rest of the year, and care in a country that does not accept US Treasury checks or does not allow travel for US citizens. Medicines that are not FDA approved are out, as is experimental care. FMP will not mail drugs from the United States or cover US mail-order pharmacy bills. Dental care is covered only when it treats a service-connected disability, or when you are within 90 days of discharge, or when your DD214 does not show a complete dental exam and treatment before discharge.

The same page also excludes non-medical home care, health-club and spa memberships, family-planning services and sterilization, gender-affirming care, deluxe equipment such as a queen- or king-sized bed or a stair-climbing wheelchair, and care from a barred provider. If you were not legally required to pay a bill, FMP does not pay it.

How do you file and get paid?

Start with the benefits letter, not with a guess about pre-approval. As of an August 10, 2026 VA News update, veterans who already qualify no longer need to register before they download that letter. The program page updated October 8, 2026 says you are already eligible when you need foreign care for a rated service-connected disability. Sign in on VA.gov, open Letters from the My VA menu, and download the Foreign Medical Program letter. Hand it to the clinic. It names the conditions VA will consider and tells the clinic how to claim.

An earlier article, dated March 30, 2026, still said you must be registered to receive reimbursement and that you can register when you file the first claim. If the letter is missing from your account, contact Ask VA instead of mailing an old registration form on a hunch. A September 10, 2026 Federal Register notice proposed replacing registration form VA Form 10-7959f-1 with VA Form 10-488 for international direct deposit. Comments on that proposal run through November 9, 2026. The claim cover sheet the October 29, 2026 claims page still uses is VA Form 10-7959f-2.

If the clinic will not bill VA

When the provider files, VA pays the provider for covered care. When the provider will not, you pay, keep the paperwork, and file yourself. The claims page, updated October 29, 2026, gives four paths: online, email to HAC.FMP@va.gov, mail to VHA Office of Integrated Veteran Care, Foreign Medical Program, PO Box 200, Spring City, PA 19475, or fax to 303-331-7803. Online filing uses the FMP claim form and, per the March 30, 2026 article, a verified Login.gov or ID.me account.

1. Download the benefits letter and show it before the visit when the clinic will take it.
2. If you pay, get an itemized bill with the provider's full name, medical title, office address, billing address, phone number, the conditions treated, and the dates.
3. Keep a receipt or a statement marked paid. For a hospital stay, add the discharge summary and the operation report if you had surgery.
4. For equipment, add the prescription, what the device is, which condition it treats, how long you need it, and why any modification was required.
5. For medicine, add the prescription and a pharmacy receipt with the drug name, dosage, strength, quantity, cost, the related condition, the fill date, and the provider's signature. The drug must be FDA approved.
6. File within 2 years of the care, or of hospital discharge if you were admitted. If another insurer was billed, attach that explanation of benefits. The dates and charges on it must match the bill.
7. If VA denies the claim, you have 1 year from that decision to mail an appeal to VHA Office of Integrated Veteran Care Appeals, PO Box 600, Spring City, PA 19475.

VA will translate papers that are not in English, and that translation can slow the claim. Call 833-930-0816, TTY 711, and select 3, on weekdays from 8:05 a.m. to 6:45 p.m. Eastern Time. Do not put health details in email to HAC.FMP@va.gov.

Why the deposit may not match the bill

The claims page converts the bill into US dollars using the exchange rate on the date you received the care. If VA then pays a foreign bank, it converts again into local currency using the rate on the day it deposits the money. Two dates means the local currency that arrives can differ from what you paid, even when VA approved the bill. The claim cover sheet states the first step the same way: payment uses the exchange rate on the date of service.

Where the money lands depends on the account FMP has, and that account is not your disability compensation deposit. The October 29, 2026 page is explicit that FMP uses a separate payment system. You must give FMP the bank details even if compensation or pension already arrives by direct deposit.

• A US bank account on file with FMP receives the claim amount by deposit.
• No US account on file means a mailed check.
• A bank in a country without international direct deposit means a mailed US Treasury check.
• A bank in a country on the direct-deposit list requires you to set that deposit up through Ask VA. If you skip it, the page says payments may be delayed.

As of that October 29, 2026 page, international direct deposit is offered in 30 countries: Australia, Austria, Belgium, Colombia, Costa Rica, Denmark, the Dominican Republic, Ecuador, Finland, France, Germany, Greece, Hungary, Ireland, Israel, Italy, Japan, Mexico, the Netherlands, New Zealand, Norway, Panama, the Philippines, Portugal, Singapore, South Korea, Spain, Sweden, Thailand, and the United Kingdom. VA says it is adding more. A March 30, 2026 news article still limited electronic payment to US accounts, so use this later list.

What changes in the Philippines, on the phone, and in Panama?

The Manila VA Outpatient Clinic is the only VA clinic in a foreign country. It sits at 1501 Roxas Boulevard, NOX3 Seafront Compound, Pasay City. Public hours are Monday through Friday, 7:30 a.m. to 4:30 p.m., and the clinic is closed Saturday and Sunday. The clinic page says both that clinic and FMP are for a rated service-connected disability or a condition held to aggravate it.

Manila versus a local bill

Directive 1521, March 25, 2024, goes one step further for the clinic itself: service-connected veterans are to be treated for non-service-connected problems within the clinic's capacity. FMP, including care the clinic cannot provide, still pays the rated condition or an aggravating condition, not a blank check for every illness. Ask the clinic whether it can see a non-service-connected problem on site before you pay a private hospital and assume FMP will refund it.

An appointment also requires enrollment in VA health care and registration as a Manila patient, which is stricter than the March 30, 2026 statement that FMP itself does not require VA health-care enrollment. The appointments page, updated October 30, 2024, requires a Philippines address, a local phone number, and VA Form 10-10EZ sent to the clinic's enrollment office at 1501 Roxas Boulevard, 1302 Pasay City, or faxed to 8-550-3964. VA does not recommend that veterans who live in other Southeast Asian countries travel to Manila for care. Beneficiary travel reimbursement is not authorized in any foreign country, per the directive.

The clinic phone lines run Monday through Friday, except US and authorized Philippine holidays, from 8:00 a.m. to 3:00 p.m.: 8-550-3888 option 2 in Manila, 02-8-550-3888 option 2 outside the metro, #6982 option 2 on Smart, Globe, or PLDT, and 011-632-8-550-3888 option 2 from abroad. If a perishable medicine cannot be delivered, you may buy it locally and ask FMP to reimburse it when the condition is eligible. The Philippines is on the direct-deposit list.

Toll-free lines, and the Panama pause

The claims page lists toll-free lines besides the US and Canada number 833-930-0816: Australia 1-800-354 965, Costa Rica 0800-013-0759, Germany 0800-1800-011, Italy 800-782-655, Japan 00531-13-0871, Mexico 001-877-345-8179, Spain 900-981-776, and the United Kingdom 0800-032-7425. A March 30, 2026 news article also gave a separate Canada mailing address in Matane, Quebec. The claims page updated October 29, 2026 does not repeat that address. If you are filing care received in Canada, confirm the current mailbox on 833-930-0816 before you use the older one.

Panama is on the direct-deposit list, and it also has a current warning. The program page updated October 8, 2026 says VA suspended many healthcare providers there as part of a long-term fraud scheme, notified veterans who may have been affected, and said those veterans still have access to VA health care. If you live in Panama, check that notice and your letter before you return to a clinic that used to bill the program.

What to set up before you drop US care

Download the benefits letter while you still have a working Login.gov or ID.me sign-in. Read which conditions it names. Then price the care the published rules leave out: routine visits that are not tied to the rating, most dental work, long-term residential care, and any drug that is not FDA approved. Keep a US bank account available for FMP even if your compensation already lands somewhere else, and add international direct deposit only if your country is on the current list.

• Match every likely bill to the rating, to an aggravating condition, or to "I pay this."
• Ask the clinic whether it will claim directly. If it will not, leave with the itemized bill and a paid receipt the same day.
• File inside the 2-year window, and diary the 1-year appeal window if a denial arrives.
• In the Philippines, use the Manila clinic for what it can do on site, and use FMP when the service-connected care is outside that clinic.

File the covered bills inside 2 years, and insure the rest before you need it. The exclusion list is much more expensive once the visit is already over.

This is not legal advice. VA addresses, forms, and the direct-deposit country list change. Confirm coverage with the Foreign Medical Program before you book care or drop other insurance.

Data notes and sources checked

Figures above were checked in November 2026 against VA pages. The claims page was last updated October 29, 2026, the main program page October 8, 2026, and the covered-services page April 30, 2026. The Manila directive is March 25, 2024. The Federal Register proposal is September 10, 2026, with comments through November 9, 2026.

• Foreign Medical Program overview
• Getting care through the Foreign Medical Program
• File a Foreign Medical Program claim
• Online claim form
• VHA Directive 1521 (Manila clinic and the 0% to 100% rule)
• Manila VA Clinic and Manila appointments
• Federal Register notice on FMP forms, September 10, 2026
• VA News, August 10, 2026, on the benefits letter and VA News, March 30, 2026, on online claims