A Pentagon-funded pilot program for U.S. civilians seeking health care in Japan is nearing the halfway mark of its second phase, but users still report a variety of issues and concerns. (Alex Wilson/Stars and Stripes)
A pilot program aimed at improving health care access for Defense Department civilians in Japan has saved patients about $1 million, but participants say significant barriers to care remain, according to a recent information session.
The Defense Health Agency launched the program last year to connect civilian employees with Japanese medical providers and assist with appointments, billing and, more recently, interpreter services. The effort is intended to address longstanding challenges civilians face when seeking care off base.
During a March 11 online session attended by about 200 participants, DOD officials said the program had facilitated more than 1,400 appointments and reduced upfront costs that can reach thousands of dollars.
Lt. Cmdr. Sierra Nichols, a senior health policy analyst with the Pentagon’s health affairs office, said the program’s success depends on broader participation.
“We want to reiterate that this is a pilot, and we’re depending on you to utilize the pilot,” she said during the session.
Participants, however, raised concerns about the program’s limitations. Some said it excludes dependents, restricts access to specialty care and leaves patients confused about insurance procedures.
Nichols encouraged participants to work with their insurance providers and share feedback directly.
“We’re working hard on our end to help improve access, but we also need you all to help communicate that to [insurance providers] as well,” she said.
During the session’s question-and-answer portion, Alexandra Cummings, a volunteer for Japan Civilian Medical Advocacy, said the group has struggled to get responses from government agencies.
“We’ve had people go to [the Office of Personnel Management], we’ve had people go to [the Federal Employees Health Benefits Program], we’ve had people go to a whole range of bodies,” she said. “And everyone kind of finger points and says that’s somebody else’s issue.”
The advocacy group — a grassroots organization that helps DOD civilians navigate Japan’s health care system — has documented problems including coverage denials, inconsistent compliance and insurance directories listing unavailable providers, or “ghost networks,” according to Cummings.
“We have folks who have had their births rejected, folks who’ve had relatively minor things not paid for — a range of issues,” she said.
Nichols said the Pentagon and its agencies are working to address those concerns and pledged to help identify the appropriate points of contact.
The pilot is administered by International SOS Government Services Inc., the primary contractor for the Tricare Overseas Program. Introduced last year, it was renewed last fall through Sept. 29.
The contractor plans to survey participants to identify areas for improvement as the pilot continues, Danielle McCammon, chief of the Overseas Program, said at the information session.
The pilot was one of the Pentagon’s primary responses to backlash at a series of town halls in Japan regarding civilian’s access to health care in 2022 and 2023.
DHA, acting under a congressional mandate, was limiting civilian access to military health facilities to space-available appointments and encouraged them to seek care from local providers.
Many civilians complained that most Japanese providers do not accept foreign health insurance and can deny service outright.
