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Changes to FSM Health Insurance Plan

PALIKIR, Pohnpei (FSM Information Service): May 7, 1997 - Two changes are being made to the FSM Health Plan, which are necessary for the survival of the program, in view of the implementation of salary reduction and financial adjustments for all the states of the FSM and the extremely high costs of health care in the United States, as compared to the low premium structure of the National Government Employee Health Insurance Plan (NGEHIP), according to an April 15, 1997, letter from the Director of the Office of Administrative Services, Kapilly Capelle, to all FSM National Government Department and Offices.

The changes are as follows: an "open season" starts during the month of May 1997, for those who wish to make changes to their current enrollment in (the) Plan. Secondly, the Plan has identified and accredited the following providers or hospitals: in Manila, Philippines, the St. Luke medical Center and the Philippines Heart Center for cardiac cases; and in Honolulu, Hawaii, the Honolulu Medical Group and the Tripler Army Medical Center.

Referral patients who chose not to go to the selected and accredited health care facilities or hospitals shall take the responsibility of paying all medical billing up front. Reimbursement of such billings will be based on regulated fee schedule being followed by all off-island accredited health facilities of the Plan, Capelle concluded.