16 FAM 120
APPLICABILITY AND ELIGIBILITY
(CT:MED-41; 03-07-2019)
(Office of Origin: MED)
16 FAM 121 applicability
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
Section 904 of the Foreign Service Act, 22 U.S.C. 4084, is
the authorizing legislation for the Department of State to operate a medical
services program abroad. The law defines basic eligibility as follows:
"The Secretary of State shall establish a
health care program to promote and maintain the physical and mental health of
members of the Service, and (when incident to service abroad) other designated
eligible Government employees, and members of the families of such members and
employees."
16 FAM 122 eligibility
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
An individual must meet the applicable criteria
(employment, family member, ICASS, medical clearance status) to be eligible for
participation in the Medical Program (MED). In
addition, an individual whose sponsoring agency does not fund medical
evacuations must provide documentation that he or she has personal
medical evacuation insurance.
16 FAM 122.1 Employment Status
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
Eligibility based upon employment status includes:
(1) A full-time direct-hire U.S. Government employee
who is assigned, by official travel/transfer orders, to a position abroad
established under chief-of-mission authority;
(2) Part-time direct-hire U.S. Government employees,
including both Foreign Service and Civil Service employees who are assigned
abroad on official temporary duty (TDY) travel order including employees on
when actually employed (WAE) appointments; and
(3) Contractors, fellows, scholars, summer interns
hired in the United States, and other categories of employees whose sponsoring
agency subscribes to ICASS on their behalf.
16 FAM 122.2 Family Member Status
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
a. Eligibility based upon family member status includes:
(1) A spouse, domestic partner as defined in 3 FAM 1610, or
unmarried dependent child under 21 years of age who is included on official
travel orders and domiciled at post of assignment;
(2) An unmarried child under 23 years of age who
travels to post on educational travel orders; or
(3) An unmarried, dependent child who has a medically
documented disability that occurred prior to the childs 21st birthday and that
renders him or her incapable of self-sustaining employment (16 FAM 530).
b. Members of household, as defined in 3 FAM 4180, are
not eligible for participation in the Medical Program.
16 FAM 122.3 ICASS Status
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
Eligibility based upon ICASS status includes:
(1) The sponsoring agency must subscribe to
the Interagency Cooperative Administrative Support Services (ICASS) health
service cost center program at the Washington-level;
(2) The sponsoring agency must subscribe at
post for ICASS health services and must contribute its share of the
costs of the overall Medical Program through that subscription for health
services. When authorized by MED, the employing agency must also fund
medical travel and hospitalization directly for individual employees or family
members; and
(3) The embassy management officer will provide to the
post health unit a list of individuals eligible for health services based upon
their sponsoring agencies subscription to ICASS.
16 FAM 122.4 Medical Clearance
Status
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
a. Eligibility based upon medical clearance status
includes:
(1) A person who holds a valid medical clearance as
defined in 16
FAM 211.2 for the post of assignment;
(2) Foreign Service, Civil Service, and employees
serving in when actually employed (WAE) appointments who:
(a) Travel abroad for 30 consecutive days or more in a
calendar year on temporary duty (TDY) travel orders, and
(b) Hold a valid medical clearance as defined in 16 FAM 211.2;
and
(3) New family member acquired through birth,
adoption, marriage, domestic partner affidavit as defined in 3 FAM 1610, or
legal guardianship, for the 90-day period after being included on the
employees Form OF-126, Foreign Service Residence and Dependency Report, and
after which time, the new family member must have the required medical
clearance for continued eligibility for benefits within the Medical Program.
b. Spouses, domestic partners as defined in 3 FAM 1610, or other
family members of TDY employees who are not included in travel authorizations
are not eligible for the Medical Program. These family members who
elect to accompany an employee on TDY travel orders are advised to obtain
comprehensive medical travel insurance that includes both hospitalization
abroad and air ambulance evacuation benefits.
16 FAM 122.5 Nonfunded Medical
Evacuation
(CT:MED-41; 03-07-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Civil Service and Foreign Service Employees)
An individual whose sponsoring agency does not fund
medical evacuations must provide documentation that he or she has
personal medical evacuation insurance.
16 FAM 123 through 129 unassigned