Government of the Federated States of Micronesia

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.