MARCH 31, 2026 – The Office of the Assistant Secretary of War for Health Affairs hosted a virtual information session March 10, 2026, to gather feedback on the effectiveness of the Pilot Health Insurance Enhancement for Department of War Civilian Employees In Japan.
Launched Jan. 1, 2025, the program provides supplemental health services for approximately 11,000 DOW civilian employees in Japan — addressing challenges when seeking medical care including language barriers and high up-front costs.
Susan Orsega, deputy assistant secretary of war for health services policy and oversight, highlighted that “participant insights and feedback play a critical role in shaping the future of the program, which has already helped many individuals get the care they need.”
Since its launch, the program has facilitated over 1,400 appointments and prevented over $1 million in upfront costs to patients. In collaboration with International SOS, or ISOS, the pilot program will continue through Sept. 29, 2026.
How the health insurance enhancement works
To start the information session, officials presented an overview of the pilot program’s key services: Health Expert assistance through ISOS in finding providers, overcoming language barriers, and understanding local procedures Streamlined cashless/claimless billing and reimbursement services through ISOS Interpreter support
Current pilot eligibility is extended to DOW civilian employees with assignments in Japan enrolled in participating Federal Employee Health Benefit program plans, which include: Federal Blue Cross Blue Shield Foreign Service Benefit Plan Government Employee Health Association Hawaii Medical Service Association Mail Handlers Benefit Plan Nonappropriated Funds employees are eligible if enrolled in Aetna International
The pilot program’s services are at no cost to eligible employees, while standard copayments and cost-shares still apply per individual FEHB programs.
To use the pilot program, employees must make an initial 15- to 20-minute setup call with ISOS, which one beneficiary described in the town hall as “extremely easy.”
Translation and interpretation
Officials at the town hall identified language as a common barrier to health care for employees in Japan. The program provides a call center staffed with bilingual professionals, including nurses, to assist with:
- Appointment scheduling
- Arranging payment guarantees
- Answering program questions, or providing guidance for navigating Japanese health care
In-person interpreter services are also available in some cases. On the topic of language barriers, one beneficiary in attendance shared they “couldn’t have navigated Japan’s health care without this pilot program.”
Officials also outlined specific best practices when navigating Japan’s health care system to foster a positive DOW employee reputation among Japanese providers, including being:
- Proactive in calling ISOS as soon as care needs are identified
- Courteous of provider’s time by cancelling appointments well in advance
- Open-minded to the specialties offered in Japan and work with ISOS to find the best course of action
- Understanding of limitations of provider availability in Japan
Streamlined billing assistance
Officials detailed how, during a call with ISOS, they will assist in:
- Verifying coverage through a benefit review
- Coordinating with insurance carriers for direct billing to prevent upfront costs wherever possible
- In cases where direct billing isn’t possible, ISOS can help streamline reimbursements
Direct billing is powered by agreements with a large network of medical providers in Japan, allowing ISOS to issue guarantees of payment to providers — preventing patients from having to pay any upfront costs. Under the agreement, FEHB plans reimburse ISOS, and patients direct their regular copayment and shared costs to ISOS.
Looking ahead to future access to health care
Officials report strong advocacy for the program from users and ISOS has 98.7% success in collecting co-pays from patients after FEHB carriers process the directly billed claims.
Ultimately, the pilot program continues to gather feedback from users and evaluate its impact. The Undersecretary of War for Personnel and Readiness will review the program’s outcomes and determine how to sustain, scale, or adapt it prior to the program’s contracted conclusion in September 2026.
Many participants in the town hall voiced enthusiasm for the program’s continuation, with one beneficiary stating, “I very much appreciate the program and we’re hoping for an expansion. It has been a life saver.”
Story by Andrew Ortuzar
Office of the Assistant Secretary of War for Health Affairs/Military Health System