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<td><a href="https://health.mil/News/Articles/2026/04/01/It-has-been-a-life-saver-Department-of-War-civilians-in-Japan-discuss-health-care-pilot-program" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">‘It has been a life saver’: Department of War civilians in Japan discuss health care pilot program</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Mar 31st 2026, 20:00</div>
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<p><p>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<a rel="noopener noreferrer" href="https://okinawa.tricare.mil/Portals/121/DOW%20Civ%20in%20Japan%20Pilot_FACT%20SHEET%2003102026_508.pdf?ver=N8JXkYvGP8RcR8KJAZhaag%3D%3D" target="_blank" title=" Pilot Health Insurance Enhancement for Department of War Civilian Employees In Japan"> Pilot Health Insurance Enhancement for Department of War Civilian Employees In Japan</a>. </p><p>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. </p><p>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.” </p><p>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. </p><h2>How the health insurance enhancement works </h2><p>To start the information session, officials presented an overview of the pilot program’s key services: </p><ul>
<li>Health Expert assistance through ISOS in finding providers, overcoming language barriers, and understanding local procedures</li>
<li>Streamlined cashless/claimless billing and reimbursement services through ISOS </li>
<li>Interpreter support</li>
</ul><p>Current pilot eligibility is extended to DOW civilian employees with assignments in Japan enrolled in participating Federal Employee Health Benefit program plans, which include:</p><ul>
<li>Federal Blue Cross Blue Shield </li>
<li>Foreign Service Benefit Plan </li>
<li>Government Employee Health Association </li>
<li>Hawaii Medical Service Association </li>
<li>Mail Handlers Benefit Plan </li>
<li>Nonappropriated Funds employees are eligible if enrolled in Aetna International</li>
</ul><p>The pilot program’s services are at no cost to eligible employees, while standard copayments and cost-shares still apply per individual FEHB programs. </p><p>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.” </p><h2>Translation and interpretation </h2><p>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: </p><ul>
<li>Appointment scheduling</li>
<li>Arranging payment guarantees </li>
<li>Answering program questions, or providing guidance for navigating Japanese health care </li>
</ul><p>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.” </p><p>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: </p><ul>
<li>Proactive in calling ISOS as soon as care needs are identified</li>
<li>Courteous of provider’s time by cancelling appointments well in advance </li>
<li>Open-minded to the specialties offered in Japan and work with ISOS to find the best course of action </li>
<li>Understanding of limitations of provider availability in Japan</li>
</ul><h2>Streamlined billing assistance </h2><p>Officials detailed how, during a call with ISOS, they will assist in: </p><ul>
<li>Verifying coverage through a benefit review</li>
<li>Coordinating with insurance carriers for direct billing to prevent upfront costs wherever possible </li>
<li>In cases where direct billing isn’t possible, ISOS can help streamline reimbursements </li>
</ul><p>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. </p><h2>Looking ahead to future access to health care</h2><p>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. </p><p>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. </p><p>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.” </p></p>
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<td><a href="https://health.mil/News/Articles/2026/04/01/Reducing-tobacco-and-nicotine-use-key-to-having-a-healthy-fit-force" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Reducing tobacco and nicotine use key to ‘having a healthy, fit force’</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Mar 31st 2026, 20:00</div>
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<p><p><a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/php/data-statistics/adult-data-cigarettes/index.html" target="_blank" title="CDC webpage">Tobacco use remains the No.1 preventable cause of death in the U.S.</a>, according to the <a rel="noopener noreferrer" href="https://www.cdc.gov/" target="_blank" title="CDC webpage">Centers for Disease Control and Prevention</a>, and poses a readiness issue for the military. </p><p>The Military Health System is concerned that about one-third of service members still use tobacco and nicotine products — a rate higher than the general population (19%), said Department of War Principal Deputy Assistant Secretary of War for Health Affairs <a href="https://health.mil/About-MHS/Biographies/Dr-Stephen-Ferrara" target="_blank" title="Dr. Stephen Ferrara bio">Dr. Stephen Ferrara</a>, citing statistics from department-wide health behavior surveys. </p><p>Ferrara spoke on this topic at the National Press Club on the dangers of tobacco use in the military and how the MHS is addressing the issue at an event in March 2026 titled, “Serving Those Who Serve, Embracing Tobacco Harm Reduction.” </p><p>Acutely aware of the impacts on readiness, the MHS has long focused on reducing tobacco and nicotine use through a comprehensive approach involving medical, behavioral, and cultural interventions, said Ferrara. </p><p>In 2026, that commitment is deeper than ever with the DOW’s deeper emphasis on a healthy force. </p><p>“Prevention is in our DNA,” he said. “The way we succeed on the battlefield, of which we're in active operations as we speak, is by having a healthy, fit force.” </p><p>As a vascular and interventional radiologist with multiple tours of duty in the U.S. Navy for 25 years, Ferrara is keenly aware that tobacco and nicotine dependence have long been embedded “in the culture” of the military, which offered behavioral off-ramps to smoke. </p><p>Ferrara said, “old myths” that tobacco “increases your alertness” have been debunked. “We know now it actually leads to slower wound healing, slower injury healing … especially the cardiovascular” system,” he said.</p><p>Stressors associated with military service and cultural dependencies mean “people use different things, whether it's food, whether it's cigarettes, whether it's other habits … as a crutch or as an aid to help them deal with that stress that we asked them to endure.” </p><p>The MHS emphasizes a comprehensive approach to help people quit, which includes prevention methods, stop-smoking aids, and behavioral therapies. </p><h2>Stepping down from tobacco</h2><p>The MHS provides intermediate, less harmful steps to help service members and veterans put combustible cigarettes down. “We're looking at nicotine replacement or other things that will satisfy or try to give people a bridge so they cannot get the most toxic tobacco experience as a way to eventually get to full cessation,” said Ferrara. </p><p>Mitigating “the most harmful behaviors and with a path” away from nicotine and tobacco dependence requires team support, he said. “That's where partnerships come in with the medical community … your friends or your family or your command structure to continue to work that journey from the most harmful behavior to ideally, to not a harmful </p><p>Ferrara said the first line of defense against tobacco can be providers, who raise the issue during the annual Periodic Health Assessment or other medical visits. The PHA specifically asks about tobacco or nicotine product use. </p><p>“If the answer is yes, we start to talk about how we can do cessation,” Ferrara explained. The MHS has abundant “pharmacologic, mental health therapies, all those things to help people, including other adjunctive therapies, to try to get people to get away from cigarettes.” </p><h2>MHS works ‘hand in glove’ with the Department of Veterans Affairs </h2><p>One important effort was the publication in January 2026 of the DOW and the Department of Veterans Affairs joint <a rel="noopener noreferrer" href="https://dha.mil/News/2025/06/27/15/03/Clinical-Practice-Guidelines-An-Evidence-Based-Tool-for-Providers-and-Patients" target="_blank" title="clinical practice guideline">clinical practice guideline</a> called “<a rel="noopener noreferrer" href="https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/CD/tobacco/Tobacco-Cessation-CPG_2026-Guideline_final_20260109.pdf" target="_blank" title="Tobacco Use Treatment">Tobacco Use Treatment</a>.” </p><p>The CPG describes the critical decision points in tobacco use treatment and presents comprehensive evidence-based recommendations for providers and patients to reduce and then stop the use of tobacco and nicotine. Ferrara emphasized the CPG demonstrates both departments’ commitment to tobacco cessation and continuity in care in transition and afterward. </p><p>“Because every veteran was once in uniform, the continuity of care must be instantaneous,” he emphasized. “We'll get you taken care of, and then we need to pass the baton to the VA, and that's why we have that joint clinical practice guideline,” Ferrara explained. “You can see that we are hand in glove with that, and that's as it should be for the folks who serve their country.” </p><h2>Behavior changes and telehealth </h2><p>Ferrara highlighted how the military has “really leaned into technology,” including telehealth or virtual appointments for tobacco and nicotine cessation. These tools “support meeting service members where they are in their tobacco-reduction journey, and wherever they are stationed or deployed worldwide,” he said. “It's an exciting time to be in medicine with what's going on in AI (artificial intelligence) and we're being able to leverage those things, not only for diagnostics but also for therapeutics.” </p><p>Because most service members are young, “there's a huge appetite for” AI and telehealth, he said. “Most of our service members … grew up very comfortable with technology, and some of them actually prefer a virtual encounter to face-to-face” meetings with a provider.” </p><p>He reinforced, “You have to meet people where they are, and I think that's … really a person-centered approach.” </p><h2>Goal is a healthier, more ready fighting force </h2><p>“Reducing tobacco and nicotine use improves health, fitness, recovery, and long-term resilience — all of which directly affect the warfighter’s ability to fight and win,” Ferrara said. </p><p>“Through continued research, strong partnerships, and sustained leadership commitment, the department is taking concrete steps to drive down tobacco use and protect the health of the men and women who serve,” he stated. “This is about readiness today, and it is also about ensuring that those who serve our nation can enjoy healthier lives long after they retire their uniforms.” </p><p>Ferrara noted that he’s already seen a shift in tobacco use. He said over the 35 years that he has been associated with the military, usage and culture have changed, resulting in fewer people smoking. </p><p>“If I had the magic wand, I think we would have a culture where we model the behavior that we never get folks started. But until then, we are going to do everything from all the things we talked about and more to mitigate that risk and continue our tobacco harm-reduction techniques.” </p><h2>Ready to quit? Accessing resources</h2><ul>
<li><a href="https://health.mil/News/Dvids-Articles/2024/01/04/news461282" target="_blank" title="Health.mil article">TRICARE</a> offers a multitude of <a rel="noopener noreferrer" href="https://tricare.mil/CoveredServices/IsItCovered/TobaccoCessationServices" target="_blank" title="TRICARE">TRICARE tobacco cessation services</a>. TRICARE covers tobacco cessation counseling if you’re aged 18 or older and you live in one of the 50 states or the District of Columbia, as long as you use a TRICARE-authorized provider. </li>
<li>TRICARE covers prescription and over-the-counter tobacco cessation products at no cost to you if you use <a rel="noopener noreferrer" href="https://www.tricare.mil/homedelivery" target="_blank" title="TRICARE Pharmacy Home Delivery">TRICARE Pharmacy Home Delivery</a> or a <a rel="noopener noreferrer" href="https://www.tricare.mil/CoveredServices/Pharmacy/FillPrescriptions/MilitaryPharm" target="_blank" title="military pharmacy">military pharmacy</a>. TRICARE doesn’t cover these products if you get them at a retail network or non-network pharmacy. A <a rel="noopener noreferrer" href="https://tricare.mil/networkproviders" target="_blank" title="TRICARE-authorized provider">TRICARE-authorized provider</a> must write the prescription. You must have a prescription for OTC tobacco cessation products such as nicotine replacement products, nasal sprays, inhalers, patches, gums, and lozenges. </li>
<li><a rel="noopener noreferrer" href="https://www.ycq2.org/" target="_blank" title="You Can Quit2">You Can Quit2</a> is a DOW-supported education program that offers coaching, online tools, and in-person support locators to help you quit tobacco. <a rel="noopener noreferrer" href="https://www.ycq2.org/resources/making-a-quit-plan/" target="_blank" title="YCQ quit plan">YCQ quit plan</a> helps you create a timeline that fits your needs so quitting tobacco is within reach. </li>
<li>You can also call your<a rel="noopener noreferrer" href="https://tricare.mil/mtf" target="_blank" title="TRICARE"> local military hospital or clinic</a> to see if they offer tobacco cessation programs. </li>
<li>The VA offers a <a rel="noopener noreferrer" href="https://www.mentalhealth.va.gov/quit-tobacco/" target="_blank" title="Veterans Affairs webpage">wealth of advice</a> on quitting smoking and smokeless products. </li>
<li>If you still use chewing tobacco, do <a rel="noopener noreferrer" href="https://www.med.navy.mil/Media/News/Article/3686355/commit-to-quit-the-spit-with-a-naval-hospital-bremerton-assist/" target="_blank" title="Article on med Navy webpage">monthly self-checks</a> of your mouth, tongue, throat, face, and neck to help you find possible early signs of damage or cancer. </li>
<li><a rel="noopener noreferrer" href="https://smokefree.gov/" target="_blank" title="Smokefree.gov">Smokefree.gov</a> from the <a rel="noopener noreferrer" href="https://www.nih.gov/about-nih/nih-almanac/national-cancer-institute-nci" target="_blank" title="National Cancer Institute">National Cancer Institute</a> has many resources and information, including <a rel="noopener noreferrer" href="https://smokefree.gov/challenges-when-quitting/stress/coping-with-stress" target="_blank" title="coping with stress without tobacco challenge">coping with stress without tobacco</a>, <a rel="noopener noreferrer" href="https://smokefree.gov/challenges-when-quitting/stick-with-it/get-back-on-track" target="_blank" title="what to do if you have a setback quitting tobacco">what to do if you have a setback quitting tobacco</a> and managing <a rel="noopener noreferrer" href="https://smokefree.gov/challenges-when-quitting/cravings-triggers/how-manage-cravings" target="_blank" title="cravings article">cravings</a>. </li>
<li>The Food and Drug Administration warns that <a rel="noopener noreferrer" href="https://www.fda.gov/tobacco-products/products-ingredients-components/smokeless-tobacco-products-including-dip-snuff-snus-and-chewing-tobacco" target="_blank" title="FDA webpage">smokeless products</a> have their own dangers. </li>
<li><a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/" target="_blank" title="CDC webpage">Smoking and tobacco</a> use from the CDC includes information on <a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/nicotine-pouches/index.html" target="_blank" title="CDC webpage">nicotine pouches</a>, <a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/menthol-tobacco/index.html" target="_blank" title="CDC webpage">menthol tobacco products</a>,<a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/e-cigarettes/index.html" target="_blank" title="CDC webpage"> vaping</a>, <a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/secondhand-smoke/index.html" target="_blank" title="CDC webpage">secondhand smoke</a>, and much more. </li>
</ul></p>
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<p><strong>Forwarded by:<br />
Michael Reeder LCPC<br />
Baltimore, MD</strong></p>
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