Military Medical Retirement <20 years

[Fireup2025]

I have a veteran who is medically retired (yes, he has the blue indef. retiree ID card) Very little is available with regard to his benefits. My references for military separations/retirements explains how to process med. retirements out of the service (I do mil separations and mobilizations/de-mobs in the Reserve) Tricare and CHAMPVA have been little help to me.

Veteran just lost his civ job and came in to see me. His VA disability $$$ are greater than what his pension would be, so he just gets the VA $$. He is responsible for providing healthcare for his dependent child. Tricare could not answer my questions regarding eligibility for his child. Other than straight VA benefits and access to base facilities, is a retiree with less than 20 years eligible for regular health care for dependents? He is in his 30's, so no medicare eligibility.

Is anyone else in a similar situation. Your experiences will be of great interest.

[OAG]

I would suggest that he get in touch with the State Veteran's Service Officer (or whatever else they are called in his state (NJ)). They usually work out of the local VA office and are advocates for the veteran. I actually was a VSO in the state of VA for a short period of time so I can attest to the fact they exist to help the Veteran. A call to the local VFW or other such Veteran's organization would point him/you in the right direction. Additionally, if he is unable to work, he should contact the SS administration regarding anything they can do for him or suggest.

[Fireup2025]

He is - that is why he is speaking to me (this is a new one - and not easily resolved) Been on hold with DEERS for over an hour, which is why I am posting here. My fellow VA geezers do not have answers either.

[Nords]

Originally Posted by Fireup2025

He is responsible for providing healthcare for his dependent child. Tricare could not answer my questions regarding eligibility for his child. Other than straight VA benefits and access to base facilities, is a retiree with less than 20 years eligible for regular health care for dependents? He is in his 30's, so no medicare eligibility.

I don't know the answers and I understand that it's risky to apply logic to this situation, but if he's retired (no matter what the reason) then he's supposed to be eligible for TRICARE. If his child is entered in DEERS then he can pay the premiums for a TRICARE (Standard/Prime) policy.

This should apply even if he's on the Temporary Disabled Retired List (TDRL). A shipmate of mine ended up in this situation (open-heart surgery then TDRL followed by TERA) in the late 1990s and had no problems with TRICARE for spouse & kids.

Military medical facilities are supposed to have a TRICARE ombudsman who lives to verify DEERS and then to answer these questions. I don't know what would be closest in your area, but any service's medical facility and maybe even a clinic could refer you to their ombudsman. Even if the child doesn't live with the retiree they would be able to register in their geographic TRICARE region-- DEERS routinely handles that for divorced parents & college students.

Another option would be the Navy's Retired Activities Officer at the Fleet & Family Services Center. These guys don't necessarily know the answers but they spend a lot of time with people who've had to deal with these types of situations, and they may know a local expert who can help shed light on the situation.

Finally, a local VFW post will have someone who's fought similar battles and who maybe even knows another way to solve the health insurance problem.

If your client is computer-savvy then he may want to start asking questions on the discussion boards at Military.com, NavyTogetherWeServed, and even GruntsMilitary.com :: Index. I hesitate to recommend that final group because they can pretty gruff & grumpy-- they banned me after my first post (we worked it out). Despite their attitude they have a heckuva lot of disabled people on that forum with encyclopedic knowledge of how to work the system. Just don't bring up the subject of early retirement...

[SoonToRetire]

From searching through the internet, it appears that he is eligible if he is 100% disabled. If he is, he and his child will be eligible for either Tricare (it's not clear when or why Tricare would deny coverage), or CHAMPVA if Tricare denies coverage. My father was 100% disabled, and the determination was made by the VA after he initially received something like 80% disability. So, if this individual is not 100% he can petition for review if his disability increases.

<Veteran just lost his civ job and came in to see me. His VA disability $$$ are greater than what his pension would be, so he just gets the VA $$.>

I don't get this. Why would his civ pension be linked to his VA $?

Here are some links:

Families of veterans who have a 100 percent, permanent disability, or of veterans who died from a service-connected disability, may be covered by CHAMPVA as long as they are not eligible for TRICARE. Eligible former spouses who when they remarried lost their TRICARE eligibility and whose marriage ended in divorce or death may also be entitled to CHAMPVA. CHAMPVA is administered by the Department of Veterans Affairs. Veterans may contact the Department of Veterans Affairs toll-free, 1-800-827-1000, for information. Details on possible CHAMPVA eligibility for Family members are available from the Veterans Affairs Health Administration Center toll-free at 1-800-733-8387.

U.S. Army HOOAH 4 HEALTH Benefits Signpost - TRICARE Eligibility

Who is eligible for CHAMPVA?

To be eligible for CHAMPVA, the beneficiary cannot be eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and to the children of a veteran who:

• is rated permanently and totally disabled due to a service-connected disability, or
• was rated permanently and totally disabled due to a service-connected condition at the time of death, or
• died of a service-connected disability, or
• died on active duty and the dependents are not otherwise eligible for DoD TRICARE benefits.

From the CHAMPVA site:


Effective October 1, 2001, CHAMPVA benefits were extended to age 65 and older. To be eligible, you must also meet the following conditions:

• if the beneficiary was 65 or older prior to June 5, 2001, and was otherwise eligible for CHAMPVA, and was entitled to Medicare Part A coverage, then the beneficiary will be eligible for CHAMPVA without having to have Medicare Part B coverage.
• if the beneficiary turned 65 before June 5, 2001, and has Medicare Parts A and B, the beneficiary must keep both Parts to be eligible.
• if the beneficiary turn age 65 on or after June 5, 2001, the beneficiary must be enrolled in Medicare Parts A and B to be eligible.

http://www.va.gov/hac/forbeneficiaries/champva/faqs.asp

[Fireup2025]

My apologies for the OP - and not making myself clear. Not all medical retirees are 100% disabled. This veteran served for 8 years, and based on medical conditions, was medically retired - meaning he gets a pension (which is less $$ than his VA disability, so he just gets 40% disability) His son was born out of wedlock years after he "retired" Many local Tricare physicians in the are are not accepting new patients. Getting his son enrolled in DEERS will be another thing, since Tricare claims he needs a paternity test (never mind the birth certificate and court order for CS) !!!

I was really looking for someone else who was familiar with this type of situation.

I have greased the local skids for him to bring his son down to get an ID and enrolled in DEERS. Hopefully this will satisfy the mandate that he provide health coverage for his son. Tricare is very tough to deal with - maybe easier as a retiree, but when I was recently on active duty in an area without a MTF (mil treatment facility) it was agonizing!

Since he did not serve 20 years, providers question his ID, and it is just VERY frustrating.

[2soon2tell]

If the veteran is rated 100% P&T (permanent and total) by the VA, their dependents are eligible for CHAMPVA medical coverage. The key is a 100% P&T rating. If the veteran meets this requirement he/she can contact the VA for the necessary enrollment forms.

If the veteran is not currently 100% rated and their condition has worsened since retirement they should file for an increase in rating from the VA. The DAV (Disabled American Veterans) has helped me file claims with the VA and can offer sound advice.

2soon

[Nords]

Originally Posted by Fireup2025

His son was born out of wedlock years after he "retired" Many local Tricare physicians in the are are not accepting new patients. Getting his son enrolled in DEERS will be another thing, since Tricare claims he needs a paternity test (never mind the birth certificate and court order for CS) !!!

That sucks and is probably a discrimination issue with marital status, but it's how Tricare must feel they're holding the line against fraud.

Dumb question-- who does the DEERS entry? I thought it was PSD when the ID card was issued (or at least someone other than Tricare) in which case it doesn't matter what Tricare thinks. Once the family member's in DEERS then Tricare is supposed to do their thing without sniveling. Never heard of a blood test requirement if the service member acknowledged paternity, but admittedly that was my active-duty days when the letters started rolling in after the Subic Bay portcalls.

Originally Posted by Fireup2025

Since he did not serve 20 years, providers question his ID, and it is just VERY frustrating.

I think providers have watched the trend in Medicare & Tricare reimbursements and will use any excuse to find other payments patients...

[Fireup2025]

Originally Posted by Nords

Dumb question-- who does the DEERS entry? I thought it was PSD when the ID card was issued (or at least someone other than Tricare) in which case it doesn't matter what Tricare thinks.

Hehe, but that is one of the things I do at PSD (ID card verification and issue) when on Navy time! Eligibility and actual service are NOT necessarily the same thing (yes they should be) - and that is why I am so pi$$ed off! Hopefully this helps explain my views on the disconnect between DEERS and Tricare. Tricare - bleah!

VSO training does not cover this mess - only VA stuff.

Nords, I agree, must be a payment issue.


(disclaimer - to explain the "pots" I have my hands in: I am still a drilling reservist, who is an admin weenie. I am also a vet rep {DVOP}, NJ VFW State Employment officer, and have completed most of my VSO training, which is focused on getting disability claims and appeals processed - and consider myself pretty well versed in the way the VA works, and veteran bennies in NJ. )

Military retirees in non military areas can get the short end of the stick.

[Nords]

Originally Posted by Fireup2025

Hehe, but that is one of the things I do at PSD (ID card verification and issue) when on Navy time!

So... are you still drilling? Next drill weekend should he show up at your PSD desk where you can solve all sides of the problem at once? Between your NJ job and your drill billet you must have the world's largest red-tape scissors! As I keep asking my spouse, what are they gonna do... make you retire?

I've formed the apparently mistaken impression that Fort Dix is providing more veteran's services than it seems to be.

Another dumb question-- I know he doesn't meet the 20-year-retirement qualification for CRSC (Combat Related Special Compensation) but is there some sort of medical-retirement loophole in the CRSC rules that'd allow him to collect both his VA disability and his medical-retirement pension?

[Fireup2025]

Originally Posted by Nords

So... are you still drilling? Next drill weekend should he show up at your PSD desk where you can solve all sides of the problem at once? Between your NJ job and your drill billet you must have the world's largest red-tape scissors! As I keep asking my spouse, what are they gonna do... make you retire?

yes; drilled out for FY, so no drills til Oct; I drill in DC, and we can get this fixed closer to home; red-tape swords rather!; YES!! Jan 1, 2009 (and hoping for a twilight boondoggle AT in HI next Oct!)

Originally Posted by Nords

I've formed the apparently mistaken impression that Fort Dix is providing more veteran's services than it seems to be.

(not @ Ft. Dix anymore)

Originally Posted by Nords

is there some sort of medical-retirement loophole in the CRSC rules that'd allow him to collect both his VA disability and his medical-retirement pension?

Only if he gets his VA rating up to 50% (request for increase in works) See rules on concurrent receipt. Right now it is all tax exempt. His med issues are not combat related (he was a squid too )

The typical issues do not make this board - just the disgruntling ones!

[Nords]

Originally Posted by Fireup2025

The typical issues do not make this board - just the disgruntling ones!

Yeah, I figure you've fixed far more problems than I've ever even heard about, let alone had to deal with. That's one part of training commands & student admin that I don't miss one bit.

Don't even get me started on spouse's Reserve travel claims...

[Fireup2025]

Originally Posted by Nords

Yeah, I figure you've fixed far more problems than I've ever even heard about, let alone had to deal with.

Thank you - and yes, some of them are nothing short of amazing (the circumstances) Have a murderer (killed someone AFTER he got out of the USAF honorably, and has served his time and now looking for a job and VA bennies) I am working with now...

Originally Posted by Nords

Don't even get me started on spouse's Reserve travel claims...

Mine just hit today for 3 weeks in July - and I faxed it in the day after I got back! I feel her pain!

[Bimmerbill]

I supervise a Deers/Rapids site. I don't actually run the machines tho, so am rusty on the specifics.

I believe that if he shows up at a site he can add his son with a birth certificate listing him as father.

Like Nords said, once he is in DEERS he is eligible for whatever benefits his father is. I think it is until 18, or 21 if in college...

RAPIDS SITE LOCATOR