Tricare Answers

[mickeyd]

This is for retired military folks enrolled in Tricare. I received an email from MOAA that included a Q/A section. A couple of the Qs related to Tricare follows this. I found them informative.

2. I'm on TRICARE For Life. How do the DoD health fee proposals affect me?
There are two parts of the plan proposed by the Task Force on the Future of Military Health Care that would affect Medicare-eligibles. The plan calls for significant increases in copays for most medications not obtained at military hospitals and clinics. For drugs purchased in retail pharmacies, the plan would raise the generic drug copay to $15 (vs the current $3), for brand name formulary drugs, it would be $25 (vs. the current $9) and for non-formulary medications, it would be $45 (vs. the current $22). Generics would be provided at no charge through the mail-order system, but the copay for other drugs would rise. The Defense Department included these proposals in the FY2009 defense budget proposal. MOAA is fighting those unfair increases.
The Task Force also proposed an annual $120 enrollment fee for TRICARE-For-Life beneficiaries, but the Defense Department didn't include that in the FY2009 defense budget, so that's not on the legislative table this year. MOAA believes it's only a matter of time before Defense leaders push for a TFL enrollment fee at least that big.

3. Has the Shingles vaccination SNAFU been fixed yet? I'm being required to pay for almost the whole thing out of pocket! TRICARE does cover the vaccine, but TRICARE deductibles and copays will apply for TFL users. That means that retirees who get the vaccine early in the year, before they've met their annual deductible will pay some or all of the cost of the benefit. MOAA believes preventive care such as this vaccine should be exempt from any deductible or copay, and has recommended that to both the Defense Department and Congress. At the very least, it should be covered as a pharmacy issue rather than a health care service, so that it would only have a $3 or $9 copay and be exempt from the deductible.

From my own experience, I know that if you can receive the Shingles vacination from a military health care facility there is no cost but you must be age 60 and have a recomendation from your primary care doc (an easy entry on the computer data base).

[packrat44]

Thanks for the "heads up".

[SoonToRetire]

I'm in Tricare from having retired from 20 years active duty. An elderly aunt just asked me a Tricare question that I can't answer, and wonder if anyone can help.

She is the widow of an Army National Guard Warrant Officer, and is on Medicare. I don't know if he officially retired from the NG, but she is receiving a widow's pension, so I assume he did. She has Medicare Part B. My question, does she qualify for TFL? If so, does she just go by and enroll in DEERS like other military dependents?

[packrat44]

SoonToRetire, That is what I would do. She would not be receiving Survivor Benefit's pension each month if her deceased husband were not officially retired. Therefore, if she is 65 or older I would think she is qualified for TFL. If younger than 65, Tricare Standard or Tricare Prime.

[OAG]

Widows "pension" paid by the VA is different from SBP paid indirectly by the Military. My Aunt receives a "pension" (husband was killed non-combat during WWII) and as such does NOT qualify for TFL. However, having said that, she definitely should call a Rapids site to find out for sure.

[SoonToRetire]

Thanks for the tips, I found out my aunt is indeed TFL eligible. Her deceased husband served in the NG, was called up during WWII and Korea, and continued in the NG and reserves until retirement. He was buried in a national cemetery, and I'm sure they must have explained to her what her benefits were. But at 89 and with a touch of forgetfulness, she probably forgot.

[packrat44]

It is nice when a plan comes together. However, it would have been nice to have caught this earlier. Might have saved some $.

[mickeyd]

Originally Posted by SoonToRetire

But at 89 and with a touch of forgetfulness, she probably forgot.

I believe that TFL has only been around for about 20 years or so, so she would probably already been on medicare at the time that it appeared on the scene. Do you know if she allowed to enroll in TFL at this late date?

[OAG]

TFL was President Bill Clinton's gift to old retired military towards the end of is second term. He must have thought it was something else when he signed the bill.