Does getting VA care negate Tricare eligibility?
April 7th, 2010 | TriCare Help | Posted by Military Times
Q. If a military retiree of over 20 years’ service is enrolled/treated at a VA hospital, does that make him/her and spouse ineligible for Tricare for Life? Also, has there been a change in the new medical bill signed by President Obama?
Tricare and VA benefits are unrelated programs governed by totally different federal laws. If a person is otherwise eligible for Tricare, using VA benefits will not negate his Tricare eligibility except that he may not file Tricare claims for any costs incurred by getting care with the VA.
The only exception to that rule is in the case of the very few VA Medical Centers that have special status as Tricare-authorized providers. Your VA center administration can advise you if your center is one of them.
Until DoD legal experts have properly evaluated the new health care law, it is not possible to say what, if any, effects there will be for Tricare. Any changes to Tricare will be widely publicized far in advance of their effective date. None are expected except the possibility of extending the upper age limits of Tricare eligibility of certain children in certain circumstances.
Tricare dependents under health care reform
April 5th, 2010 | TriCare Help | Posted by Military Times
Q. I have read that the new heath care reform legislation will not affect Tricare coverage because it is under the sole authority of the Defense Department, and as such, is governed by an independent set of statutes. Eligibility, covered benefits, copayments and other features of the Tricare program remain in place. That is a good thing to know.
However, if I understand correctly, since Tricare’s benefits are set by statute, separate legislation is required to change them to fall in line to cover children up to age 27 under their parent’s health care coverage. If changes are made to the statutes governing Tricare, then time will be required to implement the changes. Until that time, the Tricare benefit remains unaffected by the Patient Protection and Affordable Care Act. Therefore, my 22-year-old daughter, who currently is a full-time student, will still lose her health care benefits on her birthday this December while other children, not privileged to have military parents, will retain their insurance until they turn 27.
Are you aware of any moves to to change this statute so our children can enjoy the same benefits while completing their education? Or, am I hopefully all wrong here and our children will be covered until they turn 27 ?
Congratulations on not believing and being frightened by every cockamamie e-mail floating around the Internet. Unlike that of many others who have written concerning the new law, the information you cite is correct as far as I know at this time.
The age limits for the Tricare eligibility of children were established by Public Law 89-614 (codified at Chapter 55 of Title 10, United States Code, as amended) which, in 1966, created the program, formerly CHAMPUS, now called Tricare. It is possible that Congress will have to amend that law before any changes to Tricare’s age limits for children may be implemented permanently.
In the meantime, Military Times Congressional Editor Rick Maze reports that Rep. Martin Heinrich, D- N.M., introduced a bill, HR 4923, on March 24 to apply the new law’s age extension to Tricare. It is being considered by the House Armed Services Committee for inclusion in the 2011 Defense Authorization Act, which normally takes effect on October 1 or later of each year. As of now, the bill is still in committee.
Tricare’s official word on health care reform
March 31st, 2010 | TriCare Help | Posted by Military Times
Tricare has posted updated information on health care reform on its web site, along with a Q&A. Remember, information from official sources is more reliable than most things you receive via e-mail from family and friends.
News update: Tricare and health care reform
March 30th, 2010 | TriCare Help | Posted by Military Times
Whenever Military Times posts a news story about health care reform and Tricare, we’ll post a link here. The latest:
Tricare health benefits for older children would not be free to their parents under a bill introduced in the House to ensure military parents are not left out of a key early benefit of the national health care reform bill. Read the full story
Health care reform and Tricare: No firm answers yet
March 29th, 2010 | TriCare Help | Posted by Military Times
The president recently signed into law the biggest piece of social legislation since the Civil Rights Act. Millions wonder how it will affect their personal lives, and among them are the 9.5 million Tricare and Tricare for Life beneficiaries, plus VA beneficiaries, and millions of Medicare beneficiaries, mostly civilians. People want answers, and they want them now. The answers, unfortunately, are not available yet. The agencies affected must first determine how to implement the law.
Congress created special agencies to manage medical programs for the military, retirees, and veterans. Each agency wrote regulations to interpret and implement the various laws that affect their programs. Now, they must analyze the new law to determine if it will require changes in those regulations, or changes in the way their programs operate. To determine how that must be done may take weeks. No changes will take effect without advanced, official, public, notification.
My mailbox is filling with questions about whether this or that will happen. I don’t know the answers. Tricare Help has no more information than you have. I have talked with Health Affairs, and that office does not know yet if the new law will require any changes in Tricare’s rules or operations. It isn’t possible to know until the law is analyzed by DoD’s legal experts. At this time, no one knows whether any provision of the law will have any effect of any kind on Tricare or Tricare for Life.
If the new law requires changes in any government program including Tricare and Tricare for Life, the information will quickly be made public by official sources as soon as the changes are in place. Until then, sit tight. Adopt a wait-and-see attitude. Don’t believe, and don’t repeat, rumors. Wait for official facts. Official information is not distributed to individuals by e-mail.
I am reminded to say, beware of any e-mail, presumably from Tricare, about benefits or eligibility and asking for personal information. Don’t click their links. Tricare will never start an e-mail correspondence by contacting you first.
Call DEERS, toll-free, at 1-800-538-9552, with any eligibility questions. Call your Tricare Service Center for benefit information. Don’t forget your official Tricare Web site at www.tricare.mil.
Worried about rumors of Medicare cuts
October 1st, 2009 | TriCare Help | Posted by Military Times
Q. If the Congress cuts the Medicare program by $500 billion, what happens to Tricare for Life? While it is a government health benefits program, Tricare for Life is tied to the Medicare program. I am confused as to how Tricare for Life will come out.
Remember that Medicare, too, is a government program, governed by federal law. In any case, that figure is contrary to the President’s public declarations regarding Medicare, and I’m not one to speculate about speculations. Let’s wait until we have something definitive to talk about. Then we can worry.
I’m certain you can understand my reasons. Que será será.
What about health care reform?
September 29th, 2009 | TriCare Help | Posted by Military Times
Q. Isn’t it true that Medicare Part B requirements come before Tricare’s, and that medical procedures received under Medicare must be approved before Tricare takes action (with certain exceptions)? And wouldn’t reducing the standard cost of procedures under Medicare cause more competent physicians — those who charge more than the standard rate — to not accept Medicare patients and therefore reduce the number and quality of physicians available to military retirees under Tricare? These are not rhetorical questions; they reflect my skepticism regarding the total truth from those trying desperately to sell a program with far too many hidden costs and benefits.
When a uniformed service retiree, retiree family member, or a survivor of a deceased active duty or retired member becomes entitled to Medicare, that program becomes his primary health “insurance.” He becomes, in effect, a Medicare beneficiary first; Tricare Standard becomes second payer to his Medicare claims.
Under the law governing Medicare, the retiree must seek all civilian care from Medicare-authorized providers only. The Medicare provider will file an ordinary Medicare claim for the services he provides to the TFL beneficiary just as he would for any other Medicare patient.
If you are familiar with the rules governing TFL under federal law, you know that when both Medicare and Tricare cover all the medical services on the Medicare claim, Tricare will pay whatever Medicare does not pay, up to the amount Medicare approved on each charge. There is no Tricare deductible or Tricare cost share applied to the Tricare portion of the TFL claim. Thus, the Medicare claim, and the provider’s bill, are paid in full. The TFL beneficiary has no out-of-pocket costs for that claim.
For a number of years, certain factions have attempted every year to decrease the amounts Medicare may approve on claims, thus reducing the total amount Medicare may pay. If Congress were to allow those reductions, it could have the effect of reducing the number of providers who will continue to provide services to Medicare beneficiaries. That could have the effect of Medicare’s being considered a failed program in need of being replaced by private industry.
I understand your questions and concerns, but long-time readers of Tricare Help know that, since I started the print column in 1992, I have consistently endeavored to keep it free of personal opinions or other political disputes. If I did, the column would quickly become just another forum for debate, and it would lose its original nature of helping beneficiaries to better understand their medical benefits. I explain Tricare only as it is, not what it should or might become.
Therefore, I will not comment on my personal opinion or my feelings about attempts to compromise the value of the Medicare program for all its beneficiaries, civilian as well as military.
It is worth noting, however, that the President is on public record of saying that there is nothing his proposed health care reform program that will damage or reduce Medicare coverage in any way. Note also that Medicare, like Tricare, is governed by federal laws that only Congress, not the president, has power and authority to change. The President himself lacks the power to add or remove even a comma from the law as enacted or amended by Congress.