TRICARE HELP

Posted: April 17, 2010 in TRICARE HELP

Have a question on how Tricare applies to your personal situation? Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In e-mail, include the word “Tricare” in the subject line and do not attach files. You can also get Tricare advice online anytime at http://www.militarytimes.com/tricarehelp. For basic information refer to the latest Tricare Handbook at http://www.tricare.mil/mybenefit/Download/Forms/Standard_Handbook_LoRes.pdf or call your regional contractor. Following are some of the issues addressed in recent weeks by these sources:

(Q) What constituents a ‘Full time Student’? My son, who will be 21 in July, lives at home and is a student. He takes two or three classes per quarter. What is considered a “full-time student” to keep medical coverage? He has a chronic eye condition that needs regular doctor appointments and needs to be covered.

(A) To be eligible for Tricare beyond his 21st birthday, your son must be certified by his university – not Tricare – as being a “full-time” student. Contact the university’s Registrar for that information. Contact the DEERS Support Office at 1(800) 538-9552, for help and information regarding Tricare eligibility beyond age 21 for full-time students. DEERS will help with the administrative things that must be done. Tricare eligibility is determinded by federal law. Tricare has no authority to determine Tricare eligibility. Only the services have that authority. To help with eligibility issues is DEERS’ only function. Contact DEERS anytime you have a Tricare eligibility question or need help with such matters.

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(Q) How does VA and Tricare health care interact? 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?

(A) 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.

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(Q) Will my college dependent lost Tricare upon turning 23? 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 ?

(A) 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, H.R.4923, on 24 MAR 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 1 OCT or later of each year. As of now, the bill is still in committee.

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(Q) Can my parent use Tricare? I am a retired Marine. How can I enroll my mother as my dependent? I have been supporting her.

(A) To register your mother as your dependent, talk with your Personnel Section. But note that, even if your mother becomes your dependent, she will not become eligible for Tricare. Federal law forbids it. You may be able to arrange for her to get free medical care at your military hospital. Talk with the hospital’s Executive Officer or the Officer-in-Charge of Patient Administration about that. For official confirmation that your mother cannot become eligible for Tricare as your dependent, call the DEERS Support Office, toll-free, at 1(800) 538-9552.
[Source: NavyTimes James E. Hamby Jr. column 12 Apr 2010 ++]

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