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Future US Military
Retired_Activities
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The following bulletins are furnished to ANA as important information to retirees by LT EMO Tichacek, USN (Ret) who is the Retired Activities Director in Baguio, P.I. and are used with his permission. If you have questions about the articles, please direct them to the cited reference in the bulletin and NOT to ANA or LT Tichacek. 01 May 2005
Note: James Tichacek has relocated to the Philippines. Although his email address raoemo@sbcglobal.net is still good...and you will see the Bulletin being sent from that address via his Mailing List Provider in Europe...he must go on the web to access email sent to him at this address. With no DSL available to him at this location, it is a lengthy and time consuming process to open email sent to raoemo@sbcglobal.net Until further notice request...all email be sent to him be sent via raoemo@mozcom.com DoD Rising Medical
Cost: Confronting medical costs that have doubled in four years,
military officials and congressional leaders announced on 21 APR that
the Pentagon needs to rethink the generous coverage it provides to
retirees or risk making sacrifices in other areas of the Defense
Department budget. Administration officials told the Senate Armed
Services subcommittee on personnel that a rich benefits package, coupled
with expanded retiree coverage, has thrust the Pentagon into the same
financial predicament that is threatening the profitability of such
major companies as General Motors Corp. The Assistant Secretary of
Defense for Health Affairs reported the cost of covering 9 million
active-duty members, retired personnel and their families rose from $18
billion in 2001 to $36 billion this year. By 2010, that figure will
likely reach $50 billion, with 70% devoted to retiree coverage. One of
the main culprits is Tricare for Life, the program enacted in 2001 that
guarantees comprehensive coverage for retirees. It was created in
response to a public outcry from veterans as they moved from military
coverage into the less-generous Medicare program at age 65. This year,
the retiree program will cost $11 billion. Commenting on administration
official's input to the committee, Chairman Sen. Lindsey Graham
indicated they are going to have to look into redesigning health care
coverage in the future or the budget challenge will continually get out
of hand. [Source: Washington Post Staff Writer Ceci Connolly 22 APR 04 & Rick Maze Navy Times staff writer 2 May 05] Tricare Pharmacy Rates
Update 02: The Assistant Secretary of Defense (Health Affairs),
after taking recommendations from the DoD Pharmacy and Therapeutics
(P&T) Committee and the Beneficiary Advisory Panel (BAP) into
consideration, has announced the selection of three medications to be
placed in the non-formulary category of its new Formulary: Nexium® (esomeprazole),
a medication for ulcers and other stomach problems, and Teveten® (eprosartan)
plus Teveten HCT® (eprosartan with hydrochlorothiazide), both used to
treat high blood pressure. Effective 17 JUL 05 military beneficiaries
will pay $22 for up to a 30 or 90-day supply of these medications,
depending on whether they fill the prescription at a TRICARE Retail
Network Pharmacy (TRRx) or through the TRICARE Mail Order Pharmacy (TMOP).
Beneficiaries will pay the higher of $22 or 20% in retail non-network
pharmacies. Patients currently using Nexium®, Teveten® or Teveten HCT®
may wish to consult their doctor. A summary of therapeutic alternatives
to the non-formulary medications, and their corresponding cost share
are: If medical necessity is established for
using Nexium®, Teveten® or Teveten HCT®, patients may qualify for the $9
cost share for up to a 30-day TRRx supply or up to a 90-day TMOP supply.
Military Treatment Facilities (MTFs) will no longer have Nexium®,
Teveten® or Teveten HCT on their local formularies. MTFs will be able to
fill non-formulary requests for these medications only if both of the
following conditions are met: MTFs may (but are not required to) fill
a Nexium®, Teveten® or Teveten HCT® prescription written by a non-MTF
provider to whom the patient was referred, as long as medical necessity
has been established. Active duty members pay no cost shares, and unless
medical necessity is established, they may NOT obtain non-formulary
drugs. Beneficiaries who already have a medical necessity determination
for Nexium® on file at the TMOP are required to reestablish medical
necessity for the drug under the medical necessity criteria approved by
the Director of Tricare in order to receive Nexium® at the $9.00
formulary cost share. Existing TMOP medical necessity determinations for
Nexium will become invalid on 17 JUL 05. For more information about TMOP
eligible beneficiaries can call (866) 363-8667 or visit the
Express-Scripts Inc. Web site at
http://www.tricare.osd.mil/pharmacy/tmop_contact.cfm Beneficiaries
may also contact the TRRx customer service line at (866) 363-8779, or
visit:
http://www.tricare.osd.mil/pharmacy/trrx_contact.cfm Beneficiaries
may use the Formulary Search Tool for additional information about
various medications, their availability and cost at: http://www.tricareformularysearch.org TFL Criteria: Tricare
for Life (TFL) entitlement is established by the law that created the
program in 2001. To be entitled to TFL, each person must be ALL of the
following: A spouse will not become entitled to Tricare for Life until he/she becomes entitled to Medicare at age 65. If a Tricare beneficiary is properly registered in DEERS and is enrolled in Part B of Medicare, the transition from ordinary Tricare eligibility to TFL entitlement is automatic and seamless one second past midnight on the last day of the month preceding the month of that person's 65th birthday. The beneficiary does not have to do anything to make it happen. This is true regardless of whether the beneficiary becomes entitled to Social Security payments at that time. A beneficiary does not have to be entitled to Social Security payments to get Medicare at age 65. Medicare entitlement begins on the first day of the month of the person's 65th birthday, even if his Social Security payment entitlement will not start until later. Certain people become entitled to Medicare before they are 65 because of disability or kidney disease. They are called dual eligibles if they are enrolled in Part B of Medicare. Their claims are processed and paid in exactly the same way as those of TFL beneficiaries. However, they are not TFL beneficiaries because the condition creating Medicare entitlement may not be permanent. If the condition improves enough, Medicare will terminate their entitlement. Then, they will no longer have dual eligibility. They will revert to their previous Tricare eligibility status. Medicare entitlement upon reaching age 65, and the resulting TFL entitlement, is permanent lifelong. It requires only that the beneficiary's DEERS record and Part B enrollment be properly maintained. Divorce, or remarriage if widowed, will unfavorably affect the nonmilitary member's entitlement in most cases. Anyone having Tricare related questions can write to James E. Hamby Jr. at Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or e-mail him at mcochamp@aol.com In e-mail, include the word "Tricare" in the subject line and do not attach files to your message. Attachments will not be opened. [Source: James Hamby NavyTimes article 2 May 05] Locating Insurance Policies: Survivors are sometimes faced with not knowing which insurance company to notify and/or make claim to for benefits they were told by deceased family members they would receive. There is no central repository which identifies all policies in effect. There are some "Internet" companies such as http://www.LostPolicy.com that charge a fee to search for possible policies by sending mass emailings to hundreds of the major insurance companies. Each state has an Insurance commission that can be located on the Internet who will generally help survivors locate a company that might still be holding the proceeds from a life insurance policy, but they have to have the name of a company to assist you. They have no way of knowing whether any person has life insurance and with which company. To provide this information some tips for continuing your search are: 1. Examine your relatives bank
statements and check registers for payments to life insurance companies.
Life insurers commonly require payment of premiums by bank drafts. These
payments appear on monthly bank statements. Searcher's should be aware that for a life insurance policy to be valid the policyholder had to keep it in force by paying the premiums. Some cash value policies become "paid up" after a person pays premiums for a specific number of years. However, people often cancel policies or let them lapse but keep the discontinued policies in their records. If a life insurance company knows that an insured has died but it cannot find the policy beneficiaries within a specified time (normally 3 years), it must send the death benefit to the state Comptrollers unclaimed property fund. The rightful owners of the life insurance proceeds can reclaim them from the Comptroller. For more information, go to the appropriate state Comptroller's Web site. [Source: Texas Commissioner of Insurance 26 Apr 05 ++] SBP DIC Offset Update 02: Senate SBP champion, Sen. Bill Nelson, D-FL, has sent President Bush a letter urging his support in ending the unfair SBP-DIC offset that affects thousands of military widows. The issue was one of several survivors' issues raised by a group of widows the President met with during a visit to Ft. Hood, Texas. In the letter, Sen. Nelson noted that his bill, S.185, fixes the SBP-DIC offset problem and that he had filed an amendment to the Iraq Supplemental Appropriations Bill that would repeal the offset. Under current law, military survivors' SBP entitlement is offset dollar-for dollar by their DIC entitlement - currently $993 per month. The unfair practice hit home with the widows of the war on terror at Ft. Hood and they let the President know it. But Sen. Nelson's amendment was ruled "not germane" in a cloture vote on his Supplemental amendment. Despite the setback, work continues on building cosponsor support for the legislation. S.185 has 21 cosponsors, nearly double the number for a similar bill in the 108th Congress. In the House, companion bills H.R. 808 (Rep. Henry Brown, R-SC) and H.R. 968 (Rep. Jim Saxton, R-NJ), are also ahead of the last Congress' House cosponsorship of similar bills. [Source: MOAA Leg Up 22 Apr 05] COLA 2006: On
April 20, the Bureau of Labor Statistics announced the monthly Consumer
Price Index (CPI), which is the metric used to calculate the annual
cost-of-living adjustment (COLA) for military retired pay, VA disability
compensation, survivor annuities, and Social Security. After smaller
increases in the CPI during the winter, inflation has continued to rise
slowly so far this year. The March CPI is 0.7 percent above the January
tally, and 1.9 percent above last year's COLA baseline. At this point,
it is still too early to project what the 2006 COLA may be. Afghanistan & Iraq Medals: The Defense Department has announced the Afghanistan Campaign Medal and Iraq Campaign Medal for service members who directly supported Operation Enduring Freedom between 24 OCT 01 and a date to be determined in the future, or Operation Iraqi Freedom between 19 MAR 03 and a future date. Until now, members deployed to Afghanistan and Iraq during the designated periods were awarded the Global War on Terrorism Expeditionary (GWOT) Medal. Those with the GWOT Expeditionary Medal remain qualified for it, and officials said they may apply for the new medal or medals as well. However, the qualifying period for one award cannot be used for the other. Only one award of each of the new medals is authorized. No member is entitled to wear all three medals for the same act, achievement or period of service. Each military department will administer the new medals. [Source: Armed Forces News 15 APR 05] VA Handbook Update 01:
The new edition of the Federal Benefits for Veterans and
Dependents handbook by the Department of Veterans Affairs (VA) has been
released. It updates the rates for certain federal payments and outlines
a variety of programs and benefits for American veterans. Most of the
nation's 25 million veterans qualify for some VA benefits, which range
from health care to burial in a national cemetery. In addition to
health-care and burial benefits, veterans may be eligible for programs
providing home loan guaranties, educational assistance, training and
vocational rehabilitation, income assistance pensions, life insurance
and compensation for service-connected illnesses or disabilities. In
some cases, survivors of veterans may also be entitled to benefits. The
handbook describes programs for veterans with specific service
experiences, such as POWs or those concerned about environmental
exposures in Vietnam or in the Gulf War, as well as special benefits for
veterans with severe disabilities. In addition to describing benefits
provided by VA, the 2005 edition of the 120-page booklet provides an
overview of programs and services for veterans provided by other federal
agencies. It also includes resources to help veterans access their
benefits, with a listing of toll-free phone numbers, Internet addresses
and a directory of VA facilities throughout the country. The handbook
can be downloaded free from VA's Web site at http://www.va.gov/opa/feature/
or purchased from the U.S. Government Printing Office (GPO). GPO accepts
credit card orders for the publication at (866)512-1800 for a cost of $7
each to U.S. addresses, or $67 for bulk orders of 25 copies. It can be
ordered by mail from the GPO at Superintendent of Documents, P.O. Box
371954, Pittsburgh, PA 15250-7954 (stock #051-000-00228-8). VA Tinnitus Comp
Update 01: On 5 APR 05, the United States Court of Appeals for
Veterans Claims handed down its decision in Smith v. Nicholson. The DAV
had argued on behalf of Mr. Smith that he was entitled to two separate
10% disability ratings for service-connected tinnitus, i.e., ringing, in
his right and left ears. The Department of Veterans Affairs (VA) argued
in Smith's case, as well as a large number of other cases, that the
schedule for rating disabilities provided for only one 10% rating,
regardless of whether the tinnitus was present in only one ear or both
ears. The Court held that: "Based on the plain language of the
regulations, the Court holds that the pre-1999 and pre-June 13, 2003
versions of [diagnostic code] 6260 required the assignment of dual
ratings for bilateral tinnitus." Veterans who filed a claim for service
connection for tinnitus in both ears, or who claimed an increased rating
for that condition, prior to 13 JUN 03, may be entitled to receive
combined disability compensation based on two 10% ratings for tinnitus.
Additionally, the law does not permit any such ratings to be reduced in
the future, unless the severity of the tinnitus is shown to have
actually improved. Veterans who believe that they may be entitled to
benefits based on the Smith precedent should contact their DAV National
Service Officer. Missouri Veterans
Home: Making sure the Missouri Veterans Home at St. Louis
remains a comfortable residence for veterans, the VA is targeting nearly
$830,000 in grant money for improvements to the facility. The grant will
pay up to 65% of the cost of a new roof on at the 200-bed facility. The
overall cost of the project is approximately $1.3 million. The Missouri
Veterans Commission currently operates and maintains seven long-term,
skilled nursing care facilities for veterans of the state which are
located in Cameron, Cape Girardeau, Mexico, Mt. Vernon, St. James, St.
Louis, and Warrensburg with a total capacity of 1350 beds. Skilled
nursing care is available at all facilities. Residents and applicants
are categorized into one of three levels of care according to the
severity of their illness or disability. Costs for care are revised
periodically and charges are based on actual costs and the individual's
ability to pay. Charges vary greatly depending upon income and assets.
More detailed information may be obtained by consulting the "Residents'
Payment Rate Schedule" available at each facility. Veterans in need of
nursing care may seek admission to a Missouri Veterans' Home by filing
an application with the home of his or her choice. Prospective residents
can obtain application forms from any Missouri Veterans Home, from a
Missouri VSO or by contacting the Missouri Veterans Commission
headquarters at (573) 751-3779. Application forms can also be downloaded
at http://www.mvc.dps.mo.gov/Forms_Home.htm
Tricare Pharmacy
Search Tool: TRICARE has announced its new pharmacy Formulary
Search Tool, which allows beneficiaries to find medication-specific
information using either a drug name or a medical condition. The
Formulary Search Tool can be used to: Beneficiaries should consult their
provider, pharmacist, or other health care professional for specific
questions regarding their medications. For more information on the
TRICARE Pharmacy Program and to access the Formulary Search Tool, visit
TRICARE Pharmacy home page,
http://www.tricare.osd.mil/pharmacy/ The search tool is accessible
directly at http://www.tricareformularysearch.org
Macular Degeneration:
Age-related Macular Degeneration (AMD) is an eye disease that
destroys central vision by damaging the macula, a thin layer of nerve
cells that lines most of the inside of your eyeball and is part of the
retina. Nerve cells in the retina detect light and send signals to the
brain of what your eye sees. The macula is near the center of the retina
at the back of the eyeball and provides the clear, sharp, central vision
that you use for focusing on what is in front of you. Because AMD does
not affect side vision, it does not lead to total blindness. However it
will cause central vision loss, the most important part of your vision.
Central vision lets you identify shapes, colors, and details sharply and
clearly and lets you see what is directly in front of you. Therefore, in
its advanced stages, AMD can be devastating. It most commonly affects
people in their 60s or older and is the leading cause of vision loss and
legal blindness in people over age 65 in the United States. There are
two types of age-related Macular Degeneration and either type may affect
one or both eyes. Dry age-related Macular Degeneration is the most
common form (90% of cases) and does not usually cause severe vision
loss. Central vision slowly becomes dimmer or blurred as the person gets
older. Dry AMD may sometimes develop into wet AMD, a more serious form
of the disease. Wet age-related Macular Degeneration is much less common
(10% of cases). It can damage the macula quickly and cause rapid and
severe loss of central vision. Rent-a-Patient & Capping: A two-year investigation by the Orange County District Attorney's Office and other agencies has led to the filing of criminal charges against Unity Outpatient Surgery Center in Buena Park, CA. In JUN 04 the owners were charged with 46 felony counts of conspiracy, grand theft, insurance fraud, capping, and tax evasion. Unity's owners paid "cappers" to recruit people from 45 states and the District of Columbia. The "cappers" would arrange transportation, schedule the procedures, and instruct the patients on what to say. For their role in the scam, the patients would receive either a cash payment, between $300 and $1,000, or credit toward inexpensive cosmetic surgery. The cappers received a commission for each procedure performed at Unity. The most common procedures were colonoscopies, EGDs (upper gastro-intestinal procedure), sweaty palms surgery, hemorrhoid surgery, and pain management procedures. From AUG 02 to APR 03, Unity owners billed insurance companies close to $97 million and collected more than $14 million in fees. The defendants are also accused of not paying taxes by creating a series of shell corporations with different addresses, tax ID's and phone numbers, which they used to disguise their identities for billing. At least 1600 employers had employees that were involved in the fraud; and more than 5,000 patients are known to have had unnecessary procedures at Unity. Many other clinics and individuals participated in the scheme. On 10 MAR 05, 12 Blue Cross and Blue Shield Plans filed a $30-million lawsuit against nine southern California-based outpatient surgery clinics, seven medical management companies, and 34 individuals. At a press conference announcing the suit, an FBI official said that more arrests are expected and that total billings from all of the fraudulent activity totaled $1.3 billion and resulted in payments totaling $345 million. [Source: Consumer Health Digest #05-11, 8 MAR 05] New Mexico Reserve Death Benefit: The New Mexico Legislature has passed a $250,000.00 Combat Related Death Insurance Bill for National Guard personnel. The bill was subsequently signed into Law by Governor Bill Richardson. This Bill is the first of its kind in the United States. In addition to federal benefits, New Mexico provides the following benefits to eligible veterans: 1. Veterans and their surviving spouses are
allowed a $2500 reduction in 2003, $3000 in 2004, $3500 in 2005 and
$4000 in 2006, off the assessed value of real property, or a 1/3
reduction on vehicle registrations. U.S. Citizenship for Enlistees: Section 329 of Title 8 U.S. Code allows the President to authorize expedited U.S. citizenship during periods that the United States is engaged in armed conflict with a hostile foreign force. This means that foreign-born service members, who have served honorably for any period of time beginning on or after Sept. 11, 2001, are eligible to apply for expedited citizenship. In addition, under the fiscal 2004 National Defense Authorization Act, the peacetime waiting period is shortened from three years of honorable service to one. Beginning 1 OCT 03 the new law authorizes U.S. citizenship applications to be finalized at U.S. embassies, consulates and selected military installations overseas, to include citizenship interviews, testing and oaths of allegiance. Also effective Oct. 1, the new law waives the $310 citizenship application and fingerprint fee. [Source: Armed Forces News 04 Mar 04] Cell Phone Service Plan Basics: Retirees are often not aware of what they are obtaining and obligating themselves for when they sign up with a company's service plan. This can result in choosing the wrong plan to meet their needs and/or overpaying for unused minutes, hidden fees, or excessive long-distance or roaming charges. Following are some basics all users should be aware of: 1. As of June 2003, the average monthly
cell phone bill was $49.46, according to the Cellular Telecommunications
& Internet Association. Cell phones are often incompatible among different wireless service providers, so most consumers need to buy a new phone if they move their number to another service provider. Also, consumers may keep the same phone number only if they change service providers within the same local area. Finally, consumers may lose their phone numbers and be unable to get them back if they cancel their existing service before signing up for a new one. By initiating this process with the new company first, consumers ensure that the old company does not reassign their phone number as soon as they cancel that number. [Source: AARP Web letter 21 May 04] |
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