July 2002 - Since the implementation last year of expanded pharmacy and medical benefits  under TRICARE Senior Pharmacy and TRICARE For Life, many Medicare-eligible  uniformed services beneficiaries, age 65 and over, are now enjoying the peace of  mind that comes with having a robust health care benefit.

They no longer have to pay expensive supplemental insurance premiums, higher co- payments, or entire prescription charges because the TRICARE For Life program  acts as second payer to Medicare, and the pharmacy program provides coverage  they don't have from Medicare.

"Beneficiaries have reported savings of $3,000-4,000 on their prescriptions,  alone. With most prescriptions available to them for a $3 or $9 co-pay, some can  now purchase prescriptions they didn't feel they could afford before. Not only  are they saving money, but many are enjoying a better quality of daily living,"  states Thomas Carrato, Executive Director of TRICARE Management Activity (TMA).

While most of the 1.5 million TRICARE For Life-eligible beneficiaries have been  located through extensive outreach communications efforts by TMA, regional lead  agents, managed care support contractors, and various beneficiary associations,  many still do not know they have this coverage. Their files in the Defense  Enrollment Eligibility Reporting System (DEERS) have not been updated, and they  have not renewed their military identification (ID) cards. Continued eligibility  for military benefits must be established periodically, because certain events  (like divorce from a military retiree, or remarriage of a widow) may cause  eligibility to end.

As a result, when Medicare "automatically" sent its first 5 million claims to  TRICARE for its newly eligible over-65 beneficiaries, it became evident that  some of these claims belonged to beneficiaries whose information had not been  updated, and whose ID cards were expired. These claims initially were denied by  TRICARE, but agency officials have announced that they will pay these claims  temporarily, without requiring beneficiaries or providers to resubmit them.

"We will use this opportunity to advise people on their Explanations of Benefits  that they must update their information and ID cards. Those who fail to do so  will have future TRICARE claims denied," explained Mr. Carrato.

After Aug. 1, 2002, all claims for beneficiaries with expired eligibility will  be denied until their eligibility information is updated. During March, DEERS  will notify many of the people with outdated information and expired ID cards  with a letter.

DEERS also sends an "age-in" letter to newly eligible beneficiaries 90 days  before their 65th birthdays, explaining how they can remain eligible for TRICARE  benefits.

The best way to verify TRICARE eligibility in DEERS and to obtain a current ID  card is to go to an ID card issuing facility. Its personnel can provide  information about the documentation that is necessary, its address and hours of  operation. If it is not possible for a beneficiary to go to an ID card facility,  he or she should call the DoD Reverification line, 1-800-361-2620, for guidance.  Information about the nearest ID card facility can be found on the World Wide  Web at http://www.dmdc.osd.mil/rsl, or by calling TRICARE's toll-free number, 1- 888-DOD-LIFE (1-888-363-5433). 
 

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