Since 11-22-05
Tricare Help -- Consider cost, coverage in insurance decision
Since 11-22-05
From: Waspscpo@aol.com
Sent: Thursday, November 17, 2005 4:45 AM
To: undisclosed-recipients:
Subject: Tricare Help -- Consider cost, coverage in insurance decision
November 21, 2005
Army Times
Tricare Help -- Consider cost, coverage in insurance decision
By James E. Hamby Jr.
Special to the Times
Q. I’m 61 and retired from the Navy. I got hurt and had to retire
early from my government job. I have Tricare Standard and the Federal Employees
Health Benefits Program. I will get Medicare in May when my two years are up on
Social Security disability. Will Medicare put me on Tricare for Life then, or
must I wait until I am 65? Because of the FEHBP coverage and Tricare for backup,
I won’t need Part B. Will I still have to subscribe and pay the premium? Why do
I have to pay for insurance I don’t need and won’t ever use?
A. The federal law that created CHAMPUS/Tricare in 1966 contains a provision
that no beneficiary other than an active-duty family member may remain eligible
for CHAMPUS/Tricare after becoming entitled to Part A of Medicare, unless he is
also enrolled in Medicare Part B.
At the end of two years of receiving Medicare disability payments, you will
automatically be entitled to Medicare if you are still disabled.
When your Part A coverage takes effect, you will have the option to drop the
Part B coverage. If you do, however, you will lose your Tricare eligibility. You
will not become eligible for Tricare for Life. You will have only Part A of
Medicare and your FEHBP coverage.
A decision to buy or cancel health insurance is an intensely personal decision.
Only you know how much and what kind of coverage you and your family need.
However, you might want to weigh the difference in coverage between having only
Medicare Part A and the FEHBP plan and having the full coverage provided by
Tricare for Life.
It seems you have three options:
• Cancel your automatic Part B enrollment, lose your Tricare eligibility and
have only Medicare Part A plus your federal employees health insurance.
• Keep Part B and Tricare, thus having Tricare for Life (Medicare plus Tricare)
and the FEHBP.
• Cancel your FEHBP, if only to the extent of removing yourself from coverage,
and have Tricare for Life coverage.
All alternatives would provide adequate coverage, but
the first alternative would provide the least coverage and the second would be
the most expensive. All in all, the third choice is the best.
Under the first option, although Part A would pay most of your hospital
inpatient facility costs, it would be left to the FEHBP to pay your Part A
co-payments and such charges as professional fees that are usually covered by
Medicare Part B.
You would also have out-of-pocket costs for the FEHBP deductibles and
co-payments for items not covered by Medicare Part A. In addition, you would
have to continue to pay the same FEHBP premium that you pay now.
The second option would provide an almost guaranteed freedom from out-of-pocket
medical costs, but you’d have to pay the Medicare Part B monthly premium, in
addition to the FEHBP premium you pay now.
The third option, the one I believe is the most realistic, would have you cancel
the FEHBP, at least for yourself, and enroll in Medicare Part B. That is the
traditional Tricare for Life configuration. It has no other health insurance
except Medicare (A and B) and Tricare, but nevertheless will pay most of your
medical care expenses in full for the rest of your life.
You didn’t mention other family members
who might need health coverage, but are not yet eligible for Medicare and
Tricare for Life.
If you have a spouse and/or unmarried children under age 21 (age 23 for
full-time college students), they must factor into any decisions you make about
canceling the FEHBP.
Tricare alone should not be thought to provide sufficient coverage if one has a
good employer’s health insurance plan available.
If there is only one other family member on your FEHBP, perhaps a wife, removing
yourself from that plan likely would allow you to save about one-third of the
premium cost each month. Check with your local Civilian Personnel Office before
canceling any coverage.
If you should decide to cancel any part of the
coverage, be sure the personnel office understands you don’t want a permanent
cancellation, and that you want to retain the right to reinstate the FEHBP
during open season any year.
James E. Hamby Jr. may be reached by writing to
Tricare Help,
Times News Service,
6883 Commercial Drive,
Springfield, VA 22159;
or by sending e-mail to
tricarehelp@atpco.com .
Please include the word Tricare in the subject line and do
not attach files to your e-mail message. Attachments will not be opened.
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Contributed,
YNCS Don Harribine, USN(ret)