Tricare Help - Leaving Medicare Plan D isn’t difficult

Since 02-01-06

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Sent: Tuesday, January 31, 2006 2:25 PM
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Subject: Tricare Help: Leaving Medicare Plan D isn’t difficult

 
February 06, 2006
Army Times

Tricare Help: Leaving Medicare Plan D isn’t difficult

By James E. Hamby Jr.
Special to the Times

Q. You warned us not to sign up for the new Medicare Part D prescription drug coverage, but I’m one of those people who has to learn everything the hard way. You may remember that I’m the guy with a brother-in-law who knows everything. He tells me that now that I’m enrolled in Part D, I’m stuck for a whole year before I can get out. He was wrong last time. How about this time?


A. Well, I wouldn’t take stock market advice from your brother-in-law or go along with his choice in the Super Bowl, either.

According to a very nice woman I talked with at Medicare, your brother-in-law is wrong again.

Medicare officials told me that Medicare, not the commercial pharmacy benefit managers Congress gave the program to, still run that part of the program. The woman told me to tell anybody wanting out of Part D to contact Medicare, and it will have you out of the program by the end of that month.

Now, Part D became effective Jan. 1, so the nice Medicare woman did not know of anybody who had actually withdrawn yet.

She said, however, that even if Medicare doesn’t get your letter until a couple of days before month’s end, it can still cancel your enrollment effective the next month.
You’ll probably have to pay the last month’s premium, but if you want out badly enough, it will be worth it.

Please let me correct something you wrote. I didn’t warn people not to sign up for Part D. Starting last spring, I advised caution during several months while Medicare was putting Part D together and information was scanty.

Then, I wrote that because military retirees and their families have the Tricare pharmacy plan, most would gain little or no financial advantage from Part D.
The Pentagon’s Office of Health Affairs agreed and added that only those Tricare beneficiaries whose family finances fall below federal poverty guidelines, and who qualify for financial aid, are likely to benefit from Part D.

I believe that in the next several months, some organizations will be collecting and reporting information and opinions. That has already begun, but only anecdotally, which isn’t very useful. Before long, however, we’ll start seeing some statistics.
As with all “research” reports, caution is needed there, too. The addition of numbers can make information seem valid when it isn’t. It’s important to question where the numbers came from, who collected them and how.


Q. I have sent you questions several times and some of my friends have, too, about the fact that the government reneged on its longtime promises of free medical and dental care for life for military retirees. Why don’t you ever put any of those questions in the paper?


A. What you have sent me so far weren’t questions. They were position papers. But that isn’t the reason they haven’t been in this column. The issues you raise are important, but this column isn’t an appropriate place for them.

When the Army Times Publishing Co. asked me to start this column in 1992, it was named “CHAMPUS Help.” Later, it became “Tricare Help.”

The content of the column has always concerned help regarding CHAMPUS and Tricare policies, rules and procedures.

It has always included answers, explanations and advice about covered and noncovered services, claims processing, payments, problems and problem solving, explanation of benefits, appeals and the like. Those are things mandated by law, regulation or established policy.

If I cite law, regulation or official established policy, it has always been about what they say, and how I have seen them applied, but never why they say this or another thing, or why they are interpreted and applied as they are.

There are plenty of forums that advocate for beneficiaries concerning the political and legal aspects of government programs of all kinds, including Tricare.
Some are very professional and effective. Some have the involvement of state and national legislators, plus assorted experts who can often accomplish a great amount in their area of expertise. I’m just not qualified to do that.

This column will continue to try to help Tricare beneficiaries to understand better, to use more effectively and/or get better service from their health care program under whatever rules exist at the time. It won’t go beyond that.

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. In e-mail, please include the word Tricare in the subject line and do not attach files to your message. Attachments will not be opened.
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Contributed,
YNCS Don Harribine, USN(ret)