Health Care Happenings

Gosh, can you believe Thanksgiving is next week? … Where did the year go? … How do I get everything done for the holidays and before the New Year begins?

If you are like me, the questions and stresses can pile up quickly this time of year. And, before I know it the joy of the holidays gets lost in the hustle and bustle of the season.

Did you know though, we aren’t alone. There certainly seems to be plenty of reasons to be anxious and stressed this time of year…office work deadlines that have to be met, office parties, gift shopping, and finances… the list goes on.

But for most, the biggest stressor is family related–family obligations, family traditions, family meals…

MOAA is a military family. While we know our troops, retirees, veterans, and their family members often face the holidays alone or experience other difficult challenges, we know the holidays can still be a happy and fulfilling time when we share ourselves and resources with others.

Here’s some ways to de-stress and create some happy memories this holiday season:

• Make Time for Fun! Don’t focus on the ‘to do list,’ rather, your fun list. Reach out to a military/family member and include them in the fun.

o Pace Yourself! Don’t overdo things. Plan ahead and try to not put too many activities on your calendar. Place limits on your time. Try not to worry so much about how things should be or about things that are outside of your control.

• Take Care of Yourself! Rest, diet, exercise are especially key and all contribute to a healthy outlook, which in turn promotes emotional and physical well-being and strong bodies.

Remember—“A Healthy Mind is as Important as a Healthy Body”

Here are some helpful resources for the holidays.

Real Warriors Campaign:
          The Real Warriors Campaign is an initiative launched by the Defense  Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) to promote the processes of building resilience, facilitating recovery and supporting reintegration of returning service members, veterans and their families.

Military OneSource:
          Education, relocation, parenting, stress - you name it - Military OneSource can help with just about any need. Available by phone or online, our free service is provided by the Department of Defense for active-duty, Guard, and Reserve service members and their families. The service is completely private and confidential, with few exceptions.

Share these resources with your military family—let them know you care about them and you want their holidays to be happy days too!

On this Veterans Day, MOAA extends our heartfelt thanks and appreciation to all those serving, and those who have served, including their courageous families whose service and sacrifice often goes unnoticed.

Each “Greatest Generation” has seen and experienced horrific conditions and personal struggles.

As we thank those who have sacrificed and given so much for their country, let us all do our part by reaching out to them and their families this holiday season.

For most Americans, the holidays can be a difficult and demanding time. For our military and their families, separation and deployments make the season even more challenging.

MOAA has joined forces with the Department of Defense to stomp out the stigma associated with seeking help.

We want our military and families to know that help and resources are available to manage the psychological stresses of separation or combat. Thanks to the “Real Warriors Campaign,” we can all do our part to help our military and veterans get the help they need, when they need it.

MOAA members, Councils and Chapters can do their part individually—by encouraging troops, veterans and their families to check out the resources available through the Real Warriors Campaign website or by encouraging your organizations or companies to become a partner with DoD to stomp out stigma and promote health and wellness within our military community.

Check it out—“Real Warriors.”

Let’s serve those who serve and make every day, “Veterans Day!”

Now that we have a single, consolidated national health reform bill (H.R. 3962) in the House, let’s take a look at what it says about military and VA health care.

Most important, Section 311 of the bill states explicitly, “Nothing in this subtitle shal be construed as affecting any authority under title 38, United States Code [which covers VA health care] or chapter 55 of title 10, United States Code [which governs all military-funded health benefits, including TRICARE For Life].”

A provision of the bill imposes a 2.5% surtax on individuals who do not obtain “acceptable coverage”, but section 302(d)(2) expressly defines acceptable coverage as including TRICARE, TRICARE For Life, VA coverage and Medicare – so those covered beneficiaries would not be subject to the surtax.

Section 302 limits eligibility to participate in the bill’s Health Insurance Exchange (e.g., its form of “the public option”) to people who do not have “acceptable” or “other qualified health benefits plans”.  Because military and VA beneficiaries have acceptable coverage, they would not be eligible to participate in the Exchange.  Rep Steve Buyer (R-IN) is considering offering an amendment to establish an exception to allow military and VA-eligibles to enroll in the exchange to cover any contingency (e.g., a member who has VA coverage but not family coverage or a member who is enrolled in VA coverage but lives 100 miles from the VA facility).

Should anyone wonder, Section 329 of the bill specifices “Nothing in this division shall be construed as requiring anyone to enroll in the public health insurance option.  Enrollment in such option is voluntary.”

Did you know today is the launch date for the new TRICARE Pharmacy Program contract?

The new contract is expected to be seamless and transparent to those using the program, but features a number of new enhancements to beneficiaries because of the consolidation of the mail-order pharmacy and retail pharmacy contracts into one new contract.

Improvements include the Specialty Medication Care Management program in the mail-order pharmacy; expansion of the Member Choice Center providing assistance to help beneficiaries switch to mail-order; and, one call center phone number: 1-877-363-1303.

Most of you have probably already received the TRICARE Pharmacy Program Handbook in the mail. The handbook provides complete details on the new pharmacy program and how to access benefits available to you and your family.

Military beneficiaries now have comprehensive prescription drug coverage and a number of options for filling your prescriptions.

Your Pharmacy Options Include:

• Military Treatment Facility (MTF) Pharmacies—this is the least expensive option for filling prescriptions. You may receive up to a 90-day supply of most medications at no cost. Most MTF pharmacies accept prescriptions written by civilian and military providers. However, non-formulary medications generally are not available.

• Mail Order Pharmacy—this is the second most economical option. You may receive up to a 90-day supply of maintenance medications delivered directly to your home for minimal out-of-pocket costs. Simply fill the first prescription by mail or fax and request refills online or by phone. You can also transfer your current retail prescription to the Mail Order Pharmacy by calling the Member Choice Center.

• TRICARE Retail Network Pharmacies—network pharmacies are convenient for short-term medications when MTF pharmacies are not available. To receive your medication, present the written prescription along with your military ID card to the pharmacist.

• Non-Network Retail Pharmacies—you will pay full price for your medication at non-network pharmacies and file a claim for reimbursement. Reimbursements are subject to an annual deductible or out-of-network cost-shares and copayments.

Visit Express Scripts or TRICARE Pharmacy Program for the handbook and more information about the program and your options.

Let us know what you think of the new program–we look forward to your feedback!

Last week I had the privilege on behalf of MOAA, to sit down for an interview with RADM Karen Flaherty at Navy Medicine’s Headquarters in Washington DC. RADM Flaherty is the Director for Wounded Ill and Injured for the Navy. …
Here are excerpts from our interview:
Beasley: Admiral thank you for taking the time this morning to talk about what Navy Medicine and the Marine Corps are doing to care for our wounded service personnel coming back from Iraq and Afghanistan.
Flaherty: First, Congress and the American taxpayers were very generous. The Services received Congressional funds of over $200M for new projects directed to the following key areas: access to care, surveillance, quality care, and transition coordination care. At Navy Medicine we have put Programs put in place which are targeting resilience. We know that the number of deployments can adversely impact resiliency. We have put together programs in partnership with civilian academic institutions such as UCLA and have developed our signature program “Project FOCUS” headed by Dr. Patricia Lester. This is a research program set up to work closely with the family system to examine the stressors experienced by the family as it undergoes multiple deployments. Children are a focus as well as the whole family unit. We know that families undergo stress when they experience 4 to 6 deployments. The Navy Surgeon General and Navy Medicine have always been focused on the family with our concept of family centered care. So we naturally began with looking at the family and their network of support and infrastructure to determine what they will require in terms of their abilities to succeed in managing the stress. This has been a very big focus area for us. Initially, we started Project FOCUS with the Navy Special Warfare community. To understand what we need to have in place. The program has been very well received.
Beasley: Navy also takes care of the Marine Corps. Can you comment on the support for the Marine Corps?
Flaherty: Along with the Navy, we have the Marine Corps in fully in our sights and mind when we put programs in place. They are a bit different and we tailor programs and provide them to where and when the Marines deploy and where they are located. We work closely with the Wounded Warrior Detachment in Quantico and with Headquarters Marine Corps here in Washington.
Beasley: It was noted by several of our panelists during our (MOAA’s) recent Wounded Warrior Symposium, that there exist differences between the Services in the manner with which they handle transition care. Can you comment on this observation?
Flaherty: First, each service has a unique culture and identity. When the Marines look at their warriors they view them as “Marines for Life”. They have numerous programs such as the Semper Fi Fund, which directly support the Marines and their families. They also take a more holistic approach. I would like to note though that one service’s model is not better than the other. But there are different models. The Marines very quickly developed the Wounded Warrior Regiment (WWR) model. The WWR provides and facilitates assistance to Wounded, Ill and Injured Marines and Sailors attached to Marine Units, and their family members, throughout the phases of recovery. The WWR is a single command with a strategic reach that serves the total WII force: Active Duty, Reserve, Retired and veteran Marines. The Wounded Warrior Battalions East and West are located at Camp Lejeune and Camp Pendleton. Detachments include major Military Treatment Facilities and VA Polytrauma Centers. The Regiment Headquarters is in Quantico VA. The WWR provides non-medical care management with a personal touch. Their assets include: Family Support Staff; Chaplains for spiritual support; Recovery Care Coordinators to assist with transitional issues; VA liaisons; Clinical Services Staff to assist with care coordination and TBI/PTSD outreach education and much more. The Marines truly take care of their own. You can find out more at their website at www.woundedwarriorregiment.org
Beasley: The VA and DoD have just held a joint Mental Health Summit here in DC with the objective of identifying where gaps are between the two departments with respect to transitioning service personnel. Based upon your experience with the VA can you comment on this from your perspective?
Flaherty: First, the transition needs to be smooth and we need to partner when ever and where ever we can. In a perfect world it would be ideal to have the joint electronic record which could be initiated on the battlefield and to follow through until VA rehabilitation. But this is a few years out and we have work to do before this happens. Our energies must be focused on building the relationships and partnering connections and encouraging people in the support of each other. We will get there. Whenever we can forge partnerships and relationships at the hand offs and connections between the two systems, this will benefit the sailor and Marine and their families.
Beasley: What can the Military Service Organizations such as MOAA, and the other advocacy groups do to assist in the military’s efforts with the Wounded Ill and Injured?
Flaherty: I think you all are doing a magnificent job! You all live in the communities where these young men and women are coming home to. I think the recognition of the commitment they have made and the help with the smooth reintegration for these men and women is where you can and do help. You help celebrate what these people have done and the more you can allow them to tell their stories the better - as this is therapy. We rely on you as critical partners in this.
Beasley: Thank you Admiral for all that you and your team are doing.
Flaherty: Thank you for helping get the word out and for all of your support.

Earlier this week, I attended a joint hearing of the Special Committee on Aging by the Subcommittee on Oversight of Governmental Management, The Federal Workforce, and the District of Columbia, Committee on Homeland Security and Government Affairs. This was chaired by Senator Akaka of Hawaii. The purpose of the hearing was to hear witnesses testify on the rescent decision by the federal government’s Office of Personnel Management’s (OPM) to raise one of their long-term care insurance product’s premiums by as much as 25%. This unexpected rise in premiums affects approximately 144,000 individuals holding a policy with this particurlar option. The option is the Automatic Compound Inflation Option, or ACI.
Over seven years ago, OPM provided an insurance product for long-term insurance through a contract with John Hancock and Metropolitan Life as the insurance underwriters. This product was designed to help protect enrollees against the high costs of long term healthcare. Most Federal and Postal Service employees and retirees, active and retired members of the uniformed services and qualified relatives are eligible to apply for the insurance coverage. The program offered flexible benefit options to meet the diverse needs of the Federal family. The covered benefits included at-home formal and informal caregiver services, adult day care, assisted living facility care, hospice care etc.
Many individuals selected the aforementioned ACI option. This option stated in the published literatureby OPM at the time, that “Your premium will not change because you get older or your health changes or for any other reason related solely to you”. Which clearly implied to the enrollees that their premium’s would remain static and their benefits the same over the course of time if they paid their scheduled premiums on time. However, this year that proved not to be the case. OPM, due to some faulty assumptions and calculations on inflation, discovered that without an adjustment, the long term program would face a projected shortfall in funding for enrollees with the ACI option. Hence, their decision to raise the premiums. Their “original estimates appear inadequate”.
I can tell you that the Senate Sub-Committee was incensed with OPM that this could have occured and placed so many well intended federal retirees at risk! A representative from John Hancock Insurance Company also testified with proposed amends for these individuals, but these were met with a tepid response by the Committee members.
This brings us to some rescent proposed legislation by Senator Kohl D-WI. “the Confidence in Long Term Care Insurance Act of 2009″. This bill is designed to strengthen the consumer protections afforded to purchasers of long term care insurance, specifically by implementing protections, regulations, data collection, providing criteria for the creation of a “model” disclosure form which will provide consumers with consistent information regarding the insurance product which will be in an easily understandable format, as well as other protections for consumers.
In summary, I put this out to our members for their awareness, and suggest that we all become as educated as we can in the planning of our future long term needs.