Health Care Happenings

TRICARE Management Activity released a year-end statement highlighting “TRICARE Expanded Benefits and Customer Service in 2009.”

They are telling beneficiaries it has been a busy year. Here’s what they tell us they’ve been working on:

     • New TRICARE Assistance Program (TRIAP)—a new web-based technology program to provide short-term professional counseling closer to those deployed military members and their families or those transitioning back home.

     • Extended Care Health Option (ECHO)—an increase in certain benefits for special needs family members of active duty sponsors.

     • Enhanced Standard Preventive Care—waives all cost shares for Standard beneficiaries for certain screenings, immunizations and well-child visits.

     • New Active Duty Dental Program—for active duty service members who assigned to areas where there are no dental facility, and those referred by their dental facility to civilian specialty care or when timely appointments are not available.

     • No Copay for Over-the Counter (OTC) Medications—continues the demonstration project to allow TRICARE beneficiaries to substitute certain prescription drugs with OTC versions of the medication without a copay.

Sounds like a busy year. All MOAA members need to take credit for some of the progress here. Thanks to your efforts—email alerts, letters to Congress and local Council and Chapter advocacy efforts, we collectively worked to keep the focus on beneficiary needs and your voice counted in making such changes.

HAPPY NEW YEAR TO EVERYONE!

Keep your thoughts coming in and we’ll keep transmitting your messages to Capitol Hill and the Administration—we need you and others to weigh in on these important issues in 2010!

See you in the New Year!

         How are you doing?

         Christmas is 2 days away.

How would you answer the following right about now?   Yes/No

1. Do you forget to laugh—No ho ho ho?                                ___ ___

2. When little things go wrong, does it ruin your day?            ___ ___

3. Do you constantly feel exhausted?                                      ___ ___

4. Do you hate it when the plan changes?                               ___ ___

5. Do you feel worried, nervous in your mind or body?             ___ ___

Did I miss a question that fits you better?

      Wishing you and your family a happy and stress-free holiday!

As a “grey area” reserve, I am thankful for one of MOAA’s significant legislative victories in this year’s defense bill.

Although authorized to begin on Oct. 1, 2009, TRICARE benefit changes typically take a year or so to implement so we anticipate seeing the tentatively named “TRICARE Retired Reserve” coverage by late summer or early fall 2010 as announced by TRICARE Officials earlier this week.

The retired reserve health care benefit will be provided under TRICARE Standard and Extra, similar to TRICARE Reserve Select (TRS) but it differs in that it requires premiums equaling the full cost of the program; whereas, TRS premiums are 28% of the cost. We won’t know the exact cost of the premiums until the program rules are posted in the federal register.

What we do know is that the “grey-area” retiree will pay the retiree cost share/deductible and fall under the retiree catastrophic cap of $3000/family per FY. Additionally, they will be able to enroll as member only or member and immediate family.

We’ll keep you posted – so standby for further updates as we receive them!

Are you getting ready to leave town for Christmas or the New Year?

Well don’t forget to think about your medications when planning your holiday trip.

Sounds simple enough for some, but if you take several medications it’s worth the extra effort to plan, just to be safe.

There is a lot going on this time of year and the higher level of activity and buzz of the season can make it especially difficult for those individuals dealing with chronic illnesses, including pain, to keep up with the hectic routine of the holidays while also trying to stay on schedule with your medicines.

So plan ahead for travel!
•      Keep a list of all your medications (prescription, over-the-counter or supplements) that includes the name, purpose, dosage, and schedule or other important information related to the medication you are taking in case you have to visit a physician or pharmacy when you are traveling.
•      Make sure your prescriptions are current—fill them before you travel to make sure you don’t run out on the road.
•      Check the state you will be visiting to find out the procedures for refilling controlled medication just to be on the safe side.
•      Always carry your medication with you if you are flying—keep the medicine in its original container with the prescription label attached.
•      Use a pill box, alarm or other method to remind you to take your medicine so you can stay on schedule.

I hope this helps make your trip a little easier.

ANYONE OUT THERE HAVE SOME OTHER SUGGESTIONS TO HELP MAKE OUR TRAVEL A LITTLE EASIER?   Please share!!!!

Status of Medicare Part B Premiums for 2010

Typically, the Social Security COLA has no bearing on the amount of the Medicare Part B premium that most beneficiaries pay – but 2010 is not shaping up to be a typical year. Historically, Social Security payments have increased annually by a COLA, just as Medicare Part B premiums have increased almost every year to keep pace with the growth in Medicare Part B expenditures, with beneficiary premiums covering 25% of program expenditures. For most beneficiaries, the dollar amount of the monthly Social Security COLA increase each year has been more than enough to offset the dollar amount of the increase in the monthly Part B premium, resulting in net increases in Social Security benefits from year to year.
Under current law, a so-called “hold-harmless” provision prevents Social Security payments from decreasing from one year to the next as a result of Part B premium increases. With no cost-of-living increase projected for Social Security recipients for 2010 and 2011, the hold-harmless provision will prevent the majority of Medicare beneficiaries (75%) from paying the increase in Part B premiums, despite projected increases in Part B expenditures.
For the 25% of beneficiaries who are not protected by this provision, under current law they will be required to pay steep Part B premium increases. These include higher income beneficiaries with a modified adjusted gross income greater than $85,000 for individuals and $170,000 for couples in 2009. Also this applies to new enrollees whose Social Security payments could not have declined as they were not previously enrolled and are not protected by the hold-harmless provision.
There is currently a bill which has passed the House and now resides in the Senate Finance Committee, H.R. 3631 which would modify the current law so that new enrollees are not required to pay higher premiums than beneficiaries who are protected by the hold-harmless provision.
With attention increasingly focused on Medicare and Social Security entitlement spending, this issue underscores some of the difficult tradeoffs involved in trying to protect seniors’ incomes, particularly during a recession, without compounding the fiscal challenges facing Medicare, Social Security and the federal budget.
View 2010 Part B Premium rates here.

With national health reform talks consuming attention in the Senate, MOAA has been trying to get answers from Senate leaders about any back-up plans to address two big problems that will hit on January 1 unless Congress acts to prevent them.

The first is the 21% cut in Medicare and TRICARE payments to doctors that will be imposed Jan. 1 under current law.  The House passed legislation (HR 3961) to repeal the cut.  The Senate voted down a similar bill, but there is a provision in the Senate national health reform bill that would suspend the cut and substitute a small increase for 2010.  But Senate national health reform debate is dragging on, and the Jan. 1 deadline is rapidly approaching.

The other issue is the significant Part B premium hike that will be faced by people turning 65 in 2010 and for people whose incomes exceed $85,000 ($170,000 for a married couple).  These groups make up about 25% of eligible Medicare beneficiaries, but will get hit with an extra part B premium hike Jan. 1 under current law, because the other 75% were automatically exempted from any Part B increase once it was determined that there wouldn’t be any Social Security COLA.  The House passed legislation (HR 3631) last September to exempt all Medicare-eligibles from a Part B hike, but the Senate has yet to take action on it.

MOAA has made several inquiries to the Senate as to what the plan is to make sure both of these issues are addressed before Jan. 1.  But we haven’t had any answer yet on either issue.

We’ll keep pushing and keep you posted.  In the meantime, use MOAA’s alerts to urge your senators to action on Part B relief, and Medicare/TRICARE payment cut repeal.