Health Care Happenings

TRICARE has just issued its new handbook for TRICARE Standard and Extra beneficiaries.

The 68-page handbook includes information on accessing routine, urgent and emergency care, as well as TRICARE’s prior authorization and referral requirements. Also provided are sections on what’s covered by TRICARE Standard’s health and pharmacy benefits, and how to coordinate TRICARE with other health insurance (OHI). Information on claims, appeals, grievances, reporting fraud and abuse and much more can also be found in this new TRICARE Standard handbook.

TRICARE STandard and Extra are available to family members of active duty service members, retired service members and their families and others including those who purchase TRICARE Reserve Select. With TRICARE Standard, beneficiaries manage their own healthcare and have the freedom to seek care from any TRICARE-authorized provider. TRICARE Extra provides discounted cost-shares for seeking care from network providers.

The “TRICARE Standard Handbook: Your Guide to Using TRICARE Standard and TRICARE Extra” is available in a convenient e-Version at: http://www.tricare.mil/standardhandbook

Did you know TRICARE covers the following nutritional therapy for medically necessary nutrition used as the primary source of nutrition?

• Enteral nutritional therapy,
• Parenteral nutritional therapy,
• Oral nutritional therapy,
• Medically necessary vitamins and minerals added to the nutritional solution,
• Intraperitoneal nutrition (IPN) therapy for individuals suffering from malnutrition as a result of end stage renal disease, and
• Ketogenic diet if it is part of a medically necessary admission for epilepsy.

For further information, go to the TRICARE Policy Manual 6010.54-M Chapter 8, Section 7.1.

That’s right.

TRICARE is expanding its outreach so they can hear from beneficiaries like us, using online social media communication tools.

In March, TRICARE will launch a media center Web page that will serve as its central hub for social media activity—a kind of one-stop-shop for the latest news, beneficiary information, and communication activities.

To do this “TRICARE NEEDS YOU!”

Before they launch their media center they want to hear from “YOU” and get your feedback through Facebook or Twitter on ways to improve beneficiary services.

You probably already know that younger folks are all about using social media networks to stay in touch, but, did you know that’s increasingly becoming the case for those, well, more mature folks like us as well?

You got it.
Much of this is of course due to the explosion of technology in the U.S. This technology has even inched its way up the steps of Capitol Hill. My sources are telling me National Health Care Reform is fueling the debate. That is, older Americans don’t want to be left out of this important debate and they are flocking in huge numbers to social media outlets so they can stay connected and weigh in on these critical issues.

It’s important to let the military and veterans’ health care and benefits providers know what’s on our mind — just like MOAA lets the Administration, Congress, the Pentagon, and VA know what our members have to say.

GO FOR IT!—Click here on TRICARE  —to tell them what’s on your mind and to learn more!

TRICARE beneficiaries can now receive the following three vaccines with NO out-of-pocket copay at your local retail network pharmacy:

• H1N1 flu vaccine
• Seasonal flu vaccine
• Pneumococcal vaccine

In order to receive the vaccine you’ll want to call your local TRICARE retail network pharmacy to ensure it :

• participates in the vaccine program,
• has the vaccine in stock, and
• has a certified pharmacist on duty to administer the vaccine before you leave your home.

Click to locate a participating retail network pharmacy or call 877-363-1303.

          Are you a veteran enrolled in the Department of Veterans Affairs (VA) Health Care system?

          Are you registered with “My Healthe Vet?”

If not, the VA would like you to make some New Year’s resolutions to help you get active in your health care, online.

If you are registered, VA would like to help you upgrade your account so you can be even more active in your care.

Here’s what they’d like you to know:

#1: Improve Yourself: The VA offers Veterans, active duty Service members, their dependents and caregivers the gift of My HealtheVet, VA’s award-winning online Personal Health Record. Access is easy and convenient anywhere the Internet is available. With My HealtheVet, users access trusted and secure VA health information to better manage their health care and facts about other VA benefits and services. My HealtheVet helps Veterans partner with their health care teams and provides them opportunities and tools to make informed decisions. Simply follow the directions to register today .

#2: Improve Your Access: If you are already a My HealtheVet user and a VA patient, get an upgraded account! An upgraded account allows Veterans enrolled at a VA health care facility access to advanced features of My HealtheVet and links their Personal Health Record with information from their VA electronic health record. To access advanced features, Veterans must complete a one-time process called In-Person Authentication or “IPA.” This includes making a visit to their VA facility to verify their identity in person. After completing the IPA, VA patients can use My HealtheVet to:

o Refill VA prescriptions by name, not just by the prescription number
o Access a blended view of their VA and non-VA medications
o Receive VA Wellness Reminders
o Access new features as they become available

#3: Improve Your Online Activity with VA: Expected in 2010, VA patients that have completed the IPA process will view their VA appointments, VA lab test results, and VA list of allergies. They also may communicate electronically with their health care teams through “Secure Messaging” as this feature becomes available at their VA facility.

So register today on My HealtheVet, complete In-Person Authentication, and make your 2010 a healthy, happy and active year with your VA.

After all, it’s quick, easy and it’s for you!

Having recently retired from active duty one of the biggest adjustments I faced (and pleasantly), was the choices that existed for my healthcare.  Retiring from my active duty career in the military offered a lot of choices that were not available while I was serving in uniform. 

While on active duty we were required to use TRICARE Prime or Prime Remote.  Retiree’s such as myself, who are not eligible for Medicare can and may be eligible to continue on in Prime or choose TRICARE Standard or Extra.  Each of these programs has advantages pertaining to cost, location and convenience.  But the great thing is you get to decide what is best for you!

If space is available, continuing care in a military treatment facility (MTF) with a primary care manager through TRICARE Prime requires re-enrolling and paying an annual fee of $230 for an individual and $460 for a family.  Retirees who choose to enroll in TRICARE Prime at an MTF, in my case NNMC Bethesda, will recieve care based upon the same access-to-care standards as all other Prime beneficiaries.  I choose this because of location convienence and continuity with my provider.

Retirees who move to a location that is not near an MTF, or where Prime is not offered, may find TRICARE Standard or Extra to be the best options.  TRICARE Standard is a flexible, affordable plan that gives beneficiaries and their eligible family members a greater choice of providers, no enrollment fees, waiver of cost shares for most preventive healthcare services and the same low catastrophic cap as TRICARE Prime.

TRICARE Extra offers even lower out of pocket expense if beneficiaries use network providers.   Although there is no enrollment fee for TRICARE Standard and Extra, a deductible of $150 for individuals and $300 for a family must be met before cost-sharing begins.  Under TRICARE Standard and Extra, most beneficiaries retain the same access to pharmacy benefits through a local MTF or the TRICARE Mail Order Pharmacy, as well as the option to use the TRICARE retail pharmacy network.

A couple of other things to keep in mind are that as a retiree you may also be eligible for certain medical and pharmacy benefits from the Department of Veterans Affairs in addition to your TRICARE benefit.  Also, you may want to start serious consideration of your healthcare choices well ahead of your actual transition as it will ensure a smooth transition post-retirement.  Believe me there is a lot to think about as you may find out in your Transition Assistance Program (TAP).