Thursday, February 5, 2009

Do you know someone who should be covered?

Do you know someone who should be covered?

By James E. Hamby Jr.
Special to the Times
9 February 2009 Issue

Q. My wife met a woman whose retired Army husband died suddenly several years ago. She gets a military pension, but she doesn’t know anything about Tricare. Where can she get help?

A. Readers should always be alert for people like this woman.

They fall through the cracks when they lose touch with the military community, and they don’t know where to turn. Some are not even aware that Tricare exists or that they might be eligible for benefits.

The best piece of information you can give anybody who you think might be eligible for Tricare or Tricare for Life is the toll-free number for the Defense Enrollment Eligibility Reporting System, or DEERS — (800)) 538-9552.

Here’s another problem: We get so used to using e-mail these days that it’s easy to forget that not everybody has access to the Internet. Sometimes, the Web is the only place where Tricare-related material can be found easily.

Beneficiaries sometimes send snail mail to Tricare Help asking me for printed Tricare materials, but since I work for Military Times, not Tricare, I don’t have any information I can mail.

However, I learned a few weeks ago that those in need of printed materials can call toll-free (800) 874-2273; callers will be directed to the appropriate Regional Tricare Office, where they can get program information by mail.

Carry both of the numbers above in your wallet in case you meet someone who might be eligible and doesn’t know it.

Q. Your recent column about the Medicare Part B premium prompted me to tell you my story [“Why did my premiums just triple?” Jan. 19].

Before I retired, I had accepted a well-paid position with a large company. I went to work for them right after I left the Navy.

The company provided excellent health insurance at very little cost, so I never gave Tricare a thought. I worked for another four years after getting Medicare Part A in 2001, but Medicare told me that I didn’t have to enroll in Part B for as long as I worked with that company.

When I retired from that position, my health insurance costs went sky-high, so I started looking into Tricare for Life. That’s when I learned that I had to be enrolled in Medicare Part B to be eligible. I learned then that what Medicare told me about Part B enrollment all along was wrong. I learned that I had lost my Tricare eligibility when I first got Medicare because I didn’t enroll in Part B at that time.

I didn’t know that there are two different rules about when you have to enroll in Part B.

A. Thanks for sharing your story.

Many Tricare beneficiaries become confused when they learn that federal law has what they see as conflicting rules about when a person is required to enroll in Part B. They are not aware that they’re dealing with two different federal benefit programs — Medicare and Tricare — each governed by its own laws and regulations.

The problem arises when a beneficiary asks Medicare about when he must enroll in Part B.

He learns about requirements of Medicare law without being aware that Tricare has different rules about Part B enrollment.

According to the law governing Medicare, when a person becomes entitled to Medicare Part A, he has a grace period during which he must enroll in Part B. If he does not enroll in Part B before that grace period expires, Social Security assesses a lifetime penalty of 10 percent of his Part B premium for each year that enrollment is delayed.

But if the beneficiary has a health insurance policy through employment, Medicare does not require him to enroll in Part B and waives the late enrollment penalty for as long as he continues to work for that employer.

When the Medicare beneficiary stops working for that employer, he has a grace period for enrolling in Part B to avoid the late enrollment penalty.
This has nothing to do with Tricare’s rules, however.

According to the law governing Tricare, a military retiree or retiree family member who becomes entitled to Medicare must be enrolled in Medicare Part B immediately, at the moment Part A coverage becomes effective. Any beneficiary who does not have Part B at that moment is automatically dropped from Tricare, and eligibility cannot be restored until Part B enrollment is effective and can be used as part of Tricare for Life.

The Medicare rules cover all Medicare beneficiaries; the Tricare rule is for military retirees and their families, survivors of active-duty and retired members, and a few others.

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

Do you know someone who should be covered?

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