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Personal
Affairs Update for October 1, 2001
(1) Tricare For Life is Effective
Today, October 1, 2001.
This is a huge step toward
fulfilling the “lifetime health care” promise.
(2) OPM Issues Interim Rule Concerning
FEHB and TFL.
The following information (in italics)
was printed in the federal register on September 26, 2001:
OFFICE
OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN:
3206-AJ36
Suspension of TRICARE-Eligible's Enrollment in the
Federal
Employees Health Benefits (FEHB) Program
AGENCY:
Office of Personnel Management.
ACTION: Interim
Rule.
SUMMARY: The Office of Personnel Management is issuing an
interim rule to allow TRICARE-eligible FEHB Program annuitants and former
spouses to suspend their FEHB enrollments, and then return to the FEHB
Program during the Open Season, or return to FEHB coverage immediately, if
they involuntarily lose TRICARE coverage. The intent of this rule is to
allow TRICARE-eligible beneficiaries to avoid the expense of continuing to
pay FEHB Program premiums while they are using TRICARE coverage, without
endangering their ability to return to the FEHB Program in the
future.
DATES: Effective September 26, 2001. Comments received on
or before
November 26, 2001.
FOR FURTHER INFORMATION
CONTACT: Michael W. Kaszynski, Policy Analyst, Insurance Policy and
Information Division, OPM, Room 3425, 1900 E Street, NW., Washington, DC
20415-0001. He can also be reached at (202) 606-0004 or by electronic mail
(e-mail) at: mwkaszyn@opm.gov.
SUPPLEMENTARY INFORMATION:
Effective October 1, 2001, the National Defense Authorization Act for 2001
will reinstate TRICARE coverage for Medicare-eligible uniformed services
retirees, their survivors and eligible dependents. TRICARE coverage will
be advantageous to many Medicare-eligible military system beneficiaries
who now are covered under the FEHB Program as Federal civilian retirees,
family members, or former spouses.
Under current FEHB
regulations, however, an annuitant or former spouse who cancels his or her
FEHB coverage to use TRICARE coverage
would not be allowed to return to
FEHB coverage. Therefore, OPM is
issuing these interim regulations,
with a request for comments, to allow these FEHB participants to suspend,
rather than cancel, their FEHB coverage when they begin TRICARE coverage.
Under this rule, they would be allowed to return to FEHB coverage
immediately if they involuntarily lose TRICARE coverage or, if not, during
the next annual FEHB Open Season.
We are also amending
our regulations to clarify a similar situation
involving FEHB-covered
annuitants and former spouses. The regulations allow an individual who
drops FEHB coverage when he or she enrolls in a Medicare-sponsored plan,
or in Medicaid or a similar State-sponsored program of medical assistance
for the needy, to return to FEHB coverage
during the annual Open Season
or immediately upon being involuntarily disenrolled from the non-FEHB
coverage.
The Health Benefit Suspension/Cancellation
Confirmation Form RI 79-9 is being revised to include suspending the FEHBP
to enroll in Tricare For Life. To receive the form needed to make this
change, or for more information about this rulemaking, contact OPM at
1-888-767-6738. In the local Washington DC area, contact OPM at
202-606-0500.
(3) Emergency Medical Care During Heightened Base
Security.
Don’t let reduced access to military installation
health facilities deter you from getting needed emergency medical
care.
Tightened security at military installations may limit some
beneficiaries’ ability to get new or refill prescriptions at military
pharmacies or to see their providers for new medication. Here are some
ways affected members can still access their medications:
*If you
need a renewal, contact a TRICARE Network Pharmacy and request a telephone
or fax transfer of your prescription from the military pharmacy. If you
transfer this prescription to the retail pharmacy, you need to know that
the refill may not be transferable back to the MTF.
*To find the
nearest TRICARE network pharmacy, call toll free 1-877-363-6337 or
visit the web at: http://www.tricare.osd.mil/pharmacy/
(click on “retail network pharmacies” in the left margin).
*If you
obtain a new handwritten prescription, you can take it to the nearest
TRICARE Retail Network Pharmacy to be filled. TRICARE Pharmacy cost shares
will apply.
*Another option is the National Mail Order Pharmacy
(NMOP) for maintenance medications (prescriptions that you don’t need
immediately). Your MTF prescription can’t be transferred there, but a new
prescription will be honored. For more information on the NMOP go to www.tricare.osd.mil/pharmacy/mail_order.htm
or call 1-877-363-6337.
*If you are a TRICARE Prime
beneficiary and you cannot get to your MTF provider, call your Primary
Care Manager (PCM) for a referral to a civilian network
provider.
We’ve also heard from some members who have been
unable to access their primary care managers at military hospitals and
clinics because the installation had been "locked down" or they were told
there were no appointments. Beneficiaries needing care and finding
themselves in this circumstance should call the Health Care Finder for
guidance. Phone numbers for various installations can be found on the Web
at http://www.tricare.osd.mil/tricareservicecenters/default.cfm.
Particularly
in cases of an emergency, beneficiaries must seek help immediately rather
than delaying care because they can’t get to the military facility. But
how do you know what constitutes an emergency?
TRICARE defines an
emergency as “a condition characterized by acute symptoms of sufficient
severity (including severe pain) that would lead a prudent layperson with
an average knowledge of health and medicine, to believe and reasonably
expect that the absence of immediate medical attention could result in one
or more of the following:
*Serious jeopardy to the health of the
individual or to the health of a pregnant woman or her unborn child;
or
*Serious impairment of bodily functions;
or
*Serious dysfunction of any bodily organ or part.
(Examples include severe eye or ear injuries, broken bones, serious wounds
or profuse bleeding, heart attack symptoms or severe abdominal
pains.)”
Medical emergencies do not require approval from your
physician. Here’s a good rule of thumb to follow when in doubt: if your
condition seems too serious to take time to call your primary care manager
(PCM) before dialing 911 or going directly to the nearest Emergency Room
(ER), it probably is.
If a TRICARE-eligible patient is
referred to a civilian emergency room by a military hospital or clinic, by
your PCM or the TRICARE Line for Care (TLC), TRICARE will pay the claim
automatically. If you have not received a referral, you must notify your
PCM within 24 hours of receiving emergency room care. This is important,
because TRICARE will not cover follow-up civilian care (and you would have
to pay that expense out-of-pocket) unless the emergency room visit has
been authorized.
These are difficult times and will require
patience on the part of all beneficiaries.
(4) Federal Retirees May Re-enter
Workforce Without Pension Reduction Penalty.
As part of the
response to the recent terrorist attacks, agencies may bring back federal
retirees, with no reduction in their pensions, to fill jobs temporarily.
Retirees wishing to return to government service may call
1-888-353-9447 or send e-mail to Patriot@opm.gov. This does not apply to
military retirees, unless you are also a retiree from a civilian federal
agency.
(5) Veterans Affairs (VA) Expedites
Services to Victims of Terrorist Attacks.
The Department of
Veterans Affairs (VA) is coordinating a range of services and benefits for
veterans, active-duty military members and their family members killed or
injured in terrorist attacks on Sept. 11.
Secretary of
Veterans Affairs Anthony J. Principi promised that processing for monetary
benefits to survivors of veterans and military members and for cemetery
burial markers will be expedited.
"Among the heroes in this
catastrophe are many who sacrificed for us when they served in uniform.
They were heroes before they fell in New York City or at the Pentagon,"
Principi said. "The men and women of VA are honored to serve them and
their loved ones in this time of tragedy."
VA has assembled a
casualty assistance team to ensure that survivors of veterans and military
members killed in the attacks are aware of their VA benefits. Team members
will work with DoD personnel and funeral homes to identify survivors who
may be eligible for Servicemen's Group Life Insurance, dependency and
indemnity compensation, dependents' educational assistance, home loan
guarantees or a burial allowance.
VA has requested holders of home
mortgages that it guarantees not to start foreclosures affected by the
attacks for 90 days from Sept. 11. VA encourages loan servicers to extend
the dates for imposing late charges on mortgage payments. On another
front, VA is informing lenders that National Guard and Reserve members who
may be called to active duty could be entitled to loan repayment relief
under the Soldiers' and Sailors' Civil Relief Act of 1940.
Principi
said VA's mental health counselors are responding to requests for
psychological counseling for trauma. Professionals from some of VA's more
than 200 Vet Centers, skilled in treating post-traumatic stress disorder
and other stress-related problems, are assisting people affected by last
Tuesday's disasters.
Principi noted that VA medical personnel from
across the country are ready to travel to sites where additional medical
help is needed. These medical professionals are trained, certified and
available to be sent voluntarily wherever needed if VA receives a request
from the Department of Health and Human Services. VA medical employees
have responded in previous medical emergencies declared by American
presidents.
One of VA's medical missions, the secretary
noted, is to enhance the nation's response in a national emergency by
providing timely contingency medical support and other services. VA
medical facilities in New York, Washington, Baltimore and Altoona, Pa.,
were readied to handle casualties. VA's three New York City hospitals
treated 55 patients, all but three of whom were released.
VA
national cemeteries nearest the disaster sites, including the national
cemeteries at Calverton, Long Island, N.Y., and Quantico, Va., are
planning for burial requests for veterans and active military members. New
York City firefighter Glenn Wilkinson, a Navy veteran, became the first
victim of the attacks to be buried in one of VA's national cemeteries when
he was interred at Calverton National Cemetery on Monday, Sept.
17.
(6)
Veterans Affairs Benefits for Family Members of Military Personnel
Killed in Terrorist Attacks.
The Department of Veterans
Affairs (VA) has a variety of programs to assist survivors of active-duty
military members killed in the Sept. 11 terrorist attacks. VA officials
expect these benefits would primarily affect military personnel who were
killed in the jet crash into the Pentagon, although benefits would equally
apply to active-duty members who died at the World Trade Center towers.
For life insurance benefits in particular, VA expects there additionally
will be payments to the families of reservists who were civilian employees
or visitors at any of the locations attacked, or who were passengers on
the planes.
Shortly after the attacks, VA began working with the
casualty offices of the military services to expedite life insurance
benefits as remains are identified. VA will give the highest priority to
help surviving family members obtain their VA benefits.
VA has
compiled information in "Veterans Benefits for Survivors" currently
highlighted at http://www.vba.va.gov/. In addition,
because a significant portion of the population is a veteran, VA expects
that a large number of veterans were killed in the attacks in addition to
the active-duty members. The widows and widowers of these former
servicemembers also may be eligible for certain benefits depending on
income, whether the veteran had been rated with a serious disability,
whether the veteran served in a period of war and other factors. More
information about how VA services apply in individual cases is available
from benefits counselors at 1-800-827-1000.
Death
Payments
When an active-duty member dies at work or in the line of
duty, the death is considered service-connected whether accidental or due
to a hostile force. VA pays a basic monthly rate of $911 to eligible
surviving spouses. In some cases, VA can pay more, such as an adjustment
for each dependent child. Under this program, called Dependency and
Indemnity Compensation, the basic rate is adjusted annually and payments
continue indefinitely, generally until the death or remarriage of the
spouse.
Life Insurance
Most servicemembers and reservists
take VA's life insurance coverage, though some decline coverage. VA
expects most will have opted for life insurance coverage at the highest
levels, setting payments as high as $250,000. VA is ready to process
insurance payments for the beneficiaries of those killed in the terrorist
attack within 48 hours of receipt of the casualty report from the Defense
Department and the claim from the beneficiary. VA also offers the
designated policy beneficiary free, personalized and objective financial
planning services through nationally renowned commercial insurance and
financial services.
Burial and Headstones
The
servicemembers who died -- as well as civilians who were honorably
discharged veterans killed in the attacks -- all are eligible for burial
in a VA national cemetery or, if the family wishes to arrange burial in a
private cemetery, VA will provide a headstone or marker. Because deaths
while on duty are considered service-connected, VA will pay up to $1,500
toward private burial expenses in those cases. If the decedent will be
buried in a VA national cemetery, some or all of the cost of transporting
the deceased to the cemetery may be reimbursed. Certain burial benefits
would also extend to those retired from the reserves or National
Guard.
Educational Assistance
VA's Survivors' and
Dependents' Educational Assistance program generally provides up to 45
months of education benefits to the surviving spouse or child aged 18 to
26 where a service member died in the line of duty. In addition,
professional, educational and vocational counseling will be provided to
these beneficiaries without charge.
Home Loans
Widows and
widowers of military members who died in the terrorist attacks may be
eligible for a VA-guaranteed home loan from a private lender. The loan may
be used to purchase, construct or improve a home, to refinance an existing
mortgage or for certain other purposes.
(7) San Antonio Area Military Medical
Centers Conduct Spinal Stenosis Research.
Certain
individuals who suffer from lumbar spinal stenosis are needed for a
research study being conducted in the Physical Therapy departments of
Wilford Hall and Brooke Army Medical Centers in San Antonio,
Texas.
Purpose of this study is to investigate the effectiveness of
two different non-surgical treatment approaches for spinal stenosis. To be
eligible, you must meet the following criteria:
* Be 50 years of
age or older and eligible to receive military health care;
*
Must have back pain with buttock, thigh, or lower leg discomfort or
numbness and tingling. The pain or discomfort must be greater when
standing or walking than when sitting.
* Be able to speak and read
English and live within one hour of either Ft Sam Houston or Lackland
AFB.
Participants will be tested for walking tolerance,
participate in a six-week course of physical therapy, and must answer
questionnaires on three different occasions over the next year.
For
further information, contact one of the following clinical
investigators:
Capt. Julie
Whitman
Physical Therapy Department
Wilford Hall Medical
Center
Lackland AFB, TX
Phone: (210)
292-5033/5040
Pager: 292-6110 X 0844
E-mail: mailto:Julie.Whitman@59mdw.whmc.af.mil
Maj.
Matt Garber
Physical Therapy Service
Brooke Army Medical
Center
Ft Sam Houston, TX
Phone: (210)
916-2651
Pager: 513-4842
E-Mail: Matthew.Garber@amedd.army.mil
Persons with questions or
comments on the Persaff Update should visit http://www.troa.org/PersonalAffairs/assistance.asp.
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