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Old 03-22-2010, 10:22 AM
 
Location: Hawaii
1,707 posts, read 6,384,227 times
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Quote:
Originally Posted by forest beekeeper View Post
I have not heard that it would have any effect on the military.
For some reason Tricare and Medicare are lumped together as far as our law makers see it. Payments to doctors for both were supposed to be cut by 21% on March 1st but that has been temporarily delayed. These type cuts are supposed to help pay for the new program.

NAUS :: Member News :: TRICARE & Healthcare
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Old 03-22-2010, 10:37 AM
 
Location: Aurora, Colorado
2,212 posts, read 4,599,586 times
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I have been following this closely and got an e-mail yesterday from my old boss (who was a MDG commander and in charge of Tricare). He sent an e-mail out to a bunch of us because he said he knew that we would have questions.

He said emphatically that TRICARE isn't going to go away. There are laws in place to ensure that this doesn't happen and just like with any other lobbying group, TRICARE knows that wheeling out some disabled vets and having them sit in front of news cameras while telling America that they will no longer have health insurance is a bad PR move.

However, he did give us some worst-case scenarios. There are some older vets who are "grandfathered" in and don't have to pay anything for their healthcare. Those who retired recently pay a certain amount each year (if they opt for Prime, for example) and those costs can rise, under law, to $1000 per year (right now it's under $450 per year for a family of 4). There has also been discussion about Tricare for Life, which isn't protected under the same rules that Tricare is protected under and my old boss thinks that if any program is to get cut, TFL would be it.

The reality is that the DoD pays a huge amount of its budget for medical care...especially for retirees and their families but in my own experience, I have never heard from doctors that I've seen that TriCare is a healthcare plan that doesn't pay well. I usually get treated like a celebrity when I go to the doctor and often am told when I speak with a billing agent that "Tricare is very good". Another example was last weekend, my 2-year-old woke up with a really high fever and we took her to one of those walk-in clinics that are open on weekends. We were seen, given medication, and were standing at the counter waiting to pay our co-pay. Behind the counter, there were papers stuck all over that said things like "we don't accept Medicare/Medicaid, Blue Cross/Blue Shield" etc. I think that those going on the government health care system are going to find a lot of doors closed to them. I haven't found that with Tricare and I've had Tricare for retirees in Florida and Colorado and we had to go to the ER in California when we were on vacation and sat in the waiting area for about 15 minutes and were called right away. They bypassed a lot of people there for us and I suspect that it was because we had insurance. It's an unfortunate truth about the ERs.
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Old 03-22-2010, 10:47 AM
 
Location: Aurora, Colorado
2,212 posts, read 4,599,586 times
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Quote:
Originally Posted by dmarie123 View Post
OK- so Tricare does NOT meet the minimum requirements or this new Health Care Law, meaning that Tricare will cover less, medically, than the rest of the country will get. Instead of giving us more coverage, they are making the military Exempt from the law. We donít have to have the same coverage as everyone else. We can legally have less. We now would have better health care if we left the military.


House votes to exempt TRICARE from health reform bill (3/21/10) -- GovExec.com
I think you may have read this wrong. What I saw when I opened up your link is this statement:

"It clarifies the tax code to stipulate that coverage provided by Defense is treated as minimal essential coverage, ensuring that service members and their families will not need to purchase additional coverage to meet new health insurance requirements."

The government is going to require that everyone in America has some sort of health care coverage. There are going to be some people who are going to want to purchase the bare minimum because they either don't have the money or are considered healthy and rarely go to the doctor. Those policies will have to be evaluated because the fact remains that it only takes one emergency to wipe out your finances and if someone purchases minimal health coverage under the assumption that they will never need care, what happens if they have a car accident or get a cancer diagnosis?

Believe me, I'm no fan of this healthcare boondoggle, but I think what the above link is saying is that TRICARE isn't going to be scrutinized because it meets whatever standards the government has in place that provides "adequate coverage." Basically, if you have TRICARE, you aren't going to be told you have to purchase additional coverage. If you have Aetna minimal coverage (which covers basically nothing but a checkup (for example)), the government is going to come in and tell you that you must purchase supplemental coverage.

My family (all 4 of us) have been to the doctor quite a few times since my husband retired almost 3 years ago. We've had a baby, we've had well kid visits, we've had annual physicals, we've had a knee surgery, we've had a car accident and a 2-day hospital stay, we've had a cervical cancer scare...the list goes on. In every single instance, we've been able to receive excellent care from very good doctors and have always been told that our insurance is a good one. This came from the mouths of those who do the billing so they are the ones I would trust. Tricare has never sent me to one of those "free-for-all" clinics or to a place that gave me the impression that it was a "bare-bones" medical care type of place. I've always been able to see highly regarded specialists and get care at very good facilities. I was actually surprised that Tricare Prime wasn't considered "cadillac coverage"....but I'm glad it's not.
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Old 03-22-2010, 10:52 AM
 
Location: Hawaii
1,707 posts, read 6,384,227 times
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Here is a AUSA article:

MEDICARE/TRICARE PAYMENT CUT DEADLINE APPROACHES (AGAIN)


The Senate recently passed a 6-month fix (until Oct. 1) that would prevent the 21 percent cut in Medicare/TRICARE payments to physicians. The provision was included in the Tax Extenders Act of 2009 (H.R. 4213).
If the House makes any changes to the legislation, House and Senate leaders will have to work out any differences and the bill will have to be passed again in both chambers. Complicating matters is the two-recess that starts at the end of this week. Therefore, the House must act immediately. Please go to the AUSA website, www.ausa.org, click on “Contact Congress”, type in your zip code beside “Elected Officials”, scroll down to “Fix the 21% Medicare/TRICARE Cut” and urge your representative to act now
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Old 03-22-2010, 11:11 AM
 
3,422 posts, read 9,679,310 times
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Quote:
Originally Posted by the3Ds View Post
There has also been discussion about Tricare for Life, which isn't protected under the same rules that Tricare is protected under and my old boss thinks that if any program is to get cut, TFL would be it.
Being able to continue on Tricare Prime for a low premium is probably the number one reason I want my husband to stay in til retirement. The pension is probably his #1 reason - for me its a close second, but good guaranteed coverage for cheap is so valuable to me after talking to friends and finding they pay upwards of $900/mo for HMO style plans that have a $3000 family deductible they have to meet first before the insurance kicks in. I would have no problem with $1000/yr for Tricare Prime coverage for retirees. $450/yr is phenomenal but $1000 IMO is still quite reasonable.

HMM I am sure there has been a study on this at some time in the past - I wonder what is the cost difference between a dependent being seen at the MTF versus the average (I know this will vary by region) outpatient visit at a civilian network provider. If it is signifcant enough in either direction I wonder if there will be more of a push for dependents to enroll at the lower cost option.
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Old 03-22-2010, 12:14 PM
 
Location: Aurora, Colorado
2,212 posts, read 4,599,586 times
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Quote:
Originally Posted by lisdol View Post
Being able to continue on Tricare Prime for a low premium is probably the number one reason I want my husband to stay in til retirement. The pension is probably his #1 reason - for me its a close second, but good guaranteed coverage for cheap is so valuable to me after talking to friends and finding they pay upwards of $900/mo for HMO style plans that have a $3000 family deductible they have to meet first before the insurance kicks in. I would have no problem with $1000/yr for Tricare Prime coverage for retirees. $450/yr is phenomenal but $1000 IMO is still quite reasonable.

HMM I am sure there has been a study on this at some time in the past - I wonder what is the cost difference between a dependent being seen at the MTF versus the average (I know this will vary by region) outpatient visit at a civilian network provider. If it is signifcant enough in either direction I wonder if there will be more of a push for dependents to enroll at the lower cost option.
I can only tell you what my experiences have been under TRICARE prime. I love it! The doctors and the care I have received have been excellent. I haven't been to a MTF since my husband retired 3 years ago. As for your husband, you wouldn't believe how many people stay in for 20 for the healthcare...and rightfully so. A good friend of mine had gestational diabetes when she was pregnant and after the baby was born, the diabetes stayed. She was medically discharged but her husband was an Air Force Air Traffic Controller and wanted to get out after he got his training (ATCs get paid very well). His mom talked him out of it because she saw the writing on the wall and knew that he would never be able to get insurance for his wife (who would be labeled with a pre-existing condition) if he became a civilian. He's got only about 4 years left now of his 20 and he's still looking forward to doing his job as a civilian (and he can...he'll only be 39 when he retires).

Just as a reference, my husband now works for the City of Denver (which most people in this area would categorize as providing good health care). Luckily he has TRICARE so he could opt out of his employer's insurance plan (though we do pay for dental care). On his first day, he went to the Human Resources briefing where they tell you about healthcare, retirement plans, disability insurance, etc. We just glanced at his healthcare policies and for the "okay" health care (which provided decent care but also had high copays), it would have cost our family $1375 per month. PER MONTH!!! Nothing, and I mean nothing, would have made that affordable. My husband gets his retirement pension from the military and he gets a very good salary from his current job...but $1375 per month just for healthcare coverage would mean a significant lifestyle change for us and we are in no way "living the high life." That's almost our mortgage payment!

BTW, my husband also pondered getting out not long after we got married (he'd been in for 10 years at that point). Thank God for his first sergeant who went through thing like healthcare with him because he talked him out of separating and so...at the time, he was MSgt...Jorgenson...THANK YOU, THANK YOU, THANK YOU!!!
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Old 03-22-2010, 04:29 PM
 
Location: San Antonio
3,345 posts, read 9,840,410 times
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I'm glad everyone is having good experiences. The article says it is "TREATED AS IF" it met minimum requirements. TREATED AS if it met them, not the it DOES IN FACT meet them. Also, some doctors may quit accepting it if they lose 1/5th of the money they can charge for it.

This is from one article: "On March 18, 2010, Chairman Skelton issued a press release raising concerns about the Senate-passed legislation, stating: “Although the health care legislation passed by the House explicitly exempted TRICARE from being affected, the Senate bill did not. Unfortunately, the parliamentary rules of the reconciliation process did not allow for the inclusion of language that specifically protects these programs. To reassure our nation’s service members and their families that their health coverage will remain unaffected by this, I will introduce legislation this week to explicitly state that TRICARE and the NAF health plans meet all requirements for individual health insurance; this language will also be included in this year’s national defense authorization bill.”
While McKeon disagrees with Chairman Skelton’s assertion that the House-passed legislation offered adequate protection for military families, he does agree that the Senate-passed legislation could jeopardize health care TRICARE beneficiaries. Under the final Democrat health care bill, the 9.2 million military service members, retirees and family members who are covered under the Department of Defense’s TRICARE health plan might be forced to pick new coverage on the exchange—even if they are satisfied with their coverage."
Committee on Armed Services, Republicans : Press Release :: Final Democrat Health Care Legislation Threatens Coverage for 9.2 Million Military Personnel, Retirees & Families

Why would we have to purchase additional coverage if our already actually met minimums?


Another article:
"Although the health care reform legislation passed by the House explicitly exempted TRICARE from being affected, the Senate bill did not include such specific language presuming that existing IRS Code language is sufficient protection for TRICARE, and the parliamentary rules of the reconciliation process underway this weekend did not allow for the inclusion of the House language that specifically protects TRICARE." NAUS :: Member News :: TRICARE & Healthcare
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Old 03-22-2010, 04:52 PM
 
Location: New Mexico U.S.A.
25,232 posts, read 41,240,049 times
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From the TRICARE web site at: TRICARE.mil Portal

Quote:

(There is a video in the URL below, which would not work in this post)

WASHINGTON, March 22, 2010 - The TRICARE military health plan meets the standards set by the health care reform bill the House of Representatives passed last night, Defense Secretary Robert M. Gates said in a statement issued yesterday.
Quote:
Defense.gov News Article: Tricare Meets Health Care Bill‚€™s Standards, Gates Says

Tricare Meets Health Care Bill’s Standards, Gates Says

American Forces Press Service

WASHINGTON, March 22, 2010 – The Tricare military health plan meets the standards set by the health care reform bill the House of Representatives passed last night, Defense Secretary Robert M. Gates said in a statement issued yesterday. Calling their health and well-being his highest priority, Gates reassured servicemembers and their families that the legislation won’t have a negative effect on Tricare, which “already meets the bill's quality and minimum benefit standards.”

“This was clarified by a vote in the U.S. House of Representatives [March 20], and is expected to be re-affirmed by the Senate,” Gates said in the statement.

“The president and I are committed to seeing that our troops, retirees and their families will continue to receive the best quality health care,” the secretary said.






I'm not sure what the commotion is about, a lot of the references were articles before health care reform bill the House of Representatives passed last night. Trying to discuss "what if's" becomes confusing to me. It has been discussed several times in the forum in the past.

Right now, I have not seen anything that will in fact affect TRICARE benefits. I'm not saying it will not happen, but I have in the past had no problems writing my representative, not sure if my writing has helped, but I have usually gotten an explanation.


Rich
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Old 03-22-2010, 05:29 PM
 
1,747 posts, read 3,979,279 times
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And so as a current member of the Reserves and a beneficiary of Tricare Reserve Select (200/mo for family premium), which is analogous with what an active duty member who elects to have Tricare Standard would see, I welcome you all to ponder how good it feels to have affordable GOVERNMENT SUBSIDIZED HEALTHCARE in the midst of all this demonization about government run health care that is going around this debate and the impact it has on the people who we are serving for. People who neither have the job stability the military paycheck provides nor the options to financially opt out the aforementioned $1375/mo premium, for a nominal 80/20 1000/cap Tricare Standard-like level coverage. Kinda of a double whammy for the people who pay our salary isn't it?

I'm proud of my service to my Country, but just like wearing stripes or bars is not a pre-requisite to have honor, military affiliation nor age should be a pre-requisite to attaining social dignity. Medicare-for-all should be the goal. All this lay-up we gave up for the insurance companies today do is validate the insurance co. existence and separate those who we serve from the ability to enjoy the social dignity we enjoy by obtaining nominally good health care at a premium that doesn't preclude us from living the discretionary lifestyle we seek.
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Old 03-22-2010, 08:10 PM
 
Location: San Antonio
3,345 posts, read 9,840,410 times
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hindsight, I wasn't trying to debate the merits of universal coverage. Just that I thought I was reading that Tricare didn't meet the standards it was supposed to meet, and that it was being ignored. Perhaps I didn't have correct information, which is why I posted here. To have a conversation. I googled, I read, I searched, and nothing was clear to me. It seemed like I was reading that it didn't meet standards, but would be treated as if it did meet standards.

I see now that perhaps I didn't have up to date info. Thanks to those who passed on good links to me!
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