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Enclosure to Carrier Letter 2002-31
The Department of Defense Federal Employees Health Benefits Program (FEHBP) Demonstration Project: The three-year Department of Defense Federal Employees Health Benefits Program (FEHBP) demonstration project will end on December 31, 2002. After this date, you will no longer have health care coverage under this demonstration project, but be assured that TRICARE is here for you. These Frequently Asked Questions were developed to help you understand the end of the FEHBP demonstration project and to provide you with information on your other health care options.
Q1. Why is the FEHBP demonstration project ending? A1. The FEHBP demonstration project is a three-year congressionally mandated demonstration project. This temporary demonstration project began on January 1, 2000 and will endwill end on December 31, 2002. These dates were established in the legislation that created the demonstration project. Q2. Will there be any temporary continuation of FEHBP coverage after the FEHBP demonstration project ends? A2. No. After December 31, 2002, you will no longer have any health care coverage under the FEHBP demonstration project. Effective, January 1, 2003 your health care eligibility through TRICARE will resume. Q3. When is my last premium payment due for the FEHBP demonstration project? A3. Your last payment due date for December's coverage will depend on your method of payment. If you use:
Q4. Do I need to disenroll from the FEHBP demonstration project? A4. No. You may remain enrolled in the FEHBP Demonstration Project through December 31, 2002. However, eEffective 12:00 AM on midnight January 1, December 31, 20032, however, you will automatically be disenrolled from the FEHBP demonstration project. T and here is no additional will have no additional paperwork for you to complete. If you want to disenroll from the FEHBP demonstration project before December 31, 2002:
Q5. What are my health care options after the FEHBP demonstration project ends on December 31, 2002? A5. Your health care options will vary according to where you live and your beneficiary category. Please make sure that your military ID is current so your eligibility can be verified. Refer to the questions and answers below as they are separated according to different beneficiary categories.
Q6. How do I check my eligibility? A6. Maintaining your TRICARE eligibility is the most important step you can take to ensure you and your family members are eligible for health care. To obtain or renew an ID Card that shows your eligibility status, the sponsor must initiate the paperwork in person at the nearest ID Card facilitysection. The sponsor needs proof of marriage or proof of divorce (if applicable) for the spouse, proof of birth for children, and proof of dependency for other dependents. More information about DEERS can be obtained online at: http://www.tricare.osd.mil/deers/. Questions and additional information may be obtained by calling DEERS Customer Service at 1-800-538-9552
Q7. I am a Military Health System beneficiary and am age 65 (or older), Medicare-eligible andeligible and have Medicare Part B. What are my health care options when the FEHBP demonstration project ends?
A7. You are eligible for TRICARE for Life. TRICARE For Life operates as a second payer to Medicare and provides comprehensive health care coverage for Uniformed Services retirees and other eligible beneficiaries who are Medicare-eligible and have purchased Medicare Part B. There is no fee for TRICARE for Life. However, you need to:
Q8. I am a Military Health System beneficiary who is over age 65 and Medicare-eligible. But I do not have Medicare Part B. What are my health care options when the FEHBP demonstration project ends? A8. By law, in order to be eligible for TRICARE for Life, Medicare-eligible beneficiaries must be enrolled in Medicare Part B. TRICARE for Life operates as a secondary payer to Medicare. Q9. How do I enroll in Medicare Part B if I did not enroll when I first became Medicare-eligible?
A9. Beneficiaries in the FEHBP demonstration project that only have Medicare Part A will be given an opportunity to purchase Medicare Part B during a Special Enrollment Period that will be announced at a later date. Individuals who enroll in Medicare Part B during the Special Enrollment Period will have Medicare Part B coverage effective January 1, 2003 and will then be able to participate in TRICARE For Life. Q10. Will I have to pay a penalty if I enroll in Medicare Part B during this Special Enrollment Period? A10. Your Medicare Part B premium may increase 10 percent for each 12 month period that you could have had Medicare Part B, but did not take it. For example, in 2002, the Medicare Part B premium is $54 per month. If you delayed enrolling in Medicare Part B for 24 months from the time you first could have had Medicare Part B, your premium in 2002 would be $64.80 per month. For more information on the Special Enrollment Period, please call the FEHBP Customer Care Center at 1-877-363-3342 (English) or 1-866-363-3342 (Spanish). Q11. I am a Military Health System beneficiary who is under age 65 but Medicare- eligible due to disability. What are my health care options when the FEHBP demonstration project ends? A11. Beneficiaries who are under age 65 and Medicare eligible because of disability must be enrolled in Medicare Part B in order to be eligible for TRICARE coverage. If you do not have Medicare Part B, refer to Questions 9 & 10 above for more information about a Special Enrollment Period for you to enroll in Medicare Part B. Beneficiaries in the FEHBP demonstration project that only have Medicare Part A will be given an opportunity to purchase Medicare Part B during a Special Enrollment Period that will be announced at a later date. Individuals who enroll in Medicare Part B during the Special Enrollment Period will have Medicare Part B coverage effective January 1, 2003 and will then be able to participate in TRICARE For Life. For more information on the Special Enrollment Period, please call the FEHBP Customer Care Center at 1-877-363-3342 (English) or 1-866-363-3342 (Spanish). Your health care options vary and are affected by where you live. Your options may include:
You can contact the regional MCSC for the region where you live to determine whether or not Prime or Extra is available where you live.
Q12. I am a Military Health System beneficiary who is under age 65 and not Medicare-eligible. What health care options do I have when the FEHBP demonstration project ends? A12. Your health care options vary by the plan selected, beneficiary category and your location. Your options may include:
Q13. Am I eligible for Pharmacy benefits when the FEHBP demonstration project ends?
A13. Yes. TRICARE offers several convenient ways for you to have prescriptions filled depending on your specific needs. You must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) to use the TRICARE Pharmacy benefit. NOTE: Beneficiaries who were age 65 before April 1, 2001, do NOT have to enroll in Medicare Part B to use the mail order or retail pharmacy benefits. Those who turned age 65 on or after April 1, 2001, MUST be enrolled in Medicare Part B in order to use the mail order and retail pharmacy benefits. See the chart below for more information: Your Cost Your Cost
Q14. Am I eligible for Dental benefits when the FEHBP demonstration project ends? A14. Yes. You are eligible for comprehensive dental benefits under the TRICARE Retiree Dental Proggram (TRDP) but you need to enroll in the program and pay the premiums. Benefits include diagnostic services, preventive services, basic and major restorative services, endodontic and periodontic services, prosthodontic services, orthodontics, oral surgery, anesthesia, drugs and post-surgical services, and emergency services. Beneficiaries enrolled in the dental plan are responsible for paying the full cost of the premiums in order to obtain the dental insurance. For more information on the Dental program, please call Delta Dental Customer Service at 1-888-336-3260 or check their website at www.ddpdelta.org</P> Q15. Where can I go if I have questions about Medicare supplement (Medigap) insurance? A15. Medicare supplement insurance, also called Medigap policies, generally pays for some or all of the Medicare's coinsurance and copayment amounts, and some or all deductibles. Some Medigap policies also pay for services not covered by Medicare. Since the FEHBP demonstration project is ending, if you are age 65 or over, you have a temporary right to buy Medigap policies A, B, C or F, if they are sold in your state. You must apply for a Medigap policy no later than 63 calendar days after your health coverage under the FEHBP demonstration project ends. For more information on Medigap policies or Medicare, please call Medicare at 1-800-633-4227. For specific information on Medigap policies sold in your area, the Medicare helpline can direct you to your local State Health Insurance Assistance Program (SHIP). NOTE: If you are under age 65 but Medicare-eligible due to disability, you will be able to purchase Medigap policies A, B, C, or F, if these policies are sold to Medicare-eligible beneficiaries under the age of 65 in your state. Q16. Will I need a supplemental insurance policy if I am eligible for TRICARE For Life? A16. The Department of Defense cannot instruct beneficiaries to keep or drop Medicare supplemental insurance; however, TRICARE For Life essentially provides wraparound health care coverage similar to supplemental policies, yet TRICARE For Life has no premium costs. Q17. What if I have questions?
A17. There are number resources available to get your questions answered:
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