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Tricare Help: Does nursing-home patient risk losing Tricare?

Mar. 8, 2012 - 12:45PM   |   Last Updated: Mar. 8, 2012 - 12:45PM  |  
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Q. I work for a Medicare Advantage plan, a special-needs plan for people who live in nursing homes and have Medicare Parts A and B. We have someone who wants to enroll a parent who has Tricare. I know we work with Tricare, but wanted to make sure this person is not at risk for losing any benefits.

A. I know of no way a Tricare beneficiary can lose Tricare eligibility by joining another plan.

One thing to keep in mind, however, is that by federal law, Tricare is always last payer to all other coverage. That is, claims must be filed with all other coverage first, and each plan must pay its maximum benefits before a Tricare claim can be filed.

For more information about how Tricare works with other coverage plans, http://www.tricare.mil/claims">go to this website or contact the Tricare regional managed care contractor at that link.

Q. I am retired Air Force, and I just got married. I want to enroll my wife in the Defense Enrollment Eligibility Reporting System so she can be covered under my Tricare Prime, since we live near a military hospital that accepts military retirees for care. How long after enrollment in DEERS will my wife need to wait for benefits?

A. Your wife's Tricare coverage became effective on the same day you were married. For her to use Tricare, however, you must enroll her in DEERS and get her a military ID card. She can use Tricare as soon as her DEERS registration is complete. See your local retiree personnel section for help doing those things.

Q. My husband is a disabled Army veteran, and he cannot tell me what Tricare is or if he can get it. I understand it is some kind of insurance. Could we be eligible for it?

A. There are two programs for which you might be eligible.

You wrote that your husband is a disabled vet. Depending on his disability rating from the Veterans Affairs Department, you may be eligible for care through VA. If his rating is "100 percent, permanent and total," he may qualify for free VA medical care for the rest of his life, and his wife and unmarried children under age 18 would be entitled to the companion program called CHAMPVA.

Alternatively, if your husband is entitled to receive military retired pay, he and his family may be entitled to Tricare.

For official information on your husband's Tricare eligibility, he should call the Defense Enrollment Eligibility Reporting System at 800-538-9552. He must make the call himself. Due to provisions of the Privacy Act, that information can't be given to another person.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com?subject=Tricare%20Help:%20Does%20nursing-home%20patient%20risk%20losing%20Tricare?">click here to email us. In email, include the word "Tricare" in the subject line and do not attach files. http://www.militarytimes.com/tricarehelp">Get Tricare advice anytime on our blog.

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