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Tricare Help: Retirees eligible for federal long-term care insurance

Oct. 18, 2012 - 02:34PM   |   Last Updated: Oct. 18, 2012 - 02:34PM  |  
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Q. I'm 45 and have Tricare Prime. I've recently been diagnosed with multiple sclerosis and have continuous symptoms. I'll be rated 60 percent disabled by the Veterans Affairs Department after my claim finally goes through. Should I get supplemental end-of-life insurance, like for a nursing home, when I get to that stage of the disease? My mother recently entered a nursing home with Medicaid pending paperwork, and the cash price is about $145 a day.

A. Yes, you may want to look into long-term care insurance. Tricare generally does not cover long-term care (also known as custodial care) for degenerative conditions, even under Tricare for Life, although occasional exceptions or partial exceptions are made on a case-by-case basis.

A variety of commercial long-term care insurance plans are out there. However, on the assumption that you're a military retiree, a good place to start your research is the Federal Long-Term Care Insurance Program, which is open to active-duty members, National Guard and reserve members and military retirees.

You can get all the details on the FLTCIP at http://www.ltcfeds.com/">www.ltcfeds.com.

Q. I am an Army retiree in Tricare Prime, and I'm trying to find out if my 29-year-old daughter can be covered through Tricare, as well. She has neurological and emotional limitations that limit her ability to work and, in turn, get medical insurance on her own. She lives at home and is 100 percent dependent on me for support. I've contacted Tricare and they say they don't know. I'm paying a small fortune every month for a medical policy for her.

A. Children age 21 and over may be covered by Tricare Prime or Standard, as well as the Tricare pharmacy program, if they meet two basic conditions:

• They are severely disabled and the condition existed prior to their 21st birthday, or if the condition occurred between the ages of 21 and 23 while the child was enrolled as a full-time college student.

• They are dependent on their sponsors for more than half of their support.

Such children can remain eligible for Tricare for as long as their disability endures. But if the disability ever improves to the point that the child becomes capable of self-support, Tricare eligibility is lost and cannot be restored even if the disabling condition recurs later in life.

Tricare itself doesn't make these kinds of eligibility determinations; only the military services can do that. The Defense Enrollment Eligibility Reporting System support office can help you get started with that process. DEERS is the Defense Department's eligibility portal for Tricare. You can reach that office at 800-538-9552.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com?subject=RE:%20Tricare">tricarehelp@militarytimes.com. In email, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime at http://www.militarytimes.com/tricarehelp">www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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