(MEDICARE) PRESCRIPTION DRUGS

From BGen R. Clements USAF (Ret)
IMPORTANT CHANGES FOR ENROLLMENT IN PART B
Sent by john.heffernan@littlerock.af.mil

Although some may not be aware of it, one or more of the provisions in the Medicare Prescriptions Drug, Improvement and Modernization Act of 2003, will affect many members of the retiree community in the near future and in the years to come.

At the top of the list in the Act, signed into law by President Bush on December 8, 2003, are three very important changes relating to enrollment in Medicare Part B. The first two changes affect persons not enrolled or paying surcharges because they enrolled after they were initially eligible for Part B. This includes those individuals who reside overseas where Medicare doesn't pay and those who thought a local medical facility would always be available for their health needs.

Uniformed services beneficiaries who would be eligible for TRICARE for Life, but are not enrolled in Medicare Part B may enroll without penalty during a special enrollment period through December 31, 2004. The special enrollment period will be announced via Medicare on the TRICARE Web site and will be widely publicized.

Second, uniformed services beneficiaries who enrolled in Medicare Part B in 2001, 2002, 2003, and 2004 and are subject to a premium surcharge for late enrollment in Part B, can get those surcharges eliminated by demonstrating that they are covered under TRICARE.

The elimination of surcharges is effective January 1, 2004, but the Department of Health and Human Services must work out procedures to be followed. As of 3 February 2004, I talked with the local Social Security office and the paperwork is still being worked out. You can sign up for Part B now - which will cost you a penalty - but you will get your money back when all the kinks are worked out.

The third change made by the bill affects all seniors, not just uniformed services beneficiaries. The Part B premium will be tied to income beginning in 2007. Premiums for individuals with incomes above $80,000 and couples with incomes above $160,000 will increase.

Prescription drug benefits:

The number one question asked by members of the military retiree community concerning the “Medicare Prescription Drug, Improvement and Modernization Act of 2003,” has been: How does it affect my pharmacy benefits?

The simple answer is that for most uniformed services beneficiaries, it doesn't.

For older Americans, the most significant aspect of the new bill signed into law by President Bush, December 8, 2003 is the fact that it introduces an outpatient prescription drug benefit. However, the TRICARE pharmacy benefits will continue as a separate program.

On the other hand, uniformed services beneficiaries should be aware of the provisions as it could come into play in the future if they lose their TRICARE eligibility. Example: eligibility is lost when a member's widow or widower remarries a person who is NOT entitled to TRICARE benefits.

According to TRICARE officials, the TRICARE pharmacy benefit provides excellent coverage and wide availability of services through military facilities, retail pharmacies, and mail order. Thus, it is likely that the vast majority of uniformed services beneficiaries will not find it advantageous to enroll in the new Medicare pharmacy benefit. Individuals who think it could affect them in the future can obtain more details at: http://www.tricare.osd.mil.