washingtonscene
Health Care
take over for Humana Military Healthcare Will I be able to stay in TRICARE Prime? If
Happenings Blog
Services in the South region (from North you live near a military treatment facility
Carolina west to parts of Texas). (MTF) or base realignment and closure
■ Keep track of the latest
news on national health
TriWest’s contract in the West region site, the answer should be “yes” in most
care reform and how it
will be renewed. cases. But Prime will be discontinued in
will affect TRICARE, VA, The new contractors will begin tran- some other areas, so some benefi ciaries will
and Medicare beneficia-
sitioning operations soon, with the fi nal need to switch to TRICARE Standard or
ries with MOAA’s “Health
turnover to occur by April 1, 2010. TRICARE Extra. The affected benefi ciaries
Care Happenings” blog.
Health Care Happenings
Here are answers to questions we an- will be notifi ed by the new contractors.
provides inside informa-
ticipate MOAA members might have. What does this mean for people who re-
tion from MOAA’s health
Will I have to do any paperwork? No. This ceived letters about 30-minute drive-time
care lobbyists and ben- should be seamless, and all enrollment and standards? The drive-time notices have
efits experts. Visit www
claims data should be transferred to the nothing to do with the new contracts.
.moaa.org/healthcare
new contractors without any action from People who received those letters and want
happenings.
you as the benefi ciary. to continue being seen at an MTF still must
Will I have to change doctors? Based on complete the waiver process by Oct. 1, 2009.
experiences from the last contract change Will the enrollment fee, deductibles, or
a number of years ago, the vast majority of copayments change as a result of the new
people should not have to deal with that, contracts? No.
but some might. New contractors will set When and how will I receive information
up their own networks of physicians. In the from the new contractor?
past, new contractors have made special It’s too early to say. We’re confi dent it
efforts to recruit participation of those who will be sent out in a timely fashion.
were in the previous contractor’s network. I’m under TriWest — will anything change
To whom will I submit my claims? If you for me? Some changes will be mandated
use network providers, you won’t have to by the new contract, so even benefi cia-
worry about that, because the provider ries in the West region might see some
will fi le the claim. If you use a provider changes. As soon as we have information
that doesn’t accept TRICARE-allowable on these, we’ll be disseminating it.
charges as full payment and fi le your own Will this affect my special-needs child care?
claims, you’ll probably have a new fi ling The new contracts do not change the
address starting next April. As soon as health care benefi t.
the new addresses are available, MOAA I’m in TRICARE For Life (TFL). Does this
and the new contractors will publicize change affect me? No. TFL is covered by
them widely. a separate contract.
Will the contact phone numbers change? I’m overseas. Does this affect me? Like
Some of the numbers more than likely will TFL, overseas contracts are separate.
change. As these new numbers go into af- However, the current overseas contracts
fect, benefi ciaries will be notifi ed. are being consolidated into one, and we
Will this affect where and how I get my should be hearing soon about an award.
medications? No. The pharmacy contrac- I use the Continued Health Care Benefit
tor isn’t changing. Program (CHCBP). Will this change?
Will I stay in the same region? For the most The CHCBP for all geographic areas is
part, the regions will remain the same. administered by the TRICARE South
There will be a couple of changes on the region contractor. United Health Mili-
border of the North and South regions in tary & Veterans Services will assume
the Fort Campbell area. The new contrac- this responsibility, and you should see
tors will contact the affected individuals. no change other than different contact
40 MILITARY OFFICER SEPTEMBER 2009
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