This Week in BlogTalkRadio, 11/30-12/6
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Ret1stSGT
3/12/2009 8:05 PM UTC
to: Ann Breslin, TMA:Retired 1st SGT, USMC, 1994. Applied for SSD 2001. Enrolled in Tricare Prime. Major surgery occurred Mar 2005. Tricare gave authorization for service connected combat related major surgery. Jan 25, 2006 awarded SSD. 20Mar2006 SS Payment Center Baltimore MD received SSA Disability award & approved Part A effective Jan 2004 and Part B effective Mar 2006. SSA did not respond to inquiry why 26 month delay in Part B. Jan 2009 Tricare Prime recoups payments from physicians for
Dot Mil Docs
10/15/2008 8:21 PM UTC
Response to comment posted on Friday, October 10, 2008 1:01:55 AM: States pay the Medicare premiums for people who receive SSI benefits if they are also eligible for Medicaid. If you get SSI and have Medicare, you will also be eligible for "extra help" without filing a separate application. See our web site at: Help With Medicare Prescription Drug Plan Costs. (www.socialsecurity.gov/i1020/) Contact the Social Security Administration at 1-800-772-1213 for additional information.
10/15/2008 8:20 PM UTC
Response to comment posted on Friday, October 10, 2008 1:01:55 AM: You may find the following information taken from the Social Security website www.socialsecurity.gov to be helpful: Many people receive both SSI and Social Security benefits. Medicaid is linked to receipt of SSI benefits in most States. Medicare is linked to entitlement to Social Security benefits. It is possible to get both Medicare and Medicaid.
10/15/2008 8:15 PM UTC
Response to comment posted on Friday, October 10, 2008 1:01:55 AM: The fact that your husband will become eligible for Medicare at age 65 does not impact your or your children's eligibility for TRICARE. You will need to continue to pay the annual TRICARE Prime enrollment fee for yourself or family enrolled in TRICARE Prime. It is important to note that the TRICARE Prime enrollment fee is waived for enrollees under the age of 65 who also have Medicare Part B.
SSimken
10/14/2008 2:32 AM UTC
Thank you for responding to my inquiry. I still need to know about my wife's eligibility for TRICARE PRIME while I am on Medicare A & B. Do I just pay the the single rate for her?
10/13/2008 7:06 PM UTC
Response to comment posted on October 03, 2008 12:18:20 AM: If the health care costs are greater, it makes sense to retroactively enroll in Medicare Part B.
10/13/2008 7:05 PM UTC
Response to comment posted on October 03, 2008 12:18:20 AM: The letter you received from the Social Security administration should have informed you of the opportunity to retroactively enroll in Medicare Part B, so that your Medicare Part A and Part B effective dates could be the same. It is important to look at billed charges for health care services received during the retroactive period and compare them to the Part B premiums for the same period.
10/13/2008 7:03 PM UTC
Response to comment posted on October 03, 2008 12:18:20 AM: It sounds as if you were awarded disability on appeal. When disability is awarded on appeal, Medicare Part A is awarded retroactively, but Medicare Part B is awarded the month the disability determination is made. TRICARE beneficiaries become ineligible for TRICARE for any period where they have Medicare Part A only.
Response to comments posted on Sept. 30, 2008 5:57:13 PM: You will automatically be enrolled in Medicare Part A and Part B in the25th month of receiving Social Security disability payments. You must keep Medicare Part A and Part B to remain TRICARE eligible. The Medicare Part B premiums will be taken directly from your Social Security disability payment. You may remain enrolled in TRICARE Prime as long as all enrollment criteria continue to be met. Your Prime enrollment fee will be waived.
10/13/2008 7:01 PM UTC
Continued response to comment posted on Tuesday, September 30, 2008 2:26:46 PM: If you obtain health care services from a provider who has opted-out of Medicare and therefore Medicare does not make any payment, TRICARE will process the claim as a second payer. In such cases, the TRICARE payment will be the amount that TRICARE would have paid had the Medicare program processed the claim (normally 20% of the allowable charge).
10/13/2008 7:00 PM UTC
Continued response to comment posted on Tuesday, September 30, 2008 2:26:46 PM: Participating providers accept the Medicare-approved amount as payment in full. Non-participating providers do not accept the Medicare-approved amount as payment in full. They may not charge more than the “limiting charge” (115% of the Medicare-approved amount). TRICARE will pay up to the limiting charge.
10/13/2008 6:59 PM UTC
Response to comment posted on Tuesday, September 30, 2008 2:26:46 PM: If a TSGLI recipient is also receiving Social Security disability payments, he/she will be automatically enrolled in Medicare Part A and Part B in the 25th month of receiving Social Security disability payments. When Medicare Part A and Part B coverage is effective, it is your primary coverage and TRICARE is secondary. You may receive health care services from any Medicare participating or non-participating provider.
old
10/10/2008 5:01 AM UTC
my husband is 100% i.u. we were afraid to apply for ssd because of our 2 girls and grandson are on ssi and we would have to pay $400 a month for medicare and my trycare Iam 7 years younger and not disabled. Now my husband is 62 at 65 he will have to go on trycare for life this also means what for our disabled children will they lose trycare and have to pay for medicare and trycare and do I have to pay trycare also?
10/9/2008 2:03 PM UTC
Thanks for all of your questions. I have forwarded them to Anne Breslin. V/r, LT Cragg
AF Kelly
10/3/2008 4:18 AM UTC
I was medically retired from the military. I was eligible for Tricare Prime and paid all premiums accordingly. I became eligible for Social Security disability and was awarded Medicare Part A effective November 2003 and Medicare B effective April 2005. Payments for Medicare Part B were directly deducted from my Social Security disability benefits. Now Tricare said because I chose to deny Medicare Part B, I was not eligible for Tricare Prime and they recouped prior payments to my providers. I res
9/30/2008 9:57 PM UTC
I am retired Navy, married and 100% I.U. from the V.A., and receive S.S. disability. I have been informed that due to my being on S.S. disability, I have to enroll in Medicare and will lose my TRICARE Prime which will be replaced by TRICARE for Life for me. I was further informed that my wife will be able to continue in TRICARE Prime. According to what Anne Breslin said, I can keep TRICARE Prime, I assume as my secondary insurance the same as TRICARE for Life would be. Which is true, who mak
Lawrence Kelly
9/30/2008 6:26 PM UTC
This is an interesting concept. Does the existence of the Medicare mandate for certain disabilities allow for TSGLI recipients to receive Medicare benefits? If so, does this then allow the seriously wounded to look to Medicare providers for second opinions and surgical procedures outside the bricks and mortar of the military health care system? Would that allow for private practitioners taking Medicare Part B and hospitals providing Part A benefits to serve as a supplement to the military healt
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