Few doctors in new military plan

Many retirees can't use extra Medicare benefit

LORRINE THOMPSON, THE OLYMPIAN

Originally published November 23, 2001

THURSTON COUNTY -- A major change in military health benefits is a mixture of good news and not-so-good news for some Thurston County veterans.

The good news: The federal government created and funded a new program, Tricare For Life, that provides Medicare supplemental insurance and significant pharmacy benefits for men and women older than 65 who are retired from the military.

The program became effective Oct. 1 for thousands of South Sound military retirees.

The not-so-good news: Some Thurston County veterans are finding it difficult to locate doctors who will accept Washington state's low Medicare reimbursement payments, so the new program might not help them.

"We've got free health care that's no real benefit to us," said Harold Carr Sr., a retired command sergeant major.

After Tricare For Life became effective, Carr searched for physicians and grew worried when so few would accept new Medicare patients. So he chose to keep paying $138 a month to keep Group Health coverage for himself and his wife.

"I just can't take a chance," he said.

Seven weeks after the launch of the new program, South Sound veterans, doctors and Madigan officials are still learning how the program will change benefits and services for retirees.

There's no doubt the program is an important benefit for retirees, said Tony Woods, who served 24 years in the Army and now represents veterans on committees for Madigan Army Medical Center, the Veterans of Foreign Wars, and the Retired Sergeants Major and Chiefs Association.

"It's an extremely important change because it provides health care benefits that were previously unavailable," Woods said.

Tricare For Life allows most military retirees to stop paying for Medicare supplemental insurance and for many costly drugs, said Chris Hober, director of marketing and education for Tricare Northwest.

The program for Washington, Oregon and northern Idaho is administered out of Madigan, where Hober works.

"For those who have been paying hundreds of dollars out of pocket, this is a wonderful benefit," Hober said.

Woods said it's also important that the government is trying to keep its promise to provide lifelong health care for military retirees.

Working as an Army recruiter after serving in the infantry in Vietnam, Woods promised many soldiers that health care would be available for them if they made the Army their career, based on the government's promises, he said.

South Sound veterans have been discussing the new program and how it seems to be working, said Woods and Scott Olson, senior vice commander of American Legion Post 3 in Olympia.

Olson said he's heard few complaints from veterans.

Retirees don't have to enroll, as long as they are correctly registered in the Defense Enrollment Eligibility Reporting System, which all military personnel and retirees should be, Hober said. Retirees also must be enrolled in Medicare Part B -- an outpatient services part of Medicare -- to qualify for Tricare.

Retirees will automatically be placed in the program, and when their doctors bill for Medicare services, any supplemental claims will automatically be routed to Tricare For Life.

But Hober admits that some doctors have been reluctant to accept Tricare insurance because of billing problems when the original program began in 1995.

"Those docs may have had a bad taste in their mouths from the early part of the program," Hober said.

"But I think once the doctors understand that this operates exactly as a Medicare supplement, they'll be less concerned," he said.

"We've pretty much worked out the bugs in the claim system."

Carr said that Tricare For Life is not the main problem in Thurston County.

After several health networks and a major medical clinic shut down in the county this year, more than 20 doctors left and many others shut their doors to low-paying Medicare and Medicaid insurance.

"Medicare is the real problem," Carr said. "(Military officials) think we can go to any doctor, and that's not true."

He advises veterans who plan to drop their managed care plans or supplemental insurance to check with their doctors to ensure the doctors will accept the change and plan to stay with Medicare.

Woods said the Tricare For Life program is an important step, but the government also must address health care for retired veterans who are under age 65 and their family members.

"There is a gap there," he said.

Lorrine Thompson covers Thurston County and health for The Olympian. She can be reached at 360-754-5431.

Tricare For Life

For information about Tricare For Life:

- Call the Tricare Northwest service center at 800-404-2042.

- Visit the Tricare Northwest Web site at tricarenw.mamc.amedd. army.mil, or visit the federal Tricare for Life site at www.tricare.osd.mil/tfl.

The Olympian Copyright 2001

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