By Reg Jones
Q. My wife is a retiring federal civilian employee (Federal Employees Health Benefits) and just won her military retirement appeal, which should make her eligible for Tricare. As the spouse, did I have to be covered under her FEHB coverage for five years to be eligible myself? And are there similar requirements for Tricare?
Q. I am a military retiree and have been using my retired Tricare Prime for health insurance for past 15 years. I have been hired as a GS. I am planning to elect not to accept Federal Employees Health Benefits and solely rely on Tricare Prime. Is that an option and what are their implications?
Q. I am a federal worker with 30 years of service. During the entire time, except for two years, I have had Tricare insurance. When I retire, must I have had federal insurance to qualify for insurance from the federal government. If yes, for how long before retirement?
Q. I will be turning 65 next month. I have Federal Employees Health Benefits coverage. I just enrolled for Medicare Part B. I am a retired reservist. I intend to enroll in Tricare for Life. DEERS requires that I disenroll from FEHB to enroll in Tricare for Life when I start Part B coverage My HR person has no idea whether I can drop my FEHB. Where can I get definitive information on this issue (disenrolling from FEHB at 65) to show HR?
Q. I was on Blue Cross/Blue Shield for 15 years through my husband’s employment with a city, but the city contracted with Coventry Health Care instead, about one year and two months ago. I have also been with Tricare (formerly CHAMPUS) through my husband’s retirement from the Navy in 1993. We are divorcing after 37 years of marriage, and I would like to switch to BC/BS in FEHB through my federal employment. If I retire before I have vested five years in BC/BS, will I not be able to take it into retirement? Someone told me that if I had been with TRICARE all these years, that somehow I was already considered vested in a federal health care insurance and could switch over to BC/BS and take the health insurance into my retirement. Is that true? Or do I need to actually work for five more years?
Q. I am a retired Postal Service employee but still carry my insurance as I need it for my wife.
She is going on Medicare on June 1.
I would like to keep single coverage for me. Is this possible, and how would I go about doing this?
My group number is 40240 and my member number is 000687531.
February 13th, 2012 | Tricare
Q: I will become eligible for Tricare in March. Is there a need for me to continue coverage with FEHBP and if not, can I drop my coverage before the end of the fiscal year? I don’t turn 60 until March, which is when I become officially retired from the military reserve.
A: You can apply to suspend your FEHB coverage at any time. To do that, you must submit a completed suspension form and provide necessary documentation to show eligibility for Tricare or CHAMPVA during the period beginning 31 days before and ending 31 days after the date you designate as using Tricare or CHAMPVA instead of FEHB coverage. You can get a copy of the suspension form at www.opm.gov/forms/pdf_fill/sf2809.pdf.
December 7th, 2011 | Tricare
Q: In March 2012 I will be eligible for full military retirement. I am retired from the Army Reserve and will be 60 in March. I have BCBS. Is there an advantage to maintaining BCBS coverage rather than dropping it and going with Tricare, which would be less expensive?
A: Many of those who are eligible for both an FEHB plan and Tricare elect to suspend – not drop – their FEHB coverage. If you were to drop it and then lost Tricare coverage, or found that changes in its structure and benefits made it less appealing, you wouldn’t be able to re-enroll.
Tags: HEALTH INSURANCE
Q: Is there a Federal Employees Health Benefit provider that provides care in case something happens while traveling overseas? What happens to my insurance if I leave federal service for a year and do something else? Can I still pay and keep my health benefits?
A: Every FEHB plan has a section in its brochure that explains what it will cover if you live or travel outside the U.S. and Puerto Rico. As to your other question, if you were to leave government, you would receive a 31-day extension of coverage at no cost to yourself. During that time, you could elect to continue being covered by that plan (or choose another) under the temporary continuation of coverage provision of law. You would be required to pay 100 percent of the premiums for that coverage, which would last for up to 18 months.
Q: I am a retired federal employee and currently have health care coverage under one of the Federal Employee Health Benefits plans. I recently found out that I have multiple myeloma. I am also a Vietnam veteran, and after learning of my diagnosis, I found out that any Vietnam veteran who served on the ground in Vietnam between 1962 and 1975 and later developed certain diseases, including multiple myeloma, is presumed to have been exposed to Agent Orange herbicide and would be entitled to free health care for those diseases through the Veterans Affairs Department health care system.
However, much of the information I have gathered concerning treatment of veterans at VA hospitals for multiple myeloma has not been encouraging. I have read that veterans often do not get the treatment they need in a timely manner. My preference would be to have the option to use my FEHB and receive my treatment from my private doctors and myeloma treatment centers rather than relying on VA. The treatment can become extremely expensive: According to the information I received from one of the private myeloma treatment centers, the average cost for a bone marrow stem cell transplant would be $350,000. The average cost for one of the medications used is $10,000 per month. Would the FEHB plans pay for treatment of a service-connected disability/disease so I could use private health care providers?
A: FEHB plans don’t cover services and supplies when a local, state or federal government agency directly or indirectly pays for them. You’d need to check with your current plan (or any other plan that you are considering) to find out if you have the option of declining the coverage provided by law in favor of using private doctors and hospitals.