Medicare, Tricare and CHAMPVA.

If you retire from the armed services, you and your dependents are eligible for Tricare medical . The two main flavors are Tricare Standard, that is equivalent to an Health Maintenance Organization (HMO), and Tricare Prime, that is equivalent to a Preferred Provider Option (PPO).

Tricare is similar to Medicare, but it also provides prescription drug coverage. Once you reach age 65, you are eligible for Medicare. Medicare Part A covers hospital care and it is provided automatically. To maintain Tricare, you must accept Medicare part B which covers doctor visits. You are then given Tricare for Life as secondary insurance. Your spouse will continue to be covered by Tricare Prime until he or she reaches age 65. Then the spouse will be covered by Tricare for Life, too assuming Medicare Part B is accepted.

With Medicare as primary insurance and Tricare is secondary, there is no need for Medicare Part C or D that provide prescription dug coverage. Tricare for Life covers prescription drugs.

CHAMPVA is very similar to Tricare. In fact, Tricare was originally called CHAMPUS. To be eligible for CHAMPVA:

1. the spouse or child of a veteran who has been rated for total and permanent disability due to service-connected disability by the VA (that is, a VA regional office)
2. the widow/widower or child of a veteran who passed away due to a service-connected disability rated by the VA
3. the widow/widower or child of a veteran who at the time of death, was rated as permanently and totally disabled due to a service-connected disability
4. the widow/widower or child of a military man or woman who was killed in the line of duty (but not due to bad conduct– often though these will be TRICARE eligible rather than CHAMPVA)
   

Notice that dependents must have a sponsor who is (100 per cent) totally and permanently disabled or the sponsor passed away from service-connected disability (less than 100 per cent.).

If a vet never received a service connected disability, the survivors would not eligible for CHAMPVA. Of course, the death must be be related to the specific service-connected (SC) disability the VA has awarded.

Likewise the spouse and children may be eligible for Dependent Indemnity Compensation.(DIC) when a disabled veteran passes. The criteria are similar to those for CHAMPVA eligibility.

If a vet dies while a claim is being adjudicated, the survivors of a pending SC claim must open a new Accrued Claim.

Why would a survivor want to reopen an Accrued Claim? If the death is related to the claimed condition, the survivors may be eligible for both CHAMPVA a medical coverage and DIC. Even if the claimed condition is not related to the cause of death, the survivors could receive disability compensation in the form of lump sum payment.

Accrued benefits are only payable if the VA Form 21-534 was filed within one year after the veteran's death.

Once a dependent reached age 65, CHMAPVA becomes secondary insurance as is the case for Tricare. It is called CHAMPVA for Life.

Thee are also Medicare part C & D. Medicare part D does provide prescription coverage, but this private program will become more expensive in the next 10 years. This is because the program was never properly funded by the Congress and it was being subsidized by Standard Medicare FICA payroll tax receipts.

Obama removed the $10 billion subsidy form Part D and rolled the projected revenues into ACA. Medicare Part C that insurers also sell is similar to Part D.

Any vet who has either Tricare for Life or CHAMPVA as secondary insurance does not need Medicare Part C or D.

You an also purchase Medicare Supplemental or MediGap insurance to cover Medicare co-pays. This may be a better and lower cost option than Medicare Part C and D for people who need secondary insurance.

Your local Social Security office should be able to answer any questions you have on Medicare or Medigap. As a retired armed services person or disabled vet, you may have some extra medical entitlements when you reach age 65.

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Medicare Infographic explains why raising the retirement age would hurt the program

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Workers Independent News: Families USA: Seniors should pay attention to Romney plan

In the previous debate Republican Presidential candidate Mitt Romney told seniors over the age of 60 that they didn’t need to keep listening, because they wouldn’t be impacted by his Medicare proposal. 

Families USA Executive Director Ron Pollack said on Thursday that seniors, in fact, should pay close attention to what Romney was selling. His organization laid out five key ways in which seniors would be impacted by the Romney/Ryan plans.

1. It would cause seniors to pay considerably more out of pocket in respect to premiums. On average over the next 10 years the average increase cost that Medicare beneficiaries would incur would be $347 per year over the next 10 years.
2. Romney’s pledge to repeal the Affordable Care Act on day one would reopen the donut hole.

The ACA fixes this. It fixes it on a gradual basis. Right now it provides a 50 percent disount on brand name drugs when people are in this coverage gap.

Repealing the Affordable Care Act would also put a huge burden of preventive care back on the heads of seniors.

Seniors no longer have to pay anything for deductibles or co-pays. In 2011 almost 26 million people on the Medicare program availed themselves of this program.

Jesse's Package:: Families USA: Seniors should pay attention to Romney plan::Workers Independent News:

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Republicans push "pants on fire" lie about huge Medicare cuts

The Republicans are pushing a huge lie that Medicare will be cut by $716 million dollars. The Affordable health Care Act (ACA)  makes it clear that benefits will not be cut to subscribers but that the government will cut funds to medicare providers. Some of this federal funding shortfall will be picked up by ACA. Subscribe to the Rightardia feed: http://feeds.feedburner.com/blogspot/UFPYA Rightardia by Rightard Whitey of Rightardia is licensed under a Creative Commons Attribution 3.0 Unported License. Permissions beyond the scope of this license may be available at rightardia@gmail.com.

The Difference Between Barack Obama And Paul Ryan’s Medicare Plans | TPMDC

The Ryan Medicare plan would do two things. First, it would provide a $5900 voucher to the typical American who is now 55 and will be entering Medicare in 10 years.

The recipient would have to use that money to buy private insurance. They would not be able to use the money to negotiate fee simple rates for their doctors.

Essentially the Ryan plan would privatize Medicare. It would likely cause senior care costs to skyrocket.

Obama wants to make Medicare more solvent by cutting costs to insurance providers which is essential to the Affordable Heath Care Act.

Undoubtedly the FICA payroll taxes will have to be raised to make both Social Security and Medicare more solvent.

of course, you can look at increase at FICA as the glass half empty as Republicans do.

FICA can be best viewed as a long term savings plan that provides for seniors at old age and keeps them off of the welfare rolls.

graphic: Donkey Hotey, Photo license:  Some rights reserved

The Difference Between Barack Obama And Paul Ryan’s Medicare Plans | TPMDC:

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The Ryan Medicare plan: vouchers and coupons

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NewsDaily: Poll shows most Americans favor Medicaid expansion

NewsDaily (2012-07-31) -- Most Americans back the idea of extending health coverage to their low-income neighbors through the government's Medicaid program, unless it means higher costs for their own state, according to a new poll.

NewsDaily: Poll shows most Americans favor Medicaid expansion:

art: http://www.todaysseniors.com/pages/Medicare_Supplemental.html

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Medicare Beneficiaries Less Likely To Experience Cost- And Access-Related Problems Than Adults With Private Coverage

"This article provides evidence that people with employer-sponsored coverage were more likely than Medicare beneficiaries to forgo needed care, experience access problems due to cost, encounter medical bill problems, and be less satisfied with their coverage. Within the subset of beneficiaries who are age sixty-five or older, those enrolled in the private Medicare Advantage program were less likely than those in traditional Medicare to have premiums and out-of-pocket costs exceed 10 percent of their income. But they were also more likely than those in traditional Medicare to rate their insurance poorly and to report cost-related access problems. These results suggest that policy options to shift Medicare beneficiaries into private insurance would need to be attentive to potentially negative insurance experiences, problems obtaining needed care, and difficulties paying medical bills."

Medicare Beneficiaries Less Likely To Experience Cost- And Access-Related Problems Than Adults With Private Coverage:

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Social Security tax needs to be reformed

Rightardia has talked about this several times. The Social Security cap makes Social Security tax the most regressive federal income tax of all. 


The Federal Insurance Contributions Act (FICA) authorizes a payroll tax that pays for both Social Security and Medicare. 

The cap has become a political football when the president is Republican.

The cap should be abolished and 100 per cent of Income should be taxed to pay for Social Security as is the case for the Medicare part of this tax. 

This would enable the federal government to actually cut the payroll tax. Employees  pay  6.2% for Social Security plus 1.45%  for Medicare of their paycheck. The employer pays a matching amount, 

Rightardia suspects the Federal government would be able to reduce these percentages if he Social Security tax was reformed to tax 100 per cent of income. 

That will never happen in a the House with a GOP majority. 

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Politifact busts US Chamber of Commerce ad

These assertions are the basis of a US Chamber of Commerce add attacking Obama and Senator Bill Nelson.

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FlackCheck.org: An Alert To Broadcast Stations in Alabama, Florida, Michigan, Missouri and Montana

Published on Mar 29, 2012 by FlackCheck

http://www.flackcheck.org - FlackCheck.org points out that TV stations are airing a misleading attack ad and reminds these stations that they can refuse third party ads or insist on the accuracy of those they air. If you would like to email the stations in your area to encourage them to insist on the accuracy of the ads they choose to air, click here: http://services.flackcheck.org/contact-stations/

License: Standard YouTube License

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Coordinating a VA Disability Benefits Questionnaire

The major recently completed a DRO hearing and the DRO asked for a Disability Benefits Questionnaire (DBQ) from the major's specialist.

The Major and his wife traveled to VAMC after the hearing and talked to the specialists nurse. She said we had to coordinate the DBQ through the primary care doctor first. 

My primary care doctor is the northern part of the county. We then talked to her nurse and the staff appeared to be unaware of the DBQ process. 

Three weeks later I talked to the primary care doctor  about the DBQ. She did not understand she could either fill the DBQs out or forward it to the specialists office. She advised me to take the DBQs to C&P. She also wanted a blank DBQ.  Of course,  DBQs can be downloaded from a VA web site (http://benefits.va.gov) on the Internet. 

Again the DBQ is a wonderful improvement to the old way the VA had been doing business, 

So Rightardia checked to see how the DBQ is supposed to be coordinated. We got some surprises. 

According to the Department of Veteran Affairs DBQ FAQ, only the following is authorized to complete a DBQ?

Providers with active medical licenses must sign and attest to a medical condition on completed DBQs. The DBQ can be completed either by:

• Veterans’ private treatment providers, or
• Veterans Health Administration (VHA) clinicians.

The FAQ further states:

Veterans have the option to take a DBQ to their private provider or Veterans Health Administration (VHA) clinician for completion, but Veteran are responsible for any related co-pay or costs, including costs for travel or testing. (A Veteran is always entitled to an examination and any required testing at no charge for a scheduled compensation appointment that has been requested by VBA.)


Asking your primary care provider to complete a DBQ is no different than asking your provider to write a letter or note providing medical evidence of a medical condition in support of a claim. The same co-pay rules apply equally to both situations.


However, Rightrdia would point out the DBQ ask for more detail than you might include in a letter. It should prevent any requirement for additional letters from you doctor. 

Also note that the use of DBQs is not mandatory. Rightardia would suggest using this form is you want your claim resolved as quickly as possible. 

Since the major had gotten several letters form his primary care and specialist already, we had little difficulty getting three DBQ signed by private practice physicians in a two week period. 


However, we are still waiting for our VMAC specialist to sign his DBQ after three weeks because the primary care doctor had not forwarded the DBQ. 


Do you want to take a DBQ to C&P? In general, that is a bad idea. C&P is the main reason the DBQs were needed in the first place and many C&P doctors will damn you with faint praise during their cursory exams. Try to get the DBQ signed off by a hospital specialist who is medical doctor, board certified preferred. 


Be aware the term clinician includes Physicians assistance, nurse practitioners and medical doctors. Most have general medical backgrounds. 


If you have Tricare or Medicare, use a private practice physician whenever possible to complete the DBQs. These will get the job done faster! 


All of the DBQ that are available to Private physicians have been published. These DBQ can be found at on the VA website at: http://benefits.va.gov/disabilityexams 

Some  DBQs are not available for use by private providers?
since There are no DBQs for the following medical examinations:

• Initial Examination for Post-Traumatic Stress Disorder
• Hearing Loss and Tinnitus
• Residuals of Traumatic Brain Injury
• Cold Injury Residuals
• Prisoner of War Examination Protocol
• Gulf War Medical Examination
• General Medical Examination for Compensation Purposes
• General Medical Examination for Pension Purposes

How do you submit completed DBQs to VA?


A:  Veterans and/or their physicians may mail or securely fax completed DBQs to the VA Regional Office handling the Veteran’s claim. 


To find mailing addresses, visit the VBA website at: www2.va.gov/directory/guide/Allstate_flsh.asp To find fax numbers, visit the VA website at http://benefits.va.gov/transformation/disabilityexams.   


Completed DBQs may also be submitted directly to the VA Regional Office. Submit them through the Veteran Assistance office. 


See the VA FAQ on the DBQ at http://benefits.va.gov/TRANSFORMATION/dbqs/FAQS.asp

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WH blog: Medicare by the numbers

Megan Slack

March 19, 2012 
12:20 PM EDT

The average senior on Medicare will save $4,200 on their health care by 2021 because of the Affordable Care Act.

President Obama’s health reform law strengthens Medicare for seniors in a few ways.  It gives them access to preventive services, such as mammograms and colonoscopies, with no co-pay or deductibles, as well as a free annual wellness visit. 

Nearly 32.5 million people have already received a free preventive service.

And, the Affordable Care Act is making it easier for seniors to pay for the medications they need, by providing a 50 percent discount on brand-name prescription drugs for seniors once they hit the prescription coverage gap known as the “donut hole.” 

By 2020, that donut hole will be closed completely.

Already, more than 5.1 million seniors and people with disabilities saved over $3.2 billion in drug costs. That comes to an average savings of $635 per person.

For more information:

• How health reform helps seniors
• VIDEO: Health reform is giving Helen, a senior from West Philadelphia, peace of mind and more money in her pocket
• Tell us your story: How is the Affordable Care Act improving your care?

READ MORE

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The next GOP attack on Medicare in Spring

If you thought Medicare was safe from House Republicans, guess again. After the first Republican plan to end Medicare tanked, they’re back with a sequel that is even more frightening.

From the creators of “War on Women” and “Assault on the Middle Class” comes Republican Budget 2.0. The original plan by Paul Ryan Productions was the true story of seniors grappling without Medicare and facing skyrocketing health care costs. In Ryan’s reprisal, Republican Budget 2.0, they’ll try to finish the job.

“This sequel is sure to get two-thumbs down from seniors and go straight to DVD,” said Jesse Ferguson of the Democratic Congressional Campaign Committee. “Everyone knows, the sequel is always worse than the original. This horror flick could leave seniors looking over their shoulders and under their beds at night.”

Last weekend, Republican Budget Chairman Paul Ryan announced the sequel would be coming this Spring.

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Opinion - Al Jazeera English: Enshrining the lies of the US' 1%

"There is a potential lie-of-the-year in that paragraph. It's just not the one that PolitiFact thinks it found.

The real lie is the claim that Ryan's plan "is necessary because of the programme's soaring costs". In fact, the problem isn't Medicare per se, it's the entire cost structure of American medicine as a whole, which is roughly twice the per capita cost of healthcare spending in other advanced countries - even those that have 50 per cent more people aged 65+ than the US has.

The reason for that cost structure is non-competitive private oligopolies - insurance companies, drug companies, hospital chains, etc., - in sharp contrast to other countries with their government-run systems of various different kinds. There's another name for these oligopolies -they are the cash cows of the one per cent. Paul Ryan is their man, and PolitiFact is part of their protection system.

Indeed, as Thomas Ferguson and Robert Johnson explained just over a year ago, in their paper "A World Upside Down? Deficit Fantasies in the Great Recession", all of the US long-term federal debt is due to just three oligopoly sectors: the military-industrial complex (the backbone of empire, with bases all around the world and almost half the world's military spending), the medical-industrial complex (with twice the per capita costs of other systems), and the financial sector (which has recently cost trillions of dollars in lost wealth and economic activity)."

source: Enshrining the lies of the US' 1% - Opinion - Al Jazeera English

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DCCC: Don't End Medicare

Uploaded by DCCCVideo2012 on Jun 5, 2011

Join our fight at www.DontEndMedicare.com

As if once wasn’t enough, Republicans voted again last week to end Medicare and raise health care costs for seniors. That’s right: the GOP is doubling down on their plan to end Medicare, while refusing to end taxpayer giveaways to Big Oil and tax breaks for millionaires.

And now, incredibly, right-wing darling Michele Bachmann says Republicans need a Medicare message makeover and proposed a bumper sticker message. Republicans think a gimmick will cover up the truth. The GOP will not get away with their relentless attack on America’s seniors but only if we stand together and hold them accountable.

Now that Republicans are back home in their districts, we’re launching the Medicare Action Center so grassroots Democrats have the latest tools to fight back.

• the video shows Americans in their own words talking about why they rely on the Medicare benefits they have earned and share with friends.

• Help us reach 250,000 strong on our petition telling House Republicans that ending Medicare is unacceptable.

• Find out about upcoming Republican town halls you can attend in your area.

• Get your canvass kit so you can talk to your friends and neighbors about the Republican plan to end Medicare.

• Send a letter to your Member of Congress or a letter to the editor of your local newspaper denouncing the Republican plan to end Medicare -- and the GOP’s efforts to double down on their outrageous plan.

Republicans are going into overdrive to defend their plan to end Medicare. But with your powerful grassroots support we will hold them accountable.

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Politifact: Medicare overhead

This is an interesting article which suggests that the government's collective approach to health insurance is more cost effective than private insurance. 


"There's a 1.5 percent to 2 percent overhead in Medicare," Boxer said during an interview with MSNBC’s Chris Matthews on May 24, 2011. "The insurance companies have a 20 percent to 30 percent overhead."


Politifact ruled Boxer's statement half true. In one study, CBO found that privately run Medicare plans had 11 percent overhead, compared to 2 percent for traditional Medicare.


Private insurance can have 20 to 30 per cent overhead for individadual plans, but group plans have 11 -12 per cent overhead for private insurance. 

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Paul Ryan's DeathCare reform

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Far Left Side explains the Ryan Medicare Plan

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