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September 24, 2001 11:56 am

DESPITE the new war on terrorism, and federal budget surpluses melting like ice cream in summer heat, Defense health officials have sent a reassuring message to 1.5 million Medicare-eligible military beneficiaries and their civilian health-care providers: The TRICARE for Life program will spring to life Oct. 1, on schedule.

"We are bringing the promise home," said Air Force Maj. Gen. Leonard "Randy" Randolph, deputy executive director of the TRICARE Management Activity, during a Sept. 18 meeting with reporters at TMA Headquarters in Falls Church.

Not only will the program start on time, but it will be fully funded and will operate without any strain by patients or civilian health-care providers.

All signals for "are green. All signs are go. It's going to happen," said Air Force Col. Frank Cumberland, TMA director of communications and customer service. "People needed that assurance before Sept. 11, and they really need it now."

Steve Lillie, director of over-65 benefits division at TMA, said 95 percent of Medicare-eligible military beneficiaries are enrolled in Medicare Part B, a requirement for using TRICARE for Life. Most enrollees, as Congress intended, will have to drop their Medigap insurance and use TRICARE for Life as their Medicare supplement.

Still, some elderly remain skeptical. They cite various reasons:

Funding. Some retirees say they won't drop their Medigap insurance until they know TFL is a permanent entitlement and is fully funded. It is, Lillie emphasized.

For fiscal 2002, which begins Oct. 1, President Bush requested an extra $3.9 billion for new medical benefits for service elderly. Congressional approval is expected. Even if lawmakers fail to pass a defense appropriations bill by Oct. 1, TFL will start on time, Lillie said.

For fiscal 2003 and beyond, the law establishing TFL, which passed both the House and Senate by overwhelming majorities, directs a special accounting mechanism to fund TFL. Part of the money will be drawn from general revenues of the government, and part from appropriated Defense Department dollars.

Wary physicians. Some civilian doctors are advising military retirees not to drop their Medigap insurance because TRICARE has had problems paying claims. Some doctors even say they won't participate in TFL because reimbursements for TRICARE services have been set too low.

In truth, said Lillie, physicians don't need to participate in TFL, and patients don't need to rely on a specific network of physicians. Any health-care provider who treats Medicare patients can treat TFL patients. Medicare will pay for its covered services and send the unpaid portion of the bill to the second payer, which is TRICARE. Reimbursement should be a breeze.

"The provider doesn't have to do anything else, or know a thing about TRICARE, to get a check from TRICARE in addition to Medicare," said Lillie.

TRICARE officials hope to educate Medicare providers on the seamless nature of TFL through articles in professional medical journals and newsletters. They also are encouraging beneficiaries to share handouts and TFL information cards with doctors. Finally, physicians with questions are encouraged to call the TFL information center at: 888/DOD-LIFE or 888- 363-5433.

Catastrophic cap. Some retirees mistakenly believe TFL's catastrophic cap of $3,000 sets a ceiling on the amount of medical costs TRICARE will cover for a family in a given year. The reverse is correct; the cap will protect families so they pay no more than $3000 out- of- pocket in case of a medical catastrophe.

ID cards. Some beneficiaries expect a TFL identification card. It won't be coming. To use TFL, they only need to be enrolled in Medicare Part B and to update personal information in DEERS, the Defense Enrollment Eligibility Reporting System.

Active-duty members who have been denied leave this month, or have seen their leave cut as a result of U.S military activity after the Sept. 11 terrorist attack on the World Trade Center and the Pentagon, will not loose those vacation days.

The Defense Department has lifted a 60-day limit on accrued leave that service members can carry over into the new fiscal year, which begins Oct. 1. Leave relief will assist critical personnel who have more than 60 days on the books. They stood to lose those leave days if not used by Oct. 1.

The terrorist attacks prevented some service members from using excess leave this month. They now will be authorized to carry up to 90 days of accumulated leave through Sept. 30, 2002.

With the pace of operations rising to challenge terrorists, sea service officials are expected to press harder for a delay in startup of the $100-a-day ITEMPO pay. Set to begin Nov. 5, the pay is a kind of speeding ticket that the services must pay if they fail to heed operational strain on individual members.

Members will be eligible if away from home ports or permanent duty stations for more than 400 days of the last two years. Payments, once begun, continue until the rolling count falls below 401 days away out of the previous 730.

Service secretaries can make exceptions to limit ITEMPO eligibility. Officials worry, however, that such actions could block payments to persons who deserve them most, like members of special operation forces who deploy often.

Navy officials appreciate the goal of ITEMPO pay, to improve management of personnel and avoid burn out. But the service wants ITEMPO delayed for a year or two to allow time to assess its impact, including whether the 400-day threshold is reasonable given the size of the fleet and current pace of operations.

TOM PHILPOTT is a syndicated columnist who has covered the military for more than 20 years. He welcomes your comments and suggestions. Write Military Update, Box 1230, Centreville, Va. 20122-8230, or e-mail milupdate@aol.com.





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