Tri-Care Premiums? Medical Reimbursement?

Jessicajoy7

PEB Forum Regular Member
Registered Member
I recently was notified my separation, with severance, was re-characterized as retirement.

Regarding enrolling in Tri-Care from date of “separation”, do you have to pay the annual premiums up to date? For me that’s 13 years.

If so, can you submit a claim requesting repayment of medical expenses and premiums paid between “separation” and notification of retirement?

Has anyone had success in that?
 
No, you pay your first 3 months worth of premiums. Just to cover until you set up your allotment if that's how you want to pay it.
 
I recently was notified my separation, with severance, was re-characterized as retirement.

Regarding enrolling in Tri-Care from date of “separation”, do you have to pay the annual premiums up to date? For me that’s 13 years.

If so, can you submit a claim requesting repayment of medical expenses and premiums paid between “separation” and notification of retirement?

Has anyone had success in that?
Go to finance at military installation and they will submit for backpay, premiums, spousal coverage, etc.. I ended getting back pay and premiums of to date. Also your premium locks in at the amout it was at retirement year. Yes on civilian insurance premiums being reimbursed. I just won the case with the government. I can give attorneys name if you want?
 
Go to finance at military installation and they will submit for backpay, premiums, spousal coverage, etc.. I ended getting back pay and premiums of to date. Also your premium locks in at the amout it was at retirement year. Yes on civilian insurance premiums being reimbursed. I just won the case with the government. I can give attorneys name if you want?
Dchicko, I would love to get more information from you on this if possible as I just got retired after 14 years after separation.
 
Go to finance at military installation and they will submit for backpay, premiums, spousal coverage, etc.. I ended getting back pay and premiums of to date. Also your premium locks in at the amout it was at retirement year. Yes on civilian insurance premiums being reimbursed. I just won the case with the government. I can give attorneys name if you want?
Holy cow... so insurance premiums, etc? Mine just got approved and I got out in '07. Now to navigate this...
 
Holy cow... so insurance premiums, etc? Mine just got approved and I got out in '07. Now to navigate this...
As I've been researching, if you were medically retired before 2018 and choose tricare select there shouldn't be premiums. So as along as you select the tricare select plan, there won't be any premiums that need to be paid back to tricare.

You can then file for reimbursement and if you want tricare prime switch over at the next open enrollment period. This is just my understanding so may be wrong. I'm still waiting on my records to be updated so I haven't done anything yet.

Here's the link to compare tricare premiums and costs: Copayments & Cost-Shares | TRICARE



SmartSelect_20210902-121720_Chrome.jpg
 
Go to finance at military installation and they will submit for backpay, premiums, spousal coverage, etc.. I ended getting back pay and premiums of to date. Also your premium locks in at the amout it was at retirement year. Yes on civilian insurance premiums being reimbursed. I just won the case with the government. I can give attorneys name if you want?
Can I get the attorney you used
 
Go to finance at military installation and they will submit for backpay, premiums, spousal coverage, etc.. I ended getting back pay and premiums of to date. Also your premium locks in at the amout it was at retirement year. Yes on civilian insurance premiums being reimbursed. I just won the case with the government. I can give attorneys name if you want?
Can you please give me the attorney info as well?
 
Potentially good news regarding back pay after being awarded medical retirement from a BCMR or federal court. As I was working to update my Tricare so it would be retroactively effective from when I separated, Tricare East said they could only backdate it to 2018. That is the date when Humana took over the contract. They were telling me that they could backdate it to that date and process any claims to that date. I ended up reaching out to DHA (defense health agency). They verified my information with the BCMR and then said they would open a case to get Tricare set up to the date of separation.

The person I talked to reached out to me a couple weeks ago and said the information was up to date and now they just need the documentation so they can backpay me my out of pocket costs and premiums. She mentioned that they didn't have an official process yet so I could just email her a paystub that shows medical premiums paid for each year and an end of year statement of out of pocket costs. Until I saw some of these federal court cases where people were awarded medical premiums, I thought you could only get paid back for out of pocket costs. I am still waiting to see how it all plays out but the good news is that it looks like they are setting up a process to pay back any private premiums paid as well as out of pocket costs.
 
Potentially good news regarding back pay after being awarded medical retirement from a BCMR or federal court. As I was working to update my Tricare so it would be retroactively effective from when I separated, Tricare East said they could only backdate it to 2018. That is the date when Humana took over the contract. They were telling me that they could backdate it to that date and process any claims to that date. I ended up reaching out to DHA (defense health agency). They verified my information with the BCMR and then said they would open a case to get Tricare set up to the date of separation.

The person I talked to reached out to me a couple weeks ago and said the information was up to date and now they just need the documentation so they can backpay me my out of pocket costs and premiums. She mentioned that they didn't have an official process yet so I could just email her a paystub that shows medical premiums paid for each year and an end of year statement of out of pocket costs. Until I saw some of these federal court cases where people were awarded medical premiums, I thought you could only get paid back for out of pocket costs. I am still waiting to see how it all plays out but the good news is that it looks like they are setting up a process to pay back any private premiums paid as well as out of pocket costs.
Robins,

How did you go about finding these court cases? I am in the middle of one now and would love some insight on how to proceed

Thanks

Nick
 
Robins,

How did you go about finding these court cases? I am in the middle of one now and would love some insight on how to proceed

Thanks

Nick
I was awarded retirement as well but the back pay for out of pocket costs and premiums was just through contacting DHA which is the organization that manages Tricare contracts.

You can look up court cases here. https://www.uscfc.uscourts.gov/aggregator/sources/8. The search function isn't the easiest to use though.

You can also look up BCMR cases here: https://boards.law.af.mil/. The BCMR search function is terrible though so you almost have to just scan through them to find cases related to medical retirement/separation.
 
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