Tricare Retired Reserve/ChampVA Confusion

bignateswife

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Registered Member
I've soured the internet looking for answers but am still confused.

My husband is rated 90% by the VA but receives IU at 100%. His PEB was recently completed with the Army rating him at 80%. He also receives SSDI. All of his disabilities are combat related and service connected. We are currently on Tricare Reserve Select.

It is important to note that we also have two sons with serious chronic illnesses that require incredibly expensive care, which is currently being covered by TRS.

Here is the problem. His retired date is coming quickly. We were just informed that it will be official on May 24th. And it sounds like that means that we will no longer be eligible for TRS. My husband called Tricare and ChampVA this morning and was told by Tricare that he would qualify for Tricare Retired Reserve at a monthly rate of nearly $1000. ChampVA said that because he is eligible for the Tricare Retired Reserve, he is not eligible for ChampVA. The way I am understanding this is that our only health insurance option is going to cost us $1000 a month.

Please tell me there is another option, or I am missing something here...
 
Not sure about the reserve stuff, but if he is 100% rated with the VA, they should cover all of his medical (even for non-service connected items). Then, you only need insurance for you and your kids. For me, that comes out to about $600/month but that is the best insurance I could find for them (and my daughter has ADHD which jacks up the rate). You could probably get by on less. You could find a job with medical benefits and that may make it cheaper.

I don't know if anyone else on here can answer about the Tricare vs ChampVA and especially for a reservist. Hopefully they will come along and give you the right answer. I wish I had it for you. Just keep in mind that several people have made this transition and you can, too.

Also, if you have to do things for him around the house, make sure that you apply to the VA for the caregiver's program. I just found out about it and it sounds pretty good. They will give you a monthly stipend and possible health care benefits just for taking a couple of online courses and then doing all the same stuff for your husband that you are doing right now!

Hope you can get the answers you need. Good luck to you.
Trevis
 
I can not speak for the children's insurance. Mine are all grown.
Your Husband's (Because he is receiving SSDI) Primary Insurance carrier will become Medicare part A & B.
His secondary carrier (which will cover what Medicare doesn't cover) Is who ever you choose.
Rated @ 100% with VA... they will also take care of his medical needs.

I just retired and was going to retain Tri Care Prime but since they are dropping the area in which I live I went with Tri Care for Life which costs me $0 because of my retirement.
So far they cover my Doctor visits that aren't Medicare Providers...
And VA is trying to meet my needs, sometimes with very dismal results.
I was medically retired by the PEB @ 90% TDRL and received a 100% Rating from the VA.
I was legacy... ;)
 
I've soured the internet looking for answers but am still confused.

My husband is rated 90% by the VA but receives IU at 100%. His PEB was recently completed with the Army rating him at 80%. He also receives SSDI. All of his disabilities are combat related and service connected. We are currently on Tricare Reserve Select.

It is important to note that we also have two sons with serious chronic illnesses that require incredibly expensive care, which is currently being covered by TRS.

Here is the problem. His retired date is coming quickly. We were just informed that it will be official on May 24th. And it sounds like that means that we will no longer be eligible for TRS. My husband called Tricare and ChampVA this morning and was told by Tricare that he would qualify for Tricare Retired Reserve at a monthly rate of nearly $1000. ChampVA said that because he is eligible for the Tricare Retired Reserve, he is not eligible for ChampVA. The way I am understanding this is that our only health insurance option is going to cost us $1000 a month.

Please tell me there is another option, or I am missing something here...

I could be totally wrong and I am sure somebody will correct me if I am, but I think your husband needs to explain he is a chapter 61 retiree. If they are just tracking he is a reserve soilder, they may be assuming he is not elligable for benefits until his reserve retirement would kick in at 62, or whatever it is. With chapter 61, he should start collecting retirement now, as well as the benefits that come with it. Again, if I am wrong, somebody tell me.

Secondly, what she is saying they have "have two sons with serious chronic illnesses " an insurance company is going to crush them for a pre existing condition and charge them a lot.
 
Secondly, what she is saying they have "have two sons with serious chronic illnesses " an insurance company is going to crush them for a pre existing condition and charge them a lot.

Sorry, you are right ranger, I missed that part. Can't the chapter 61 reserve retirees get Tricare at the same rate as the active duty folks? That would mean they could get it at $600/yr for Prime or go with Tricare for Life at free (both for full family coverage)? I thought I saw that somewhere, but I could be wrong.

Even if they can't, some states have insurance for those with pre-existing conditions and they may be able to get insurance cheaper from there than anywhere else. Maybe check into other state/federal programs for that very thing.
 
1. Since he is being medically retired (Chapter 61) you will be entitled to your choosing of Tricare Standard or Tricare Prime for you and your kids.
2. Tricare for Life only starts once someone receives both Medicare Part A and B. Part B does NOT start until 24 months after the date of disability. Therefore, your husband might be enrolled in Tricare for Life immediately after retirement or not for a few months to two years. Until he is enrolled in both Medicare A/B, Tricare (standard or prime) will also be his insurance plan. Once he is Medicare part B eligible he automatically is enrolled in Tricare for Life while you stay with Standard or Prime.
3. Medicare will become his primary insurance with Tricare for Life secondary as stated above. This has NO impact on you or the kids.

** Keep in mind transfer between Standard and Prime can happen in as little as 24 hours. You choose what is best for you and the kids.
 
ChampVA is not an option since you have and will have Tricare. Your husband can use the VA if he chooses. If he is considered permanent and total (P&T) from the VA your family is eligible for a host of other benefits.
 
ChampVA is not an option since you have and will have Tricare. Your husband can use the VA if he chooses. If he is considered permanent and total (P&T) from the VA your family is eligible for a host of other benefits.

Thanks for chiming in pittpan2005. I was pretty sure, but not 100%. I will keep it in the toolbox for next time.
 
Thanks for chiming in pittpan2005. I was pretty sure, but not 100%. I will keep it in the toolbox for next time.
Anytime......and this is based on current policy. With the ACA coming on board and the recent talk with Tricare changes (co-pays, distance for eligibility of Prime, etc) I am sure this will change again soon.

Another piece of the puzzle is the Medicare A/B requirement. Once eligible for Medicare Part B you are enrolled in Tricare for Life. There is only one way that someone who collects SSDI and is enrolled in both Medicare Part A/B can maintain Tricare as primary payer.......they must stop receiving SSDI.
 
Thanks Pitt, I can't remember... but isn't everyone that once they retire that receives SSDI on Medicare Part A & B, provided they filled out the paperwork... (If it's not filled out in time... once they do, it will be effective the day of retirement.
Tri Care Prime may not even be an option at all after 1 Oct 2013... (?)
I know it won't be for me because of where I live... :cool:
 
Anytime......and this is based on current policy. With the ACA coming on board and the recent talk with Tricare changes (co-pays, distance for eligibility of Prime, etc) I am sure this will change again soon.

Another piece of the puzzle is the Medicare A/B requirement. Once eligible for Medicare Part B you are enrolled in Tricare for Life. There is only one way that someone who collects SSDI and is enrolled in both Medicare Part A/B can maintain Tricare as primary payer.......they must stop receiving SSDI.

Is this for further punishment or is this just for their own entertainment...?
 
Thanks Pitt, I can't remember... but isn't everyone that once they retire that receives SSDI on Medicare Part A & B, provided they filled out the paperwork... (If it's not filled out in time... once they do, it will be effective the day of retirement & tri care prime may not even be an option at all after 1 Oct 2013? I know it won't be because of where I live...
Bravehart,
Making me work tonight like the Chicago Blackhawks are about to be worked!!

I am not sure if the Prime issue is 100% certain or still "being worked out." I'll have to explore like Ponce de Leon.

As far as the Medicare A/B issue: Medicare Part A is automatic. Medicare Part B is dependent on the date of disability per SSA (24 months). It's possible all retirees collecting SSDI are "auto enrolled" into Tricare for Life upon retirement (DEERS handles the verification), but I think it's wrong unless the 24 months are satisfied. Maybe Medicare and Tricare have worked that out so the 24 months is waived for service members, but I haven't seen it in any SSA or Tricare publication.

In my case SSDI was awarded post retirement, but retro 2+ years so my 24 months was satisfied before I received my first SSDI payment. A weird twist happened because Medicare was retro dated to a random date. That caused all my Tricare claims to go into the Medicare, Tricare Standard, and Tricare for Life hamster wheel. No one would pay because A was responsible, no B was, wait, no C was. After about 6 months they figured it out.
 
Anytime......and this is based on current policy. With the ACA coming on board and the recent talk with Tricare changes (co-pays, distance for eligibility of Prime, etc) I am sure this will change again soon.

Another piece of the puzzle is the Medicare A/B requirement. Once eligible for Medicare Part B you are enrolled in Tricare for Life. There is only one way that someone who collects SSDI and is enrolled in both Medicare Part A/B can maintain Tricare as primary payer.......they must stop receiving SSDI.

WOW!!!
 
Is this for further punishment or is this just for their own entertainment...?
No straight answer anywhere. I proposed the idea that those of us who have alternative healthcare (Tricare) should be allowed to drop Medicare, if we choose. Let the government collect its monthly Medicare fee/premium, but put it towards the deficit. I thought it was a win win.........I maintain Tricare Standard or Prime and government debt is reduced.

Personally I am forced to pay 10k a year out of pocket because I can't drop Medicare as primary payer. I can't complain though because the added SSDI compensation more than covers it, but why am I stuck paying 10k a year when I have Medicare, Tricare, and VA? I could go on for days, but the reality is my freedom to choose is what causes this.
 
Bravehart,
Making me work tonight like the Chicago Blackhawks are about to be worked!!

I am not sure if the Prime issue is 100% certain or still "being worked out." I'll have to explore like Ponce de Leon.

As far as the Medicare A/B issue: Medicare Part A is automatic. Medicare Part B is dependent on the date of disability per SSA (24 months). It's possible all retirees collecting SSDI are "auto enrolled" into Tricare for Life upon retirement (DEERS handles the verification), but I think it's wrong unless the 24 months are satisfied. Maybe Medicare and Tricare have worked that out so the 24 months is waived for service members, but I haven't seen it in any SSA or Tricare publication.

In my case SSDI was awarded post retirement, but retro 2+ years so my 24 months was satisfied before I received my first SSDI payment. A weird twist happened because Medicare was retro dated to a random date. That caused all my Tricare claims to go into the Medicare, Tricare Standard, and Tricare for Life hamster wheel. No one would pay because A was responsible, no B was, wait, no C was. After about 6 months they figured it out.

Well I had been on ssdi also for 24 months prior to retirement, In my case they said I had to pay for part B but would not receive any benefit for paying for it as all my appointment had to be made by the military and they were paying the full bill. I finally was able to dis-enroll (18 months later), but was then hassled when I had to re-enroll... I really think they spend hours laughing about how they can make a mucked up situation worse and stand around the water cooler laughing about it!!! It all worked out but I paid $200 a month for nothing 18 months)... then they back charged me after it kicked back in for about 5 or 6 months. Insurance Companies are the same as Lawyers and Wall Street, they take until there is no more to be gotten... and disappear until they find the next victim... :mad:
 
No straight answer anywhere. I proposed the idea that those of us who have alternative healthcare (Tricare) should be allowed to drop Medicare, if we choose. Let the government collect its monthly Medicare fee/premium, but put it towards the deficit. I thought it was a win win.........I maintain Tricare Standard or Prime and government debt is reduced.

Personally I am forced to pay 10k a year out of pocket because I can't drop Medicare as primary payer. I can't complain though because the added SSDI compensation more than covers it, but why am I stuck paying 10k a year when I have Medicare, Tricare, and VA? I could go on for days, but the reality is my freedom to choose is what causes this.

All of that was correct..... except we spanked the WILD last night and were just warming up!!! You should not be allowed to discuss Hockey if you live in Florida!!! HA!!! LoL!!! :cool:
 
Well I had been on ssdi also for 24 months prior to retirement, In my case they said I had to pay for part B but would not receive any benefit for paying for it as all my appointment had to be made by the military and they were paying the full bill. I finally was able to dis-enroll (18 months later), but was then hassled when I had to re-enroll... I really think they spend hours laughing about how they can make a mucked up situation worse and stand around the water cooler laughing about it!!! It all worked out but I paid $200 a month for nothing 18 months)... then they back charged me after it kicked back in for about 5 or 6 months. Insurance Companies are the same as Lawyers and Wall Street, they take until there is no more to be gotten... and disappear until they find the next victim... :mad:

So after 24 months, when Part B kicked in, you were still on AD and unable to use Medicare, but had to pay the monthly premium? Did Part B kick in prior to the 24 months? Just trying to figure out how you disenrolled and reenrolled.
 
I called Social Security, went in... signed a disenrollment form and for 9 months didn't see the deduction. After my retirement, Tricare dis enrolled me until Medicare kicked in... It took 2 or 3 months to get everything working again, but it worked... :cool: Had I told them 30 days in advance my retirement date, it would have gone smoother... ;)
 
All interesting information for historical achieves purposes!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
I am in your same situation, What was the final outcome for you? I'm National Guard being chapter 61 out, 100% Army 100% VA and they are telling me its Tricare Retired Reserve since I don't have SSDI
 
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