New Hampshire Chapter - Military Officers Association of America



Tricare

ON THIS PAGE:


LINKS:


(top)



TRICARE PHARMACY NETWORK CHANGES

(top)



Shingles Vaccine

    The new shingles vaccine, Shingrix, is a game changer according to health care experts. Shingrix is recommended for adults 50 and older to prevent shingles. Ninety to Ninety-Nine percent of people over the age of 40 had chickenpox. About one-third will get shingles at some point in their life.

    The vaccine introduced in 2006 for people 60 and older was about 70 percent effective. The Military Health System experts recommend everyone over the age of 50 get the new vaccine. Shingles can recur, so even if you have had shingles the new vaccine is recommended.

    Shingles usually develops as a stripe across one side of the body or face. People may feel pain, itching, or tingling in the area where the rash occurs a few days before the rash actually appears. A few days after the rash appears, it turns into extremely painful  fluid-filled  blisters.  They usually scab over after a week or ten days and then the scabs clear up a couple of weeks after that. The pain may persist for a long while after that.

    Some people develop post herpetic neuralgia, or PHN. The older you are when you get shingles, the more likely you will develop PHN and have long lasting severe pain, a pain that is not easily treated. This constant pain can significantly affect your quality of life. The new vaccine is a two dose series with the second dose administered two to six months after the first. Unfortunately, many patients have side effects for two or three days after vaccination. They include headaches, fatigue and nausea.  You should discuss possible side effects with providers.

(Source: Health.mil)  Note:  The Shingrix vaccine is covered under TRICARE for persons over 50.  (Source: TRICARE)

(top)



    TRICARE PHARMACY COSTS (2022)

(top)



TRICARE HANDBOOKS AVAILABLE

TRICARE STANDARD

TRICARE® CHOICES IN THE UNITED STATES

TRICARE FOR LIFE

(top)



ATTENTION: TRICARE-eligible and Medicare-eligible Beneficiaries Under Age 65

    TRICARE-eligible and Medicare-eligible beneficiaries under age 65 should receive a letter in the mail from DEERS.

    Beneficiaries under age 65, except the family members of active duty servicemembers, who are entitled to Medicare Part A because of disability or end-stage renal disease must purchase Medicare Part B.  Please note that family members of active duty servicemembers who are eligible for Medicare retain eligibility for TRICARE Prime, Standard, and Extra whether they purchase Medicare Part B or not.  However, purchase is recommended.

    Medicare and TRICARE now are able to exchange data on beneficiaries that become Medicare eligible.  If applicable, Medicare Part B enrollment now will be maintained on DEERS records. Recently, DEERS started mailing letters to this group of beneficiaries explaining the requirement to purchase Medicare Part B in order to remain entitled to TRICARE benefits.

    Additionally, if a beneficiary stops paying Part B premiums, they will become ineligible for TRICARE. That means that no future claims will be paid by TRICARE, and recoupment action could be initiated to recover payments made for any ineligible period of time.

    For questions about TRICARE and Medicare coordination, call 1-866-773-0404.

(top)


TRICARE PROVIDER CATEGORIES
(Reprinted from Hanscom Air Force Base
"Military Retirees Newsletter" - Summer 2005)

    For those under age 65 that use TRICARE, Prime, Standard or Extra there continues to be confusion about what it means when a provider “takes” TRICARE. The question to ask a provider is if he/she is an “authorized” (non-network) provider, or a  “participating” (network) provider. The difference is as follows.

 AUTHORIZED OR NON-NETWORK PROVIDER is one who has submitted his/her credentials to TRICARE including appropriate state licensing and certification documents and personal information to meet state and federal billing and tax requirements. (As of 1 September 2004, all Medicare approved providers are accepted as TRICARE authorized). They are permitted to charge 15% above the TRICARE approved amount the beneficiary will be responsible for. Non-network providers may or may not submit the claim, which is paid under TRICARE Standard. TRICARE cannot pay for services from an unauthorized provider.

PARTICIPATING OR NETWORK PROVIDER is an authorized provider who has signed an agreement with the TRICARE contractor to accept a negotiated rate as payment in full (plus your cost share) and to file claims for services paid under TRICARE Extra.

The relative availability of “network” versus “non-network” providers will vary significantly from place to place. Assistance with finding a provider can be obtained at a TRICARE Service Center (TSC) or at www.tricare.osd.mil. For the North region, www.healthnetfederalservices.com. Since Medicare is the primary payer for those with TFL, these categories do not apply. You may go to any provider that accepts Medicare.

(top)


ReturnHome

Hot Items | Contacts | TRICARE | Program Notes | Chapter News | Membership Info |
 Newsletter | Group Travel | Transition Assistance | Odds and Ends
 
 

web statistics