Posted on 06/08/2014 6:29:27 PM PDT by 2ndDivisionVet
Tom Slear, who retired from the Army as a lieutenant colonel in 2001, is a freelance writer in Annapolis.
A few weeks ago, I mentioned to a receptionist in a physical therapist’s office that I was covered by Tricare, the military’s health-care program for service members, retirees and their families. (It has nothing to do with the troubled Veterans Affairs hospital system.)
“Good deal,” I said.
“You deserve it,” she responded.
Really? If she only knew.
Though I spent more than five years on active duty during the 1970s as an Army infantry officer and an additional 23 years in the Reserves, I never fired a weapon other than in training, and I spent no time in a combat zone. I returned to active duty for five months in 1991 during the Persian Gulf War, but I was assigned to the Pentagon. My hazardous duty consisted of a daily drive on New York Avenue before its upgrade.
I am hardly unique. Despite the extended operations in Iraq and Afghanistan, nearly half of the 4.5 million active-duty service members and reservists over the past decade were never deployed overseas. Among those who were, many never experienced combat....
(Excerpt) Read more at m.washingtonpost.com ...
“Man, we were rolling in the dough!”
In 1968, I was E-5, over two, married and got a separate quarters allowance. My take-home was right around $350. We ate a lot of macaroni.
Pretty much what I was thinking-he needs to shit or get off the pot.
The author is cherry picking his numbers. As I show below, Tricare retired beneficiaries pay more than just the $547.68 annual family premium.
Most employer based insurance have comparable co-pays but their employee’s pay is a lot higher than a retiree retainer pay, (remember, the article is comparing military retiree medical benefits cost to civilians who are still in the workforce and the cost of their medical benefits).
(A typical retired E-7 with 20 years of service receives close to $19,000 annually in retired retainer pay, so the cost of Tricare is a larger percentage of his/her retired retainer pay than the percentage cost of the employer sponsored medical benefits is to a civilian employee).
Also, if the retiree is still in the workforce and the employer offers health insurance the retiree must take it. He/she cannot opt out of the employer plan in order to use only Tricare. Tricare then becomes 2nd payer to the employer plan.
Tricare for Life makes Medicare the primary payer and Tricare 2nd payer. Also, to be qualified for Tricare for Life, the beneficiary must have Medicare Part B, (monthly premium is $104.90 [$1,258.80 annually], or higher, depending on income level).
Tricare Prime vs Tricare Standard for retired beneficiaries.
Tricare Prime has an annual premium;
Individual: $273.84 per year
Family: $547.68 per year
Plus you pay;
Ambulance Services-$20 per occurance
Ambulatory (Same Day) Surgery-$25 per visit
Behavioral Health:
Outpatient-$25 (individual visit)$17 (group visit)
Inpatient-$40 per day (no charge for separately billed professional charges)
Clinical Preventive Services-$0
Durable Medical Equipment, Prosthetics, Orthotics & Supplies-20% of the negotiated fee
Emergency Room Visit-$30 per visit
Home Health Care-$0
Hospice Care-$0
Hospitalization-$11 per day ($25 minimum)
Lab & X-Ray Services-$12 per visit (unless billed as a clinical preventive service)
Maternity Care-Office visits and hospitalization and a hospital. (One global fee): $11 per day ($25 minimum)
Officed visits for delivery in a TRICARE-authorized birthing center: $25 per visit
Office visits for delivery planned at home or other setting: $12 per visit
Newborn Care-$11 per day ($25 minimum)
Outpatient Visit-$12 per visit
Skilled Nursing Care-$11 per day ($25 minimum)
If you use a non-network provider you pay;
Point-of-Service Fees: When you use the point-of-service option, you’ll pay:
Point-of-service fees instead of your regular copayment
Any other fees charged by non-network providers.
These fees don’t apply to your annual catastrophic cap.
You must pay this amount before cost sharing begins for outpatient services.
Outpatient deductble;
Individual; $300
Family; $600
Cost share;
Outpatient services: 50% of Tricare allowed charges
Hospitalization: 50% of Tricare allowed charges
Pharmacy;
At Military Hospital: (if the drug is available; most non-formulary drugs are not available), $0.00
Tricare Mail Order Pharmacy:
You can get up to a 90-day supply for most prescriptions.
$0 for generic formulary drugs
$13 for brand-name formulary drugs
$43 for non-formulary drugs, unless you establish medical necessity
Network pharmacy:
You can get up to a 30-day supply of most prescriptions.
$5 for generic formulary drugs
$17 for brand-name formulary drugs
$44 for non-formulary drugs, unless you establish medical necessity
Non-network pharmacy:
You’ll pay more to have prescriptions filled at non-network pharmacies, including host nation pharmacies overseas. Your costs depend on your plan and the type of drug.
If you use a Prime option, you’ll pay a 50% cost share after the point of service deductible is met.
Tricare Standard:
Retired beneficiaries pay $150.00 per member or $300.00 per family deductible annually.
Retired beneficiaries then pay a co-pay of 25% of Tricare allowed charges. (However. if the provider does not file the claim you will pay the provider cash and then file your own claim. In which case, if Tricare allowed charges are less than the provider billed, (and the amount you paid at the time of service), you will only get reimbursed by Tricare 75% of the allowed amount.
If, for example, the provider will not file the claim with Tricare, (this is happening more frequently), and billed you $1,000.00 but Tricare only allowed $750.00, you will absorb the $250.00 difference between the billed and allowed amount, and then Tricare will reimburse you $562.50. Your total cost would be $437.50, or 43.75% of the billed amount, (not the 25% co-pay that you are required to pay).
Even providers that file Tricare claims for Tricare Standard beneficiaries are allowed to bill 15% above the Tricare allowed amount, but anything above is called balance billing which is illegal.
And now DOD wants to increase the Tricare Prime premium to be more equal to that paid by the civilian sector. They have already increased the pharmacy fees and want to increase them even more. Many doctors and hospitals are refusing to accept Tricare. This is especially true with the highly specialized physicians and specialty hospitals, such as cancer centers.
I also served from 1985-1993 , the one fact this jerk fails to mention is that for ALL of those years he was “government property. What this means is that at ANY time he could be put anywhere his superiors saw fit. Another real factor are deaths that occur during training. Our republic generates so much wealth that those who literally sign away there lives DESERVE this . Personally I will only (maybe) utilize a VA loan...this is the only thing that interests me as I was in the medical field and want nothing to do with there services in that realm , I am quite capable to address that when the need arises. Again I cannot stress enough the feeling of being owned by the government and subject to their whim and God forbid you upset an officer ....can ruin your day,month or year . Anyone who has served active duty knows what I mean. What a terrible article full of non and half truths.
You may have been correct the first time.
Less than 1 percent of our current population ever serve in the military. Only a small percentage of that do the amount of time required to get retirement benefits. How much does this affect the budget. Hey, you want to go after someone? How about attacking the federal employees generous retirement benefits? There are far more of them than the military retirees.
One thing he says is true about Military personnel. There are a lot more rear echelon types in the military than the general public knows. I remember years ago as a Sergeant seeing a Master Sergeant (E-8, real high up in the enlisted ranks for those non military types) in the bank in his Charlies. He only had a good conduct ribbon and one sea service deployment ribbon. Which meant he was some office type who in probably 15 years or more in the Marines had never done anything. Seeing those kind of things always pissed me off because of all the combat and deployments I had done.
Sorry, I mean to say if you spent 10 of your 18 years on ship, you did a lot of deployments. Again, don’t feel bad. You did more than your share.
He is actually right.
We should use fewer soldiers and take better care of them. Those who really need the help should get it, and gilded benefits for Pentagon jockeys should be curtailed.
“Her”?
1. If this is such a good deal, then where are the people clamoring to sign up? They're not there. The conclusion is that they recognize something about a military life that they don't want. Even in peacetime, what has it been about the military life that an overwhelming number of Americans rejected, even though the pay and the benefits are good? Answer: Absence, Freedom, Demand. There are significant periods of absence even in an army that is not at war but is still deployed worldwide and still training for real conflict. One thinks of the military as a demanding place, and it is. The freedom one associates with being a civilian is lacking in the military. If you work for IBM, you can tell your boss off and hit the door. In the military, that's not a very wise move. Expanding that idea, we get to the word ‘demand’. The military demands of people. It demands 24/7/365 availability AND it follows through on that demand. It demands adherence to regulation; it demands circumspect, dignified behavior 24/7, and it demands loyalty, fidelity, and service. These are not suggestions. They are requirements.
2. Slear suggests a 1% cut is not a violation of trust with veterans. The truth is that it cannot be anything but that when you're talking about an already agreed upon deal. If the Los Angeles Dodgers agree to pay a pitcher 20 million a year, they can't get to the end of the year and say “Well, we decided to make it 19 million, instead.” If, however, on the next contract they want to go down to 19 million, then that's their right to negotiate something smaller in the future. But for those they've already got a deal with, breaking faith with them is nothing more nor less than breaking faith with them. You follow through on your deals, and with veterans already serving under a particular deal, they are already fulfilling their part of the bargain in anticipation that the nation will follow through. What would you call a person who hired you to paint their house, let you paint it, and THEN reneged on the deal? Why, you'd call them a crook, a user, a manipulator, a faithless cheat. If the government wishes to try a smaller deal for those in the future who have not yet signed up, then let them try.
3. Then there's the ‘budget deficit’ argument. It is evident to everyone that the already funded and set aside military retirement fund is what is breaking the bank. Surely, the budget culprit can't be the hundreds of billions in entitlements given to those who do absolutely nothing for their money but sit on their asses watching TV. Surely the budget culprit can't be the 2 billion annually ObamaPhone program that is 4 times larger than the 1% money they wanted to steal from veterans who'd already fulfilled their part of a bargain. Surely the culprit can't be the waste, fraud, and abuse perpetrated at all levels of bureaucracy that does things like granting bonuses to those who negligently kill trusting veterans. Surely the culprit isn't the crony corporatist corporate welfare scams that fund failing banks, investment houses, car companies, solar start-up companies, and Nevada energy scams. We're quite certain that it's far better to stiff veterans, present and future, than it is to fix real problems.
So, Mr Slear, if you read this, then you're wrong. Simply wrong. Worse than that, I think your article smacks of toadying up to one’s masters either to curry favor or just to get a ‘controversial’ bit of writing published.
Don’t feel bad, Tom. Just grow old and go to the VA. They’ll get it back.
Mega BUMP!
Extremely well said.
My father's history was similar. He served stateside during WW2 as an administrative officer(Lt Col) and maintained a reserve status afterwards. The only requirement for the reserve status was taking extension courses(by mail).
That entitled him to a pension later. Initially, Tricare was not part of his retirement benefits, but was eventually added. He lived until age 99.
He told me that there was some degree of resentment amongst active duty retirees towards reserve officer retirees.
When I was in Navy ROTC in ‘65, IIRC, an Ensign (O-1) was making about $300.
At Parris Island in ‘68 as an E-1 we were making $88/month.
Things have really changed!
Still, for laying your life on the line, they can’t pay you too much. What they need is “Draft Everyone” then allow people to hire someone to take their place (I think the Yankees did this in the War of Northern Aggression).
So, they draft some rich young lawyer who does not want to go. He/She/(It?) put their draft number out on Ebay. I make a bit of $4,000/month plus you purchase a $10 million life insurance policy for me.
Eventually the “rich young lawyer with better things to do” takes the low bid of $3500/month, $5 million policy and 5 weekends, annually, on the lawyers yacht.
Oh, and the “replacement draftee” still draws his military pay.
Free market at work!
When I was in Navy ROTC in ‘65, IIRC, an Ensign (O-1) was making about $300.
At Parris Island in ‘68 as an E-1 we were making $88/month.
Things have really changed!
Still, for laying your life on the line, they can’t pay you too much. What they need is “Draft Everyone” then allow people to hire someone to take their place (I think the Yankees did this in the War of Northern Aggression).
So, they draft some rich young lawyer who does not want to go. He/She/(It?) put their draft number out on Ebay. I make a bit of $4,000/month plus you purchase a $10 million life insurance policy for me.
Eventually the “rich young lawyer with better things to do” takes the low bid of $3500/month, $5 million policy and 5 weekends, annually, on the lawyers yacht.
Oh, and the “replacement draftee” still draws his military pay.
Free market at work!
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