MOAA LEGISLATIVE UPDATES
MOAA's Legislative Update for Friday, December 10, 2004:
Issue 1: TRICARE Transition Still a Work in Progress
On Nov. 1, the last TRICARE Region completed the switch to the new TRICARE "Next Generation" (TNEX) contracts. Since June 2004, the program has transitioned from 12 Regions and four contractors to three regions and three contractors (TriWest, Humana and Health Net).
DoD TRICARE Management Authority (TMA) leaders have posted information on the TRICARE Web site about the extent of the main problems we've highlighted, including ongoing efforts to fix them in each of the three TRICARE regions. You can find information on telephone wait times, changes in Primary Care Managers (PCMs), and Referrals and Authorizations at: www.tricare.osd.mil/healthcarecontracts/default.cfm
We believe Defense health officials and contractors alike are making sincere efforts to get TRICARE Prime care delivery back within the prescribed access standards as quickly as possible
One of our Coalition partners, the National Military Family Association (NMFA), has posted a TRICARE Prime access survey on their website. If you are a TRICARE Prime enrollee, please take the time to visit their website and take the survey at:
www.nmfa.org/site/Survey?SURVEY_ID=1441&ACTION_REQUIRED=URI_ACTION_USER_REQUESTS
Issue 2: TRICARE to Begin Enforcing Generics Policy
When Express Scripts International (ESI) took over administration of the TRICARE Retail Pharmacy program contract on June 1, 2004, many beneficiaries were caught by surprise as the company began consistently enforcing TRICARE's pre-existing mandatory generics policy. This led to denials of prescriptions for brand name drugs that many beneficiaries had previously received even though generic equivalents were available.
After MOAA protested this no-notice change, DoD authorized a 6-month waiver period, which was scheduled to expire on Monday, Dec. 13. Since then, DoD has extended it again while ESI sends letters to individually notify patients who have prescriptions for branded medications with generic equivalents.
However, once those existing authorized refills have expired, and a new prescription is presented, the generic equivalent will be dispensed and the brand name medication will not be covered unless ESI has approved a request from the beneficiary's doctor to continue the brand name drug for reasons of medical necessity.
Once beneficiaries receive their letters, they will have 30 days before ESI begins enforcement of the policy.
To qualify for medical necessity, the doctor must certify one or more of the following conditions:
* the patient has experienced, or would be likely to experience, significant adverse effects from the generic medicine;
* the generic medicine has resulted in, or is likely to result in, therapeutic failure;
* or the patient has previously responded to the brand name medication, and changing to the generic medication would incur an unacceptable clinical risk.
If the physician feels that it is medically necessary for the patient to continue to receive the brand name version of the medication, the physician should call the TRICARE Retail Pharmacy program Prior Authorization Line at 1-866-684-4488 to obtain a letter of medical necessity before the patient presents the next prescription at the retail pharmacy.
For more information on generic medications go to: http://www.fda.gov/cder/ogd/#Introduction
For additional questions regarding the prescription drug benefit, contact Express Scripts at 1-866-DoD-TRRx (1-866-363-8779) to speak with a patient care advocate. To read more about TRICARE's generics policy, visit: www. tricare.osd.mil/Status-Drug-Program-final-8-Dec-04.cfm.
Issue 3: What's New on MOAA's Web Site?
2004 Guard and Reserve legislative gains:
www.moaa.org/Legislative/Reserve/2004Gains.asp
New Family Support Resource Section:
www.moaa.org/Links.asp#family
MOAA's Legislative Update for Friday, December 17, 2004:
Issue 1: Task Force Focusing on Exchange Transformation
This week, representatives of MOAA and The Military Coalition (TMC) attended a briefing by the Unified Exchange Task Force (UETF) on the DoD's efforts to create a more efficient military exchange system. Exchanges have provided a significant and highly popular non-pay benefit for service members, their families, and retirees for over a century. More information about the Unified Exchange Task Force and its mission is available at www.unifiedexchange.org.
MOAA's Legislative Update for Thursday, December 23, 2004:
Issue 1: What's Your MOAA Membership Been Worth to You?
The legislative successes won by MOAA and others over the past five years are significant and impressive against any benchmark and have substantially improved the lives of almost everyone in the military community.
As we highlight one priority or another in any particular year, we regularly get questions from members along the lines of, "I support what MOAA is pushing this year for survivors (or last year for disabled retirees, etc.), but what has MOAA been doing for the (non-disabled retiree/active duty/Guard-Reserve/other) group of people I care most about?" We think even a cursory review of the accomplishments from 1999 to 2004 demonstrates we've been able to win major gains for every part of the military community. Check out the highlights on MOAA's Web site at http://www.moaa.org/Legislative/GainsSince1999.asp.
Obviously, these successes weren't achieved by any single organization. They were won by the combined efforts of MOAA, The Military Coalition, other military and veterans associations, and many thousands of individual members who pressed their legislators for action - and by the senators and representatives who acknowledged the pressing needs and did something about them. In certain cases, the Department of Defense played a strong supportive role, but many of the greatest victories (including TRICARE For Life, concurrent receipt, and repeal of the SBP "widows tax") were accomplished despite strong Executive Branch opposition.
But anyone associated with the process will acknowledge MOAA's leadership role in most of these efforts. So we think it's worth taking a minute to highlight what kind of return MOAA members have received on their $24 annual investment in MOAA dues.
TRICARE For Life: $2,000 annual savings for life ($4,000 per couple) for Medicare-eligible members who no longer need to carry supplemental Medicare insurance.
TRICARE Senior Pharmacy: An average of $1,300 per year that Medicare-eligible members would have spent out-of-pocket on prescription drugs that are now covered by TRICARE.
Combat-Related Special Compensation (CRSC): For a 100% combat-disabled retiree, this can amount to $27,000 a year or more, tax-free.
Concurrent Receipt: A retiree 100% disabled from other service-connected causes also may get back the same $27,000 per year or more, starting in 2005. 50% to 90% non-combat disabled retirees will get back $1,800 to $7,000 or more, respectively, in 2005, and these amounts will rise substantially in the years ahead.
REDUX Repeal. Members who entered service after August 1986 are no longer forced to give up 20% or more of all future retired pay, as they would have been if the onerous REDUX penalties had not been repealed. This can mean hundreds of thousands of dollars over an officer retiree's lifetime.
Military Pay Raises: Years of effort to restore military pay raise comparability have added an extra 11% to active duty, Guard, and Reserve pay since 1999. And that means 11% more retired pay for the rest of these members' lives.
Tax Deduction for Guard/Reserve Drill Expenses. The same legislation restored a tax deduction for overnight lodging, travel, and other expenses directly associated with inactive duty training -- worth hundreds and even thousands of dollars a year for members who travel long distances to drill sites.
Guard/Reserve TRICARE. Guard/Reserve members now get 90 days pre-deployment coverage and 180 days post-deployment coverage with no deductible or enrollment fee. Selected Reserve members not on active duty will be able to purchase a year of subsidized TRICARE coverage for each 90 days served in a contingency operation since 9/11. Even the most conservative estimates value this coverage at $1,000 to $3,000 per year, depending on family size.
SBP Benefit Increase. By 2008, elimination of the "military widows tax" for survivors age 62 and older will mean an additional $4,000 to $8,000 or more in SBP benefits for survivors of most retired officers, depending on grade, length of service and level of participation in SBP.
VA Survivor Annuity Improvement. Survivors of members who died of service-connected causes now can keep VA survivor benefits if they remarry at age 57 or older, and the benefit is reinstated for those who remarry at younger ages if the second marriage ends in death or divorce. This protects almost $12,000 a year for the affected survivors.
Issue 2: Happy Holidays!
With Congress (and many of the MOAA staff) out of town for the holidays, this will be the last legislative update until Friday, January 7.
We wish you and yours a happy holiday season. If you're traveling over the next two weeks, please be safe. We'll need every possible member back for the tough legislative battles to come in 2005.
Speaking of needing every possible member, if you know an active duty, Guard, Reserve, retired, or former officer who doesn't yet know why every officer should be a MOAA member (see item 2 above), consider giving that officer a half-price ($12) MOAA gift membership. Just call MOAA's Member Service Center at 1-800-234-MOAA (6622) (Mon-Fri, 8:00-6:00 EST) or e-mail msc@moaa.org.
MOAA's BENEFITS INFORMATION UPDATE
December 2004
Item 1 DFAS Tax Statements Schedule
Military members, retirees/annuitants and Department of Defense (DFAS) civilian employees will once again have access to view, save and print their tax statements from myPay at https://mypay.dfas.mil. Effective September 17,2003, all current myPay active/reserve military users and DFAS civilian employees who request or already have a myPay Personal Identification Number(PIN) and access myPay are consenting to receive only an electronic W-2. They may elect to receive a hardcopy W-2, however, there is a "no change" period that runs from December 1 through January 31 of each tax season.
DFAS provides the following timeline for service members, military retirees and annuitants and defense civilian employees to access their tax statements through myPay and when they can anticipate receiving the hardcopy delivery by mail.
Tax Statements myPay Access Mail Dates
Retired Annual Statement 4 Dec 04 17-29 Dec 04
Retired 1099R 13 Dec 04 17-29 Dec 04
Annuitant Annual Statement 13 Dec 04 28-29 Dec 04
Annuitant 1099R 4 Dec 04 27-29 Dec 04
Air Force, Army,
Navy Reserve W2s 27 Dec 04 4-5 Jan 05
Civilian W2s 6 Jan 05 10-14 Jan 05
Marine Corps Active
& Reserve W2s 10 Jan 05 18 Jan 05
Air Force, Army, Navy
Active W2s 14 Jan 05 18-24 Jan 05
Statements Only Available by Mail Mail Dates
Special Compensation for Severely
Disabled 1099R 17 Dec 04
VSI/SSB W2s 4-5 Jan 05
Travel W2s 10-11 Jan 05
Savings Deposit 1099INTs 10-11 Jan 05