Due to a technical problem, readers were unable to access the FRA Action Center on the following issue. We apologize for the inconvenience and invite you to weigh in using the link at the bottom of this news item.
VA Letter to TFL Beneficiaries Explained
More than 12,000 TRICARE-for-Life (TFL) beneficiaries who are also in Priority Group 8 at the Department of Veterans Affairs (VA) recently received a letter explaining a change in the out-of-pocket expenses incurred at VA medical facilities. In the past, when these veterans used VA facilities for care not related to a service-connected disability, they’ve paid very little out of pocket if they used their TRICARE benefit.
By law, TFL pays only after Medicare and any other health insurance benefit has been paid. Although the VA is TRICARE-authorized, it is not Medicare-certified, and therefore cannot receive payments from Medicare. Current reimbursement to the VA have been more than DoD was authorized to make and, effective October 1, 2013, TRICARE will pay the required 20 percent of TFL allowable charges. TFL beneficiaries seeking non-service-related care at the VA will have to pay the remaining balance.
Related to this issue, Rep. Michael Michaud (Maine) introduced the “Medicare VA Reimbursement Act” (H.R. 2953) to address this situation. The measure seeks to authorize Medicare reimbursement for eligible veterans to improve access for Medicare-eligible veterans and enhance health care funding for the VA. Most veterans pay into Medicare for most of their lives, yet the law prohibits them from using this earned benefit at VA facilities.
Members are urged to use the FRA Action Center and ask their legislators to support this bill. To contact your legislator on this issue go to: