Welcome Packets are Next Step in TRICARE West Region Transition

FALLS CHURCH, Va. – TRICARE West Region beneficiaries should keep their eyes on their mailboxes. UnitedHealthcare Military & Veterans, the incoming West Region health care support contractor, is sending out welcome packages in late February and early March.

The welcome packets include contact information for UnitedHealthcare, where to file claims, and information on continuing automatic payments, new case managers, referrals and authorizations. TRICARE beneficiaries should read their packets carefully to see if they have to take any actions to prepare for the April 1, 2013 transition to UnitedHealthcare.

One important date highlighted in the package is March 11, 2013 when beneficiaries must switch their automatic payment authorizations to UnitedHealthcare to maintain uninterrupted coverage.

Also highlighted are new features and benefit enhancements to improve beneficiaries’ access to quality providers and decrease wait times. Enhancements include Convenience Care Clinics, the UnitedHealth Premium Designation Program of providers and expanded telemedicine opportunities.

The packets contain information about how beneficiaries can request that their current providers remain part of the TRICARE network after the transition to UnitedHealthcare takes place. Beneficiaries can ask their providers if they are members of the UnitedHealthcare network, and if not, encourage them to sign up.

West Region beneficiaries can access additional information about the transition by visiting the UnitedHealthcare website at www.uhcmilitarywest.com or reach UnitedHealthcare customer service at 1-877-988- 9378. They may also visit the TRICARE website at www.tricare.mil/westtransition.

TRICARE announces new prescription co-pays

FALLS CHURCH, Va. – New copayments for prescription drugs covered by TRICARE will go into effect soon. The Fiscal Year 2013 National Defense Authorization Act requires TRICARE to increase copays on brand name and non-formulary medications that are not filled at military clinics or hospitals.  There is no increase to copays for generic medications.  Increases will be effective sometime in February, depending on when system changes can be made, and the publication of a required Federal Notice.

Read more

Active Duty unaffected by upcoming TRICARE Prime service area changes

By Amaani Lyle
American Forces Press Service

WASHINGTON, Jan. 10, 2013 – Active duty service members and their families will be unaffected when long-delayed reductions to areas where the TRICARE Prime option is offered take place Oct. 1, TRICARE officials said Wednesday.

But as TRICARE seeks to synchronize service area shifts once staggered by contract delays, some military retirees and their dependents will be moved to TRICARE Standard coverage, S. Dian Lawhon, beneficiary education and support division director, said during a conference call with reporters. Those affected reside more than 40 miles from a military treatment facility or base closure site, she said.

Read more

TRICARE Webinar on Guard/Reserve benefits Dec. 13

By  Annemarie Felicio
TRICARE Management Activity

TRICARE and Military OneSource will host a webinar on TRICARE benefits available to National Guard and Reserve families on Thursday, Dec. 13 from 10  to 11 a.m. EST.

The different stages of the National Guard and Reserve deployment cycle can make it challenging for members and their families to know what TRICARE benefits are available.

Brian Smith, policy and program analyst, Warrior Support Branch, TRICARE Management Activity, will discuss which benefits Guard and Reserve members can use throughout the deployment cycle, how to update eligibility status and who to contact for help with enrollment or purchasing the different health and dental plans.

To register for TRICARE’s webinar with Military OneSource go to  www.militaryonesource.mil/webinar.  Registration is on a first-come, first-served basis and is limited due to system capacity.  Participants must avoid sharing personal health information when asking a question.

TRICARE provides comprehensive health and dental plan options to members of the National Guard and Reserve and their families. To get tailored information visit: www.tricare.mil and answer a couple of easy questions in the profile feature.

Have we lost course in TRICARE ABA battle?

A lot has happened in the last month with the fight to change policy affecting military families and coverage of Applied Behavioral Analysis.

The July 26 court decision forcing TRICARE to issue interim policy covering ABA under standard coverage, to include retirees, has led to a literal frenzy of confusion among parents, advocates and even TRICARE representative themselves. What is the true answer? How does it apply to you? A lot of speculation ensued.

Consider that before this occurred, the objective was a straight-forward, legislation-based solution: Congress passes the Caring for Military Kids with Autism Act and includes it in the National Defense Authorization Act.

Read more

URGENT SUNDAY DEADLINE: Tell your military autism story to Congress

by Jeremy Hilton

Next Wednesday, June 20, at 1430 (in Room 232-A Senate Russell Bldg), the Senate Armed Services Subcommittee on Personnel will be holding a hearing on the issues impacting our military families affected by disabilities. I will be testifying along with four or five other witnesses. Here is the specific info on the hearing: http://armed-services.senate.gov/e_witnesslist.cfm?id=5303

I suspect a large portion of the testimony and discussion will be referencing a potential Senator Gillibrand amendment regarding ABA and the recent OPM decision to include ABA as a medically necessary therapy for the dependents of federal workers. I intend to address that issue in my written testimony, along with other issues relevant to our community including special education, Tricare, Medicaid waivers, and the EFMP programs.

Read more

New TRICARE Dental Program as of May 1

FALLS CHURCH, Va. – As of May 1, 2012, Metropolitan Life Insurance Company, Inc. (MetLife) is the new TRICARE Dental Program contractor, providing dental benefits for more than 2 million TRICARE beneficiaries worldwide.

“MetLife is a very welcome new partner to the TDP,” TRICARE Deputy Director Brig. Gen. W. Bryan Gamble said. “The company shares in our commitment to provide top quality health care to our service members and their families.”

Read more

Autism speaks: Marine dad listens, helps piece together puzzle

CAMP LEJEUNE, N.C. – My son has autism. There, I said it – not easy for a Marine and a proud father. More specifically, he has Asperger Syndrome. Some call it a disease, but it’s not. Let’s make sure that is clear up front. People can’t catch it just being around him.

He is not a freak or weirdo, at least no more so than you or I. He is a young teen, working through the difficulties of puberty with the added bonus of learning, understanding, teaching and dealing with his relatively new diagnosis.

Read more

TRICARE Extends Autism Demonstration

By  Kristin Shives
TRICARE Management Activity
March 13, 2012

TRICARE Management Activity has extended the Enhanced Access to Autism Services Demonstration (ASD) through March 2014. This demonstration program allows eligible beneficiaries to receive applied behavioral analysis (ABA) intervention services from board certified behavior analysts and paraprofessionals under their supervision.

The demonstration is part of the Extended Care Health Option (ECHO), which provides approved non-medical services to active duty family members with qualifying conditions.

ABA is a method of behavioral conditioning to teach and reinforce desired behavior while eliminating undesired behaviors. This technique has been found to help teach children with autism spectrum disorders new skills, and improve their communication abilities.

In a 2010 TRICARE Health Program Analysis and Evaluation Division survey, parents with children participating in the demonstration expressed overall satisfaction with the quality of ABA services they received.

Learn more about ECHO at www.tricare.mil/ECHO and the TRICARE Autism Services Demonstration at www.tricare.mil/autismdemo.

Experiences from a DoD Advisory Panel

by Nicholas Sabula

On Sept. 27 military family members representing all services, components and disabilities convened at the Department of Defense Education Activity headquarters in Arlington, Va. The purpose was straight-forward: to discuss issues and offer up solutions to the major overarching issues of the military’s special needs community.

It’s been several weeks now since the panel and I finally had a chance to sit down and share my experience. Following the event, American Forces Press Service put out an article and gave some good insight from my fellow panel members. You can read that article here.

As a member of the panel, I honestly didn’t know what to expect from this first effort by DoD’s Office of Special Needs to bring together the array of subject matter experts from a variety of special needs environments. What I did know was that I had a lot of information to offer the group. Thanks to your actions taking the survey on special needs and the comments, I took a great deal of autism-related (and other special needs) information into the day. To see the overall survey results I passed out that day, see our resource page.

Additionally, there were 2,138 written responses from over 260 survey respondents. I haven’t posted this information due to some privacy information that needs edited out, but will make an assessment sometime in the future on it. Needless to say people were a bit surprised that I introduced 100 printed pages of your feedback. My intent all along was to bring your concerns and ideas to the table.

Going in as a military family member representing more than just me was in many ways reminiscent of the reasons I started work on the AMFAS project in 2008. It’s about supporting each other and unselfishly making a difference for all of our families. And a reminder that together we can make a difference.

Looking over 6,000 feedback posts since July 1, 2009, when the American Military Families Autism Support Facebook page launched, I saw the stories of challenges, heartbreak, anger, resiliency, and ultimately victory by our families who had to take matters into their own hands, find new avenues for getting help for their kids and not give up.

I talked with dozens of families regarding their experiences with EFMP, base support, military medicine, moving, deployments, ECHO, etc. I also talked to several people who were true battle-hardened veterans in the fight, in this war on autism over the last decade. They are true inspirations to our cause and I took their voices, their experiences with me as well as yours.

What I’ve learned along the way is that there are many consistencies with our experiences and challenges. There are also many things DoD can do better, both from an efficiencies standpoint and a care standpoint. The leaders behind this panel knew this and were forthcoming on their focus to better understand and improve the areas needing attention.

The format was such that after covering successes, the panel wasted little time in getting to the heart of the matter: challenges with EFMP. As one of many at the table, I listened intently to others as they raised concerns  and elaborated on their personal experiences of lack of services or policies that were inconsistent. What’s important here is that transparency was a big part of the process. More important is that the day was really about solutions, understanding and collaboration.

Some of the realities of change are that overall policies take substantial time and effort to take place, our budgetary environment makes it difficult to advocate for additional support resources and each service controls their respective support services. Talking with both panel members and coordinators of the event, I did get the consistent impression that everyone present wanted to make a difference and learn from the breadth of feedback that was shared during the day.

Challenges then transitioned to solutions and ultimately the day ended with a number of recommendations, such as consistency of services at each installation, taking the best aspects of each service and applying them universally, streamlining PCS move processes, improving respite care,  access to providers and a number of other items. ECHO was also a big topic. Basically, all things that have been hot button items for our community were discussed during the day.

Many of the challenges of yours I communicated were bolstered by my own experiences on this ASD path. For those of you who experienced the challenges of PCS moves, I was able to reference my family’s experience of four moves in five years and detailed issues with the assignment coordination process that I experienced.

Of particular interest to me was providing our families access to military attorneys supporting special education law, something the Marine Corps currently has. As a parent who has fought our son’s school administrators over the last year on a simple food heating issue with his special diet and had to visit an attorney to understand my rights, I relayed the story of another military family who had built up approximately $200,000 in legal fees trying to get special education services for their child.

As members of the AMFAS community, the work you have done to support our military autism community actually received praise from DoD leadership and was highlighted as a success at the end of the day. It was unexpected, but re-enforced the original intent of AMFAS in trying to work from a grassroots level, to provide support and information for all our military families without regard to special interest fundraising and work within the system to help both our families and our care providers to better understand and support our special needs.

Another panel is scheduled for March and although I’m unsure if I’ll have the opportunity to participate again, I can say it was an honor to get to carry your messages.