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TRICARE News and Related Military Issues

A Message from the Secretary of Defense to America’s Veterans – September 17, 2001

As the men and women who have fought America's wars, you – more than all others -- understand what the September 11th attack on freedom and democracy means for the days ahead.

More than simple acts of terrorism by radical or unbalanced individuals, this was an attack on our way of life, our country, our home.

In a recent message to U.S. armed forces here and abroad, I spoke of the memorable moments that have marked all great crises throughout our history, images that live forever in our hearts and in our minds.

Not surprisingly, we've seen many such moments during this crisis as well -- moments of remarkable courage and selflessness; moments of fierce patriotism and pride:

Policemen and firefighters working night and day, with no thought for themselves; men, women and children giving blood until the banks are overflowing; businesses and corporations donating coffee, food and water to sustain those who would not stop working; chaplains counseling distraught families; friends and total strangers reaching out in loving gestures of human support.

And everywhere -- the American flag, on buses and taxicabs, in windows and over doorways, as armbands, on jackets and hats, and most especially, waving in glorious defiance above the smoking and twisted wreckage our enemies have wrought. One such flag, unfurled by firefighters, proudly hangs huge and proud near the
gash in the Pentagon wall.

But I also warned that more -- much more -- will be asked of Americans in the weeks and months ahead.

We face well-organized and sophisticated enemies, made all the more powerful by the terror they are so willing to unleash. Now that terror has been brought to our door, we owe it to ourselves and -- as the president has said -- to all future generations, to stop it, eliminate it and destroy it at its core.

Today, all Americans are united in anguish and anger. But we must also be united in purpose and in will.

While the immediate task of vanquishing freedom's enemies will fall to our military men and women, all of us – particularly those like you who understand the price of freedom -- will be called upon to strengthen our national resolve.

And so, as we ask God's tender mercies on all those who have fallen, we ask also for His guidance and protection for all of us who remain to finish the task now before us.

I thank the same God for America's veterans -- those of you who made us free and kept us free. I thank God for all you have done, and for all I know you will do again, to support peace and final victory.

God bless you, and God bless America.

Donald H. Rumsfeld

Guard and Reserve Members to Keep Coverage
By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

Federal law provides mobilized Guard and Reserve members the opportunity to keep their employer-sponsored healthcare coverage.

If the employee will be absent for more than 30 days, the employer may require the employee to pay the entire premium cost plus a 2 percent administrative fee.

The Uniformed Services Employment and Re-employment Rights Act of 1994 allows mobilized reservists to keep health insurance provided through their civilian employer for up to 18 months, said Air Force Col. Kathleen Woody, director of medical readiness and programs with the Office of the Assistant Secretary of Defense for Reserve Affairs.

"The employer could continue to provide coverage at no cost to the employee," she said. If the employer requires the
reservist employee to pay the whole tab, however, coverage could be cost prohibitive for many families, she
acknowledged.

For members who elect healthcare for their families under TRICARE programs, USERRA allows them to return to their civilian employer insurance plans with no waiting period or penalty for pre-existing conditions (other than service-connected conditions, which are covered by the military)," Woody said.

"For example, if a reservist elects to get his family care under TRICARE while he's activated and his daughter subsequently is diagnosed with diabetes, he can still go back to his employer healthcare plan under the same conditions as before he was mobilized," Woody explained.

"The family would be covered as if the reservist employee had never left."

Employees with questions about their rights under this act should contact their agency's human resources department or visit the National Committee for Employer Support of the Guard and Reserve Web site at http://www.esgr.org or call 1-800-336-4590.


Anthrax Vaccinations and Pregnancy: Study
By Harry Noyes
Army News Service, Fort Sam Houston, Texas

A study conducted by an Army preventive-medicine officer has calmed concerns that anthrax vaccinations might damage the reproductive success of military women.

Maj. Andrew R. Wiesen tracked the health of 4,092 active-duty service women. Out of that number, 513 women became pregnant during the course of the 15-month study, including 384 women who had been vaccinated against anthrax.

Compared to unvaccinated women, the vaccinated soldiers were just as likely to get pregnant and just as likely to give birth to healthy babies, Wiesen studies indicated. Birth problems and defects were no more frequent for the vaccinated moms than for others.

The study was conducted at Fort Stewart, Ga. All of the women in the study were stationed at Fort Stewart or nearby Hunter Army Airfield.

"Pregnancy is an outcome that is almost never studied with vaccination, given the inherent difficulties in studies of that nature," Wiesen said. "We were just very fortunate to have a set of databases that allowed us to get the information we needed when we needed it."

Wiesen was chief of preventive medicine at Fort Stewart's Winn Army Community Hospital during the study, which ended in March 2000. He has since transferred to Madigan Army Medical Center, Fort Lewis, Wash., as chief of epidemiology.

Wiesen initiated and conducted the study on his own, but his protocol was reviewed and approved by the Institutional Review Board of the department of clinical investigation at Southeast Regional Medical Command. He was assisted by Capt. Christopher Littell, a pediatrician who served as a subject matter expert on adverse birth outcomes.

Wiesen reported on the preliminary study results to a committee of the Institute of Medicine in July. He acknowledged that a larger study might reveal more, but that this one strongly indicates that there are no reproductive health problems associated with vaccination of military women.

"It is impossible to prove a negative, i.e., it cannot be proven that anthrax vaccine does not cause any harm," Wiesen explained. "The major benefit of negative studies such as this one -- studies that do not show a relationship between the exposure of interest and an outcome -- is that it increases our confidence that there is not a relationship.

"These types of studies are always subject to criticism that they should have been bigger, or a small effect could have been overlooked, etc. However, the likelihood of that occurring in this case is very small."

Wiesen's report on the research is being peer-reviewed for use in a major medical journal and should be published before the end of the year.

Providers Began Seeing TRICARE For Life Patients On October 1

As TRICARE For Life began October 1, about 1.5 million uniformed services retirees, their family members and survivors, age 65 and older, will now receive expanded medical coverage through the Department of Defense (DoD) health care program. TRICARE For Life will be second payer to Medicare for services and supplies that are benefits under both programs, and the provider does not have to file a TRICARE claim.

Combined with the TRICARE Senior Pharmacy Program that was implemented last April, TRICARE For Life will cover most medical costs not covered by Medicare. There are some health care services that are benefits under either Medicare or TRICARE, but not both. For example, Medicare covers some chiropractic services, whereas TRICARE does not. Conversely, TRICARE covers retail pharmacy prescriptions and Medicare does not. In these circumstances, the beneficiary will remain responsible for the applicable Medicare or TRICARE cost share and deductible. For those TRICARE For Life users who have other health insurance, such as an employer-sponsored health plan, TRICARE will pay after the other health insurance and Medicare.

"The DoD worked with Medicare to integrate our payment systems, so that the TRICARE payment is done so seamlessly that the individual is hardly aware of it," said J. Jarrett Clinton, M.D., the DoD's Acting Assistant Secretary of Defense for Health Affairs. Most Medicare-eligible beneficiaries of the uniformed services will no longer need an individual Medigap policy, he added.

No TRICARE For Life beneficiary card is necessary for them to receive care, and no enrollment is required. However, to be eligible for the expanded TRICARE coverage, uniformed services retirees, eligible family members and survivors, age 65 and over, need to be registered in the Defense Enrollment Eligibility Reporting System (DEERS). They also must have Medicare Part A, and be enrolled in Part B.

Anyone with questions about TRICARE For Life should call TRICARE's toll-free number, 1-888-DOD-LIFE (1-888-363-5433).

Details about the TRICARE For Life program recently were mailed regionally by TRICARE managed care support contractors to eligible beneficiaries, using addresses from DEERS.

Many age 65 and over beneficiaries already are taking advantage of the TRICARE Senior Pharmacy Program, which started April 1. Eligible uniformed services retirees, their family members and survivors receive comprehensive prescription drug coverage with minimal co-payments through its National Mail Order Pharmacy
Program, or through TRICARE network and non-network retail pharmacies. Co-payment amounts may be higher if beneficiaries choose non-network pharmacies. They may also continue using military treatment facility pharmacies, which require no co-payments.

To learn more about the TRICARE Senior Pharmacy Program, call 1-877-DOD-MEDS (1-877-363-6337) toll-free.

Additional information and updates about TRICARE For Life are posted on the TRICARE Web site at http://www.tricare.osd.mil/ndaa

© 2002 Texas Osteopathic Medical Association
Last updated 01/14/2004