Why do you need to help veterans? More specifically, how does TRICARE help Health Care for Veterans? This page contains information on the different plans designed specifically to meet the needs of veterans.
Why Help Veterans?
According to various studies that were conducted by the Veterans Affairs, approximately one out of every five homeless individuals has, at some point, carried out military service in the United States. At present, more than twenty two million individuals can be classified as veterans in the United States. For example, there are soldiers, who spent their time serving as part of the United States military forces in far off places such as Afghanistan and Iraq. In addition to this, out of the individuals who are currently in active service in the military, almost one million people will be retiring and returning to civilian life. This essentially means that one million people will be trying to readjust to civilian life simultaneously in the five years to come.
Readjusting to civilian life is not going to be an easy process, as has been seen in the past. This is a highly critical time period for the individual himself and his family, and there is, regrettably, always a certain percentage of these veterans who end up in places or situations that are highly unpleasant. For example, many veterans in the past have faced unemployment and homelessness. Others have come home with mental disorders, such as Post Traumatic Stress Disorder (also referred to as PTSD) and depression, which can then lead to a host of other problems, such as drug and alcohol abuse.
In addition, their families are also affected due to any economic hardships. Furthermore, because of the circumstances that the veteran has undergone, families can also be shattered. Because of the years that these veterans have spent serving the military, they are used to a highly regimented and ordered way of life, and it is, therefore, no surprise that it is hard for them to adjust to the everyday life of civilians. Keeping all of this in mind, it is possible that they just drift here and there in society, without fully knowing what it is that they have to do and might turn to the use of various substances.
In order to assist veterans ease into everyday life, many different organizations have sprung up, which aim to provide help to the men and women who gave up the comforts and luxuries of life in order to serve the nation. While social and economic problems are important and need to be tackled, it is also equally important to address the health care needs of these veterans. The years that most veterans have spent living in the most stringent and strict conditions means that many of them return with various different types of chronic health conditions, injuries and mental health problems. Given everything that these individuals have done to serve the nation, it is important for a system to be devised to address the needs of these veterans.
The main aim of these health care programs is to assist people who have retired from service in the military and veterans to ease back into their lives as civilians. The programs that are currently available have been designed differently to meet the diverse needs of people, depending on what the duty status of an individual was, as well as the circumstances of his or her transition. Furthermore, the duration of these programs is also different. While some are short-term programs (that usually provide coverage and support for a period of a maximum of three years), others can be more long-term.
The military now offers a health insurance system, which is known as TRICARE. There are different options within this insurance plan, such as TRICARE Prime, TRICARE Standard, TRICARE Extra and TRICARE for Life. These health insurance plans are not just limited to veterans, but can also be utilized by others, such as people who are still in active service, and men and women who have retired from their posts in the military as well as their families. This page will focus on how veterans can benefit from the TRICARE insurance plans and their various features.
This option is similar to those offered by a health maintenance organization (also known as HMO). A veteran who opts for this plan will be assigned a particular primary care provider. More often than not, this will probably be a military medical clinic or a hospital. The veteran can obtain most of his or her healthcare needs from this primary care provider. In certain cases, a veteran may have to see a specialist. For this, a special referral will be required from the veteran’s primary care provider before the veteran can go and see a specialist.
All veterans opting for TRICARE Prime will be required to register themselves. In addition to this, a small enrollment fee also has to be paid on an annual basis. Moreover, whenever the veteran receives any form of medical care, he or she will also have to pay a small additional fee (which is known as cost-share). The advantage of using this option is that veterans do not need to bother themselves with filling out and filing in reimbursement claims if they receive any health care service under the TRICARE system itself, as this is done by the provider itself.
In short, TRICARE Prime can be considered to be perhaps the most reasonably priced option out of all the available TRICARE options. The only limitation is that a person has to be located near some military base to avail this, as the hospitals or clinics are usually located on these military bases.
Although this is more flexible than the aforementioned plan, it also comes at a slightly higher cost. Veterans usually do not need to register for this plan in advance if they are otherwise eligible to utilize the TRICARE system; enrollment takes place automatically when a veteran first goes to receive health care upon presenting the military/dependent ID as insurance. This is also flexible in terms of the fact that veterans may avail health care from any clinic or hospital that is a TRICARE network provider; all they need to do first is show their ID cards. It is more costly because a deductible is paid on an annual basis. Furthermore, any medical expenses are also split in an 80-20 method, whereby TRICARE is accountable for eighty percent of the total expenses, but the veteran would be required to cover the remaining twenty percent. As with TRICARE Prime, veterans do not need to concern themselves with the paperwork for reimbursements as the provider covers this as well.
The option costs more than other options, but is also provides greater flexibility. Veterans can access any medical providers they wish. Like TRICARE Extra, veterans opting for Tricare standard will also be paying an annual deductible. Furthermore, they will also have to pay one fourth of the total stated cost of the medical treatment. As with TRICARE Extra, it does not require any advance registrations; veterans can simply walk into any medical facility and present their ID to receive health care services.
Prior to 2001, any retired individual who crossed the age of 65 no longer had access to the facilities provided by TRICARE. Such individuals were then under the care of Medicare and its programs. Starting in 2001, however, this was changed; TRICARE services were extended to individuals even after the age of 65 if they enrolled for Medicare Part B, where an individual has to pay a monthly premium if he or she wishes to obtain medical care from any authorized provider under Medicare. The advantage of registering for this option is that additional coverage is provided by TRICARE. If certain costs are incurred during the treatment procedure that are not covered by Medicare, those are taken care of by TRICARE. Veterans will not be required to pay any kind of deductible (as in TRICARE Extra or TRICARE Standard) or any cost-share (as in TRICARE Prime).
Although TRICARE provides for most basic health care needs of individuals, there are certain rules in place about them. For example, some treatment procedures may need authorization.
It is also possible that some procedures are not covered at all. These include abortions, unless there is a risk to the life of the mother. Furthermore, although TRICARE usually provides prescription pills for birth control, it does not cover condoms. Any kind of procedure that is done for cosmetic reasons (which may either be a surgical procedure or involve the simple use of drugs) is not covered. However, there is an exception to this case – a cosmetic procedure can be carried out on a veteran if the purpose is to reverse any disfigurement that took place. For example, it can be allowed for people who have been disfigured because of burns or an accident. In addition to this, TRICARE does not cover any treatment for controlling weight or obesity or helping an individual to quit smoking.