- The Washington Times - Tuesday, April 23, 2013

Dear Sgt. Shaft:

I disenrolled from an HMO on March 23. I was informed to send information of disenrollment from the HMO and TFL (TRICARE For Life) would reinstate my TFL. (TRICARE is the health care program serving uniformed service members, retirees and their families worldwide.)

I have faxed the information four times since March 23 after talking with TFL and Anthem Alliance. The only reason I enrolled in Anthem was because I thought it would help to compensate TFL. I did not disenroll from TFL at any time. But was informed that the HMO disenrolled me. I want my TFL back now. I am forwarding the paperwork and what was requested. Is there any way you can help me?

I have renal failure and 100 percent disability. I am unable to get my prescriptions or anything else. I am in limbo and must do dialysis three times a week. Please help me if you can.


Thanks a million,
Mary W.
Toledo

Dear Mary:

Being in an HMO, or dropping an HMO, might cause processing complications with TFL, especially if you had the HMO’s pharmacy plan, but wouldn’t impact enrollment in the Medicare/TFL program. You state that you have been enrolled in TFL the whole time. This would mean you stayed enrolled in both Medicare Parts A and B and maintained a current military ID card the whole time. If so, you are in TFL already.

To verify your TFL status, call the DEERS Support office at 1-800-538-9552 to have them check. DEERS is the Tricare/TFL enrollment program. If you are talking specifically about pharmacy benefit, if you stayed enrolled in Medicare/TFL the whole time, the pharmacy benefit also stayed in force. A separate pharmacy program, like the one with the HMO, would impact the processing of the pharmacy claims, but it wouldn’t stop the TFL pharmacy benefits.

If you were not enrolled in Medicare Part B, then your TFL stopped. This would require you to re-enroll in Medicare Parts A and B during the Medicare open season between Jan. 1 and March 31 to start your TFL again. The coverage wouldn’t start until July 1. See Page 19 of the Medicare and You 2013 handbook.

Only by dropping out of Medicare Parts A and B do you lose TFL benefits. If this is the case, your focus should be on getting Medicare Parts A and B back and making sure your military ID card and DEERS (Defense Enrollment Eligibility Reporting System ) enrollment is up to speed. Your closest ID card and DEERS offices are at:

180th FW (Fighter Wing) Ohio ANG (Air National Guard) Toledo
180th FW MSFDPMPS
Attn: ID Cards
2660 South Eber Road
Toledo Express Airport
Swanton, OH 43558

419/868-4225
419/868-4183

And…

NOSC (Navy Operation Support Center) Toledo
28828 Glenwood Road
Perrysburg, OH 43551
419/666-3444

I hope this helps.

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