The government granted relief this month to 60,000 military beneficiaries who faced financial penalties or loss of Tricare eligibility because they delayed enrollment in Medicare Part B after reaching age 65 or after qualifying for Medicare and Social Security disability payments.
The changes mandated by the Medicare Modernization Act of 2003 impact a mix of retirees, family members, survivors and unremarried former spouses. Affected beneficiaries fall into three categories:
• Automatic Enrollees: 32,044 beneficiaries were enrolled automatically this month in Medicare Part B, ensuring their eligibility for Tricare or Tricare-for-Life without facing a surcharge on Part B premiums due to delayed enrollment.
This group includes 26,000 Medicare-eligible beneficiaries under age 65 who draw Social Security Disability Insurance payments. Until now, weaknesses in data cross-matching and beneficiary education allowed almost 16,000 SSDI recipients to use Tricare while unaware they were ineligible without Part B enrollment.
• Waived Surcharges: From the start of Tricare-for-Life in 2001 through December 2003, 18,700 elderly beneficiaries enrolled late for Part B to qualify for TFL coverage. This month not only will higher monthly premiums be lowered to the regular Part B rate of $66.60, but beneficiaries will receive refunds of premium surcharges paid back through January 2004.
• 2004 Enrollees: 9,174 beneficiaries who enrolled in Part B during the General Enrollment Period (January 1-March 31, 2004), with coverage effective July 1, 2004, also will have their surcharges waived. They also may choose an earlier or later effective date than July 1 for coverage to begin.
As welcome as surcharge relief is for many Medicare-eligible retirees, automatic Part B enrollment has confused and angered some under 65-retirees. Retired Navy Master Chief Terry Peet, 54, of Colorado Springs, Colo., said he only learned Sept. 9, via a letter from the Social Security Administration, that his SSDI of $1,260 a month was being reduced to pay Medicare Part B, effective Sept. 1.
“The letter did not refer to the passage of any new law and no advance notice had been received by me or, for that matter, my local Tricare office. The letter further stated that I could decline the Medicare but would lose all Tricare benefits,” Peet complained.
“This is a terrible blow to all retired military who are on Social Security disability,” he added, “especially with zero advance notice.”
Almost a week later Peet received an “urgent” letter from Dr. William Winkenwerder, assistant secretary of defense for health affairs, explaining in more detail that he needed to be enrolled in Part B to retain Tricare eligibility and that a special automatic enrollment period was taking effect.
What disabled retirees like Peet don’t understand, say officials, is that, by law, they were ineligible for Tricare until they enrolled in Part B. The government was complicit in the error, doing a poor job tracking and communicating with this group.
The Department of Defense and Centers for Medicare &cq Medicaid Services waited five years, until this past April, to run a cross-data check to find under 65 Medicare beneficiaries without Part B insurance who nevertheless appeared on Tricare eligibility rolls.
Having spent careers in the military, these beneficiaries thought they were eligible for Tricare and so didn’t sign up for Part B, explained Dr. Winkenwerder during a teleconference with reporters Sept. 14.
“You can understand how they did not realize that,” he said.
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