Reader Seeks Help Getting Health Coverage Restored

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


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

I hope this helps.

Shaft notes

• Kudos to Secretary of Defense Chuck Hagel who recently announced that the proposed military decoration that honors drone pilots and cyberwarriors, the Distinguished Warfare Medal, has been cancelled and will be replaced by a distinguishing device that can be affixed to previously awarded medals.

Mr. Hagel halted production of the medal on April 5 and directed Joint Chiefs of Staff Chairman Gen. Martin Dempsey to conduct a review of its ranking.

• Rep. Mike Michaud, a Maine Democrat and the ranking member of the House Committee on Veterans’ Affairs, has issued the following statement on the Department of Veterans Affairs (VA) announcement that it will expedite claims for veterans who have waited a year or longer for compensation decisions:

“The announcement today by Secretary [Eric K.] Shinseki and Undersecretary [Allison A.] Hickey shows that the VA is serious about reducing the backlog and is willing to put forward new ideas to get it done. I remain firm in my support of the VA, and these leaders. We have a way to go on solving the backlog, but I believe we will get there if Congress, the VA, the unions and veteran support organizations work together.

“Today’s announcement is a positive interim solution that should result in the oldest claims receiving more timely decisions. It will not resolve the systematic challenges that face VA in the current processing model. VA needs to continue moving forward with the new processing model. We all need to look for the best efficiencies in the process and evaluate policies that drive the process.”

• Across the nation, veterans are preparing for the 33rd National Veterans Wheelchair Games. The games, representing the largest annual wheelchair sports event in the world, are presented by the Department of Veterans Affairs and the Paralyzed Veterans of America. More than 500 veterans from across the United States, Puerto Rico and Great Britain are expected to compete in the event, taking place July 13-18, 2013, in Tampa, Fla.

“The National Veterans Wheelchair Games provide an incredible opportunity for veterans who have been training and competing all year to showcase their talents on the world’s stage,” said Secretary of Veterans Affairs Eric K. Shinseki. “VA is committed to world-class care for our nation’s veterans, and we encourage them to use adaptive sports as a key component of their physical rehabilitation. These athletes, more so than anyone, know the healing power of competition and camaraderie that this event provides.”

The games are open to all U.S. military veterans who use wheelchairs for sports competition due to spinal cord injuries, neurological conditions, amputations or other mobility impairments. The 33rd Games will be co-hosted by the James A. Haley VA Medical Center and the Paralyzed Veterans of America, Florida Gulf Coast Chapter.

“Participating in the games is a truly life-changing experience for seriously injured veterans of every generation,” said Bill Lawson, U.S. Army veteran and the national president of Paralyzed Veterans of America. “Please take a moment to tell disabled veterans in your neighborhood about the games. Encourage them to get involved. We can’t wait to welcome them to the 33rd National Veterans Wheelchair Games in Tampa this summer.”

Competitive events will take place at the Tampa Convention Center, Marriott Waterside Hotel & Marina, Pin Chasers Bowling Lanes, Clearwater Long Center, Raymond James Stadium, Silver Dollar Shooter’s Club, Jefferson High School, Hillsborough Community College and the Tampa Bay Times Forum.

The 33rd Games will include competitions in 18 different events such as swimming, basketball, table tennis, archery and wheelchair slalom, which is a timed obstacle course. The athletes compete in all events against others with similar athletic ability, competitive experience or age.

In addition to the competitions and the opening and closing ceremonies, the games will include a “Kids Day at the Games” on Monday, July 15, at Jefferson High School. Local children with disabilities will have the opportunity to interact with the athletes, participate in sporting events and watch the veterans compete.

The public is invited to attend any of the sports competitions throughout the week of the Games, and admission is free. Up-to-date information is available on the official National Veterans Wheelchair Games website,

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax 301/622-3330, call 202/257-5446 or email

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