TRICARE PHARMACY POLICY UPDATE: Walgreens left the TRICARE retail network when its contract with Express Scripts expired at the end of last year. While Walgreens is the largest pharmacy chain in the country, the TRICARE pharmacy network still has over 57,000 drug stores nationwide – more than the combined number of McDonald’s and Starbucks stores.
After Walgreens announced plans to get back with ESI they will remain a non-network pharmacy provider for TRICARE beneficiaries. ESI announced that while it will partner with Walgreens on some of its other programs, Walgreens won’t be readmitted to the TRICARE pharmacy network thus remaining a non-network pharmacies.
If you choose to use Walgreens you will have to pay full price for your medication and file a claim for reimbursement. Reimbursements are subject to deductible or out-of-network cost-shares and TRICARE-required copayments. All deductibles must be met before any reimbursement can be made. Under those circumstances, the concern was that readmitting Walgreens would end up raising TRICARE pharmacy costs. While the math is understandable from DoD’s standpoint, these new windfall savings only raise new questions about Pentagon efforts to impose steep copayment increases on beneficiaries because of allegedly “skyrocketing costs.” [Source: MOAA Leg Up 7 Sep 2012]
WHO’S TRACKING YOU: Most people know the big three credit bureaus – Equifax, Experian, and TransUnion – keep a file on them that tracks their loan payment history. And that they can get a free copy of your history from each agency once every year at AnnualCreditReport.com. But credit isn’t the only thing outside companies are tracking. There are other databases out there, recording everything from prescriptions to insurance claims. Following are the major ones:
Medical reports, part 1: Medical Information Bureau, IntelliScript, and MedPoint
• If you’ve applied for an individual health, disability, long-term care or life insurance policy within the last seven years, it’s possible you have a file at the Medical Information Bureau (MIB), IntelliScript, and/or MedPoint. It’s not hard to find out. Simply request your report by calling MIB at 866-692-6901 or visiting www.mib.com/html/request_your_record.html. After making a request, you’ll receive a copy of your file (or a letter stating you don’t have one) by snail mail, generally within a week or two.
• IntelliScript and MedPoint compile information on your history of prescription drugs, including prescriptions, dosage, and refills. As with MIB reports, the information is used by insurance companies when you apply for insurance, but can also be used to hike premiums on an existing policy, or even drop coverage. As with your credit or MIB file, you can get one free copy per year. Request your MedPoint file by calling 888-206-0335. Request an IntelliScript file by calling 877-211-4816. They also have additional contact information at www.rxhistories.com/contact_us.html.
Medical reports, part 2: your personal file
Your doctor and other medical professionals you deal with also maintain medical records about you, containing such information as: visits to doctors, test results, current and past prescriptions, billing history, family relationships, sexual history, substance abuse history, and psychotherapy notes. Under the Health Insurance Portability and Accountability Act (HIPAA), only certain people can access your medical records. That includes the professionals who are providing care, of course, but also includes your insurance company. You can request a copy of your medical history from your doctor. They can only refuse access to parts of your history that might prove harmful, such as things related to your mental condition. While getting a peek at your medical history should prove easy, it may not be free, since someone has to copy it. States limit amounts that can be charged. A list of max charges by state can be seen at www.medefile.com/index.php/support/state_copy_charges. For more about getting copies of your medical history, check out the Health and Human Service website page at www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html..
Employment data reports include public records like tax liens and lawsuits as well as information on your past jobs. These reports can be used to determine whether you get a new job or promotion. Unfortunately, they’re also the most complicated of all the reports we’ve listed. Unlike other types of reports that are managed by two or three companies, there are hundreds of companies that offer employment screening services. So hunting down every report would be almost impossible – but you still have options. Under the Fair Credit Reporting Act, employers are legally required to ask your permission before they run a background check. You could simply refuse to sign the release form, but doing so would obviously result in most employers hesitating to hire you. However, if an employer denies you a job or promotion because of a background check, they have to give you the name and address of the company that supplied the employment data report. The Federal Trade Commission says you have 60 days after a denial to request a free copy of your report. One often-used employment report is the LexisNexis Screening Solutions Employment History Report. It contains employment-related and other background information. You can get a free copy by calling them at 866-312-8075, or making an online request at www.personalreports.lexisnexis.com/employment_history_report.jsp.
The bottom line is the time to pay the most attention to the companies tracking you is when the information they collect could imminently affect your future. [Source: MoneyTalksNews Angela Colley article 7 Sep 2012]
CRDP BENEFIT: Concurrent Retirement and Disability Pay (CRDP) allows military retirees to receive both military retired pay and Veterans Affairs (VA) compensation. This was prohibited until the CRDP program began on Jan. 1, 2004. This means that an eligible retiree’s retired pay will gradually increase each year until the phase in is complete in 2014. If qualified, you will be enrolled automatically. You must be eligible for retired pay to qualify for CRDP. If you were placed on a disability retirement, but would be eligible for military retired pay in the absence of the disability, you may be entitled to receive CRDP. Under these rules, you may be entitled to CRDP if:
• You are a regular retiree with a VA disability rating of 50 percent or greater.
• You are a reserve retiree with 20 qualifying years of service, who has a VA disability rating of 50 percent or greater and who has reached retirement age. (In most cases the retirement age for reservists is 60, but certain reserve retirees may be eligible before they turn 60. If you are a member of the Ready Reserve, your retirement age can be reduced below age 60 by three months for each 90 days of active service you have performed during a fiscal year.)
• You are retired under Temporary Early Retirement Act (TERA) and have a VA disability rating of 50 percent or greater.
• You are a disability retiree who earned entitlement to retired pay under any provision of law other than solely by disability, and you have a VA disability rating of 50 percent or greater. You might become eligible for CRDP at the time you would have become eligible for retired pay.
In addition to monthly CRDP payments, you may be eligible for a retroactive payment. If you are due any money from DFAS, you will receive it within 30-60 days of receipt of your first CRDP monthly payment. If DFAS finds that you are also due a retroactive payment from the VA, they will forward an audit to the VA. They are responsible for paying any money they may owe you.
Your retroactive payment date may go as far back as Jan. 1, 2004, but can be limited based on your retirement date or when you first increased to at least 50 percent disability rating No CRDP is payable for any month before January 2004.
If you have any questions regarding your CRDP payment from DFAS, call 800-321-1080. For questions concerning disability ratings or disability compensation, contact the VA at 800-827-1000. [Source: www.dfas.mil/retiredmilitary/disability/crdp.html Sep 2012]
VA BLUE BUTTON PROGRAM UPDATE: The Department of Veterans Affairs announced Aug. 31 that during August, the one millionth patient has registered for Blue Button to access and download their Personal Health Record (PHR) information.
For more information on the Blue Button initiative, refer to www.va.gov/bluebutton. [Source: VA News Release 31 Aug 2012]