New law molds Tricare into a true benefit

President Clinton signed into law Oct. 30 a health care initiative for current and future Medicare-eligible military beneficiaries that has a vastly expanded prescription drug benefit and turns Tricare into a true cradle-to-grave benefit.

Clinton said he was pleased the law supports "individuals who dedicated so much to the service of our country." But he also said he was "concerned that the Congress fails to deal fully with the high, long-term cost of this new benefit."

P. J. Crowley, spokesman for Clinton’s national security staff, said he was referring to the fact that the Defense Department will have to cover first-year costs of Tricare for Life, estimated at $2.5 billion. Because the benefit is an "entitlement," it will be funded, regardless. But after fiscal 2002, an accounting maneuver in the law kicks in and Tricare for Life becomes an unfunded liability of the U.S. Treasury, not a Defense Department expense.

Clinton also remarked on the new drug benefit for military seniors to underscore what Congress did not approve: his administration’s proposal to provide a prescription drug benefit for all Medicare retirees, paid for through the Medicare program.

Clinton’s final defense budget request, sent to Congress last February, had no health care initiatives for service elderly, despite the joint chiefs’ stand during budget negotiations that promises had been broken and, with help from the budget surplus, should be kept. In the end, the Republican-led Congress came to the rescue, spurred on by military associations and an unusual and intense grass-roots lobbying campaign by retirees.

In meeting with reporters Oct. 26, Dr. H. James Sears, executive director of the Tricare Management Activity, sounded a bit stunned himself at the richness of the benefit older retirees and their spouses have gained.

"I can’t think of a better health plan, or a more comprehensive health plan, and way beyond what I would have dreamt would have occurred this year," said Sears.

Effective Oct. 1, 2001, any Medicare-eligible military beneficiary who has enrolled in Medicare Part B will have Tricare as second payer to their Medicare benefits.

This means Tricare will pay out-of-pocket costs for any services covered under Medicare, including 20 percent co-payments on doctor care and deductibles for hospital stays. In addition, beneficiaries will be eligible for all Tricare benefits not covered by Medicare. Tricare plans an elaborate effort to inform individual beneficiaries on details.

The Tricare Senior Pharmacy Program, its official name, will begin April 1, 2001, six months sooner than Tricare for Life. A Tricare official said an easy way to explain it is it’s "the exact same benefit" provided to under-65 retirees and spouses. That includes: