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Charleston Chapter – MOAA
 
Your 2021 Guide to Military Benefits Part 2 of 2

Your 2021 Guide to Military Benefits 

Presented By: AAFES & Navy Federal Credit Union

Tricare changes:

What you need to know As the pandemic bore down on the country, the military’s Tricare health program made changes to make it easier for military beneficiaries to get care, by covering telehealth visits by telephone, and eliminating patient co-pays and cost shares for telehealth options during the pandemic. 

For several years, Tricare has covered the use of secure video conferencing to provide medically necessary services, allowing patients to connect with a provider using a computer or smartphone. Tricare has also expanded the medical services eligible for telehealth. But until the pandemic, Tricare didn’t cover the telephone-based telehealth services. 

Tricare officials have reported a spike in patients’ use of telehealth during the pandemic. 

Officials also temporarily relaxed licensure requirements across state lines for health care providers to give military families access to more providers. 

And starting in 2021, more than 800,000 military retirees and their beneficiaries must pay new enrollment fees for Tricare Select. 

That requirement is part of a 2017 law that overhauled the military’s Tricare health program. 

What it is 

Tricare is a health care program for almost 9.4 million beneficiaries that offers 11 different options, with choices depending on the status of the sponsor and the geographic location: Active-duty members; military retirees; National Guard and Reserve members; family members (spouses and children registered in the Defense Enrollment Eligibility Reporting System) and certain others, including some former military spouses and survivors, as well as Medal of Honor recipients and their immediate families. 

Those entering the military on or after Jan. 1, or changing status (i.e., from active duty to retired) should make sure they and their eligible family members are enrolled in the Tricare program of their choice. Those who don’t enroll may only receive care at a military clinic or hospital on a space-available basis, and medical care by civilian providers wouldn’t be covered. The one-month open season begins on the Monday of the second full week in November and goes through the Monday of the second full week in December. During that time, you can enroll in a new Tricare Prime or Tricare Select plan; or change your enrollment. If you’re satisfied with your current Tricare health plan you don’t have to take action to stay enrolled. 

The law overhauling Tricare included the strict limitation on switching between Tricare plans. As of 2019, beneficiaries can’t switch between Tricare Prime and Tricare Select until the yearly open season starting each November, unless there’s some sort of qualifying life event, such as the birth of a baby, a move to a new duty station, marriage or retirement. 

And for retirees, a new dental program, the Federal Employees Dental and Vision Insurance Program, or FEDVIP, has replaced the now-defunct Tricare Retiree Dental Program. 

The details 

Tricare offers two core options: Tricare Prime and Tricare Select. Select replaced Tricare Standard and Tricare Extra in 2018. All active-duty members are required to enroll in Tricare Prime; they pay nothing out of pocket. Active-duty families can enroll in Tricare Prime without an enrollment fee. Prime beneficiaries are assigned a primary care manager, or PCM, at their local military treatment facility or, if one is not available, they can select a PCM within the Tricare Prime network. Specialty care is provided on referral by the PCM, either to specialists at a military facility or a civilian provider. 

Tricare Select is similar to a traditional fee-for-service health plan. Patients can see any authorized provider they choose, but must pay a deductible and co-pays for visits. Patients pay lower out-of-pocket costs when they receive care from a provider within the Tricare network. 

All Tricare programs have a cap on how much a family pays out of pocket each fiscal year, depending on the sponsor’s status and the type of Tricare program used. 

The plans 

• Tricare Prime: Prime is similar to a health maintenance organization, which has lower out-of-pocket costs but requires enrollees to use network providers and coordinate care through a primary care manager — a doctor, nurse practitioner or medical team. It’s free to active-duty members and families; retirees must pay an annual enrollment fee ($303 for an individual, $606 for a family in 2021). Those whose initial period of service began before Jan. 1, 2018 are grandfathered in to these rates. Co-payments for medical visits are lower than other programs, and there are no deductibles unless patients get care outside the network. 

• Tricare Prime Remote: Service members who live and work more than 50 miles or an hour’s drive from the nearest military treatment facility must enroll in Tricare Prime Remote. Family members are eligible if they live with an enrolled service member in a qualifying location, or they may use Tricare Select. 

• Tricare Prime Overseas/Prime Remote Overseas: Tricare Prime Overseas is a managed-care option for active-duty members and their command-sponsored family members living in nonremote locations. They have assigned primary care managers at a military treatment facility who provide most care and referrals for and coordination of specialty care. Tricare Prime Remote Overseas is a managed care option in designated remote overseas locations, with most care from an assigned primary care manager in the local provider network, who provides referrals for specialty care. Activated National Guard and Reserve members and their families also may enroll in these options while the sponsor is on active duty; retirees and their families aren’t eligible. 

• Tricare Select: This is a preferred provider plan — authorized doctors, hospitals and other providers are paid a Tricare-allowable charge for each service performed. Costs are higher for out-of-network providers, and certain procedures require pre-authorization. There is no enrollment fee for active-duty families. Starting in 2021, retirees who entered the network before Jan. 1, 2018 are now paying monthly enrollment fees -- $12.50 per month for individuals or $25 a month for families. Copays vary by status and type of care: An in-network primary care outpatient visit costs retirees and their families $30, for example, while some active-duty family members pay $22 and others — those whose sponsor entered the network on or after Jan. 1, 2018, pay $15. 

• Tricare Reserve Select: Qualified Selected Reserve members can buy Tricare coverage when they are in drilling status – not mobilized. The program offers coverage similar to Tricare Select. 

• Tricare Retired Reserve: “Gray area” National Guard and Reserve retirees who have accumulated enough service to qualify for military retirement benefits but have not reached the age at which they can begin drawing those benefits (usually age 60) can purchase this insurance, which offers coverage similar to Tricare Select. 

• Tricare for Life: This wraparound program is for retirees and family members who are eligible for Tricare and Medicare. The provider files the claims with Medicare; Medicare pays its portion and then sends the claim to the Tricare for Life claims processor. Enrollees must enroll in Medicare Part A (free for those who paid Medicare taxes while working) and Part B (monthly premium required) to receive Tricare for Life. 

• Tricare Young Adult: Unmarried dependent children who do not have private health insurance through an employer may remain in Tricare until age 26 under a parent’s coverage via TYA Select or TYA Prime. Premiums are required for both. 

• US Family Health Plan: Beneficiaries who live in one of six designated areas, can enroll in this as a Prime option. Those enrolled get all their care, including prescription drugs, from a primary care provider the beneficiary selects, from a network of private doctors affiliated with one of the not-for-profit health care systems in the plan. Beneficiaries don’t get care at military hospitals or clinics, or from Tricare network providers when enrolled in the US Family Health Plan. 

ACTION ITEMS 

Beneficiaries must take action to enroll in a Tricare plan in order to be covered for civilian health care. Those who don’t enroll will only be able to get health care at a military clinic or hospital on a space available basis. 

Retirees have until the end of June to reinstate coverage if they were dropped from Tricare Select coverage in 2021 because they didn’t set up a process for paying the new enrollment fees that went into effect Jan. 1. By law, these retirees in the so-called “Group A” – working age retirees under age 65 who entered the military before Jan. 1, 2018 -- were required to start paying enrollment fees in 2021, which are $12.50 per month for individuals or $25 per month for families. These working age retirees should contact their Tricare contractor to set up the payments. 

To be eligible for any of the Tricare plans, beneficiaries must first be enrolled in the Defense Enrollment Eligibility Reporting System. Active-duty members are automatically registered in DEERS when they join the military, but they must register eligible dependent family members. Service members should make sure the information is correct for their family members. Only military members can add or remove family members; this is done through the local ID card office. 

Military members wishing to continue their education can find that there are a variety of financial assistance programs to help fund their endeavors. Programs such as the Montgomery GI Bill, the Post 9/11 GI Bill and in-state Tuition Assistance for members of the National Guard. (Master Sgt. Bill Wiseman/Air Force)  

GI Bill and tuition assistance: Know your education benefits 
 

The Post-9/11 GI Bill is a benefit for the latest generation of service members and veterans, as well as their eligible dependents. It includes payment of tuition and fees, a monthly housing allowance, and a stipend for textbooks and supplies. 

GI Bill eligibility 

The amount of time you spent on active duty determines your benefit level. In general, the higher your benefit level, the less you have to pay out of pocket for school, maxing out at the 100% benefit level, which covers full in-state tuition at public universities. 

Here’s what veterans who received an honorable discharge after Sept. 10, 2011, are eligible for based on the amount of time they’ve served: 

• 100%: 36 months or more of active duty service, or at least 30 continuous days and discharged due to service-connected disability 

• 90%: At least 30 months, less than 36 months. 

• 80%: At least 24 months, less than 30 months. 

• 70%: At least 18 months, less than 24 months. 

• 60%: At least 6 months, less than 18 months. 

• 50%: At least 90 days, less than 6 months. 

• No benefit: Less than 90 days. 

What it covers 

You can use your benefits toward an education at a college, university, trade school, flight school or apprenticeship program. 

While the benefit covers all in-state tuition and fees at public institutions, it may not have the same reach at a private or foreign school. The maximum tuition coverage for private nonprofit, private for-profit and foreign schools for the 2020-21 school year was $25,162.14. That figure is expected to increase again in August. 

Housing stipend 

The housing stipends GI Bill users receive depend on the level of benefits they’re eligible for, how many courses they take and where they go to class. 

The rate is determined by DoD’s Basic Allowance for Housing scale and is paid at the same rate an active-duty E-5 with dependents would receive in a particular area. If you are pursuing a degree entirely online, you get half of the national BAH average. 

However, Congress passed changes to the program at the start of the coronavirus pandemic to allow students forced online by campus closures and virus mitigation efforts to receive full housing benefits. Those protections are set to last through 2021. 

The VA had historically based the housing allowance on the location of the main campus of a school, even if the student in question is taking classes at a different branch campus that could be many miles away. However, in 2019, the Forever GI Bill directed VA to instead base the housing allowance on the location where a student takes most of his or her classes. 

Transfer rules 

Service members may transfer their benefits to a dependent, provided they have already served in the military for at least six years and agree to serve four more after the transfer is approved by the DoD. 

The transfer must happen while you are still in uniform. Veterans who have already separated from the military are not eligible to transfer their benefits. Children are only eligible to start using the transferred benefits after the service member doing the transfer has completed at least 10 years of service. Spouses can use the transferred benefits right away. 

What’s new 

• In 2019, Congress eliminated rules mandating that some benefits be used within 15 years of the servicemember’s separation from the military. 

• A pending court case could allow veterans who are eligible for both the Post-9/11 GI Bill and the Montgomery GI Bill to use both benefits consecutively, essentially giving some veterans another 12 months of education benefits. The issue is under appeal, and may not be settled in time for the start of the 2021-2022 academic year. 

• Active-duty troops who received a Purple Heart for combat injuries are now allowed to transfer their benefits to dependents regardless of how long they served or their ability to commit to more service. 

• Starting in August 2022, active-duty servicemembers will also be eligible for the VA Yellow Ribbon program, which allows private schools to match VA benefits with their own tuition assistance. 

• In 2019, Defense Department officials announced plans to make deployments to the U.S. southern border for guardsmen and reservists to count towards the 90-day requirement for GI Bill eligibility. Earlier this year, they did the same for Guardsmen deployed to Capitol Hill for security missions there. The move is expected to give partial benefits to thousands of previously ineligible individuals, and lawmakers have pushed in recent years to extend that eligibility even further. 

More online 

You can find more detailed info about the GI Bill here

You can find a GI Bill Comparison Tool here

You can apply for the Post-9/11 GI Bill online or by visiting a local VA regional office. If you’ve already chosen a school or program, arrange a meeting with the institution’s VA certifying official, who can help you get started. 

Tuition Assistance 

Service members have more education benefits available to them than just the GI Bill. 

While service members can begin to use their GI Bill benefits on active duty, they can often get help paying for college from their service branches – and save the GI Bill for later – by using tuition assistance. 

Here’s how TA works, and what you’ll need to know to make the most of it: 

What it is 

TA is a federal benefit that covers the cost of tuition, up to particular limits, for active-duty service members, as well as some members of the National Guard and reserves. The funds are paid directly to schools by the service branches. 

Eligibility 

Each service has its own requirements. 

• Air Force: All Air Force officers incur a service requirement if they use TA, but there is no service-length requirement to begin using the benefit. 

• Navy: Enlisted sailors and officers, including Naval Reservists, must have a minimum of two years of military service before becoming eligible to use TA. 

• Army: As of Aug. 5, 2018, there is no longer a one-year waiting period after completion of Advanced Individual Training, Basic Officer Leader Course or Warrant Officer Basic Course to receive TA. Active-duty officers incur a two-year service obligation. 

• Marine Corps: After previously having to wait 18 to 24 months to use TA, Marines now have no minimum service-length requirements for the benefit. However, they must agree to at least two more years of active duty service to use the benefit. 

• Coast Guard: Active-duty Coast Guard members must have been on long-term active-duty orders for more than 180 days to access TA. The Coast Guard also has unit-specific requirements and requires commanding officer approval. 

• Guard/Reserve: Soldiers who are activated or on drill status are eligible under the same conditions as active-duty Army personnel. Air National Guardsmen and reservists of other branches are eligible for TA if they are activated, and the use of TA often comes with a service obligation for a certain amount of time once the last course is completed. 

Limits 

The Defense Department caps tuition assistance at $250 per semester hour and $4,500 per fiscal year. The Coast Guard recently decreased its annual cap to $2,250 per year, down from $4,000. The Navy and Army set limits at 16 semester hours per year. 

Generally, TA funds can be used to pursue a higher degree than what you have already earned, up to the master’s degree level. If you have a bachelor’s degree, you can use it to pursue a graduate degree — not an associate or second bachelor’s, though there are some exceptions. Some branches require you to create a degree plan or take a branch-specific course before your TA benefits are approved. 

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