Sent in by Veterans News and Information Services
From: "Willie G Dougherty"
For More Information about NAUS and for Links to Benefit Services Visit Our Website: FEDERAL EMPLOYEES HEALTH BENEFITS
PROGRAM (FEHBP) SITES
Location Type* Region
Dover AFB, DEMedicare Subvention Test Site1
Puerto RicoMedium MTF Catchment Area3
(Roosevelt
Road
Naval
Hospital)
Fort Knox, KYSmall MTF Catchment Area 5 NAUS PRESIDENTS COMMENT
FEHBP BACKGROUND:
The number of plans offered varies by location there are
about 400 when local and national plans are counted and
most have an option of 12 or more in a given location.
National plans offer the same premium nationwide; local
plans may offer local rates. Retirees and active employees
pay the same premiums regardless of grade, title, gender,
age or health status. There is an annual open season that
allows beneficiaries to change plans.
Fee-for-service plans as well as health maintenance
organizations (HMOs) are offered by FEHBP. The federal
governments maximum yearly contribution in 1998 was
about $1,700 for individuals and $3,700 for families. In 1997
the beneficiarys annual contribution for individual coverage
ranged from around $400 to $2,000 and family contributions
ranged from around $800 to $5,000. With Medicare,
FEHBP serves as a supplemental insurance policy.
FEHBP plans waive most deductibles, copayments and
coinsurance for services covered by both programs. [NOTE
that for federal employees Medicare is NOT required].
FEHBP includes prescription coverage. All FEHBP plans
have limits on how much they will pay toward particular
coverages such as mental health. Catastrophic limits vary by
plan.
For the past three years, NAUS has worked toward opening
FEHBP as an option for military retirees. This is an
important first step; the next step is the removal of the
restrictions and nationwide implementation of the FEHBP
option.
NAUS HEALTH CARE PLAN:
The NAUS plan would take care of all 8.2 million military
health care beneficiaries through a system of primary
medical care providers and a secondary system of
medical care providers. Primary medical care providers
consist of military treatment facilities (MTF)- in which health
care would be at no cost to the beneficiary-- and TRICARE
networks supplemented by Medicare reimbursement to
these facilities for health care provided to the retired
Medicare eligibles. Secondary medical care providers
include VA facilities and FEHBP.
Primary Providers:
TRICARE Senior Prime should expand the number of
military retirees seen inside the MTFs and TRICARE
networks. However, this will only work where you have a
large, viable MTF. We know that if military retirees are
offered top quality care at an MTF at no cost, they will go
there for their health care. However over time we have seen,
and continue to see, the number of military hospitals and
medical centers decrease through base closures and DoD
budget drills. As the number of MTFs decreases and with
military retirees scattered among the 50 states there is a
need for a secondary system of medical care providers.
Secondary Providers:
FEHBP is the other part of the secondary system and
provides an option for retirees and their families who do not
use MTFs or TRICARE.
NAUS-NAUS Uniformed Services Journal (USJ)
The January/February 1999-USJ is now at the printers. It
should be arriving in your mailbox soon.
This concludes the Update
NAUS Online
Last week we announced the FEHBP demonstration sites
would be released this week. On Thursday, January 13,
1999, Dr. Sue Bailey, the Under Secretary of Defense for
Health Affairs hosted a meeting in the Pentagon that
centered on a lottery to select the FEHBP test sites for
Medicare eligible military medical beneficiaries. The test,
which is in compliance of the language in the FY99 Defense
Authorization Act, will enroll up to 66,000 eligible retirees at
8 sites and is scheduled to run for 3 years. Military retirees
must be Medicare eligible in order to participate; however,
they are not required to have Medicare Part B coverage.
Greensboro/Winston SalemMetropolitan Non
Catchment Area 2
Dallas, TXMetropolitan Non Catchment Area 6
Humbolt County, CARural Non Catchment Area 10
Camp Pendleton, CALarge Catchment Area 9
New Orleans, LAMetropolitan Non Catchment Area 4
*Congress mandated the type of sites for
inclusion in the test.
Major General Dick Murray said:"this will give us another
slice of bread towards our goal to get the whole loaf of
bread [of medical care] for all military beneficiaries."
FEBHP is the largest employer sponsored health insurance
program in the world and it is the largest "managed
competition" system to contain health insurance costs. It
began July 1, 1960, is administered by OPM and covers
about 9 million people 2.3 million active employees, 1.8
million retirees and 5 million family members. FEHBP offers
a selection of several types of health insurance plans
including managed care plans. FEHBP insures members of
Congress, the President, DoD civilians, their families, and
all other federal employees except for current and retired
members of the military.
The NAUS health care plan that we have pushed for several
years would ensure the federal government fulfills its
promise of lifetime health care.
NAUS supports strong, viable, robust and fully staffed MTFs
as the foundation of military health care readiness. The
militarys graduate medical education (GME) program takes
place in MTFs and depends largely on the retired
beneficiary community for a full continuum of cases. MTFs,
when supplemented by strong, effective TRICARE networks,
are the foundations of the NAUS primary provider plan.
Military retirees, as veterans, should have access to VA
facilities and Medicare should reimburse the VA for care
provided to Medicare eligible military retirees. The VA
system is in virtually every state, in many places VA facilities
are associated with large teaching hospitals, and provide a
wide range of health care. In almost all cases however it
does not accommodate family members.
