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Show 8 Hilltop Times Aug. 11, 1994 How CHAMPUS changes when a military sponsor retires or When a military member retires from active military service and begins drawing retired pay, one chapter in the member's life is ended and another begins. If the member has a family, their lives change as well. Among other things, the terms under which CHAMPUS benefits are used will change in several ways. CHAMPUS eligibility For active-dut- y military members, health care needs were taken care of by the service branch; there was no eligibility for benefits under CHAMPUS. A retiree, however, becomes eligible for CHAMPUS just as his or her eligible family members have been. CHAMPUS eligibility for most people ends when they turn 65 and become eligible for Medicare Part A (hospital services). Use off military hospitals to the charges of individual professional providers of care. Beneficiaries' of bills from individual professional providers also go from 20 percent of the allowable charge to 25 cost-shar- . es percent. Outpatient For retirees and dependents, the cost of outpatient care also changes from 20 percent to 25 percent of the allowable charges. Like inpatient care, if the provider doesn't participate in CHAMPUS, beneficiaries must pay all charges beyond the CHAMPUS allowable charge after the fiscal year deductible amount ($150 for an individual or $300 for a family) has been satisfied. CHAMPUS patients must also pay all costs for care that isn't covered by CHAMPUS. a family deDepending cides to live after retirement, they may have the choice of using the standard CHAMPUS program, or one of the several special programs that the Defense Department has established in various parts of the country. These programs are designed to find the most efficient ways to deliver high quality health care to military families, and may offer additional benefits or reduced paperwork, lower or easy access to providers of care who are familiar with CHAMPUS. The "catastrophic cap" increases from $1,000 to $7,500 upon retirement or death of the service member. The catastrophic cap is an upper limit on s that total deductibles and allowable must be paid on the charges for care under CHAMPUS in any one fiscal year. Once enough has been paid s for a family's CHAMin PUS care to reach the $7,500 limit, CHAMPUS will pay 100 percent of the allowable charges for CHAMPUS-covere- d care for the rest of the fiscal year (Oct.l through Sept. 30). Inpatient When the member Nonavailability statement cost-share- s, cost-sha- re cost-share- cost-share- New retirees who live within the ZIP retires or dies, for inpatient care for code service area of a service hospital retirees and dependents under CHAM- must now join their eligible family PUS changes from $9.30 per day (in members in needing a nonavailability 1993) or $25 per admission, whichever statement from that hospital before is more, to $271 per day (in 1993), or they get inpatient care ' 25 percent of the hospital's billed and some types of outpatient care charges, whichever amount is less. The from a civilian source. Check with the daily amounts usually change slight- nearby military hospital's health ly each year. These amounts apply benefits advisor to find out if you live only to the institutional charges, not close enough to need an NAS. the space-availab- le basis. Family members cost-shar- e non-emergen- in- cluding dependent parents and parents-in-la- w, CHAMPUS-eligibl- e cost-sha- re Cap goes up Standard or special? on where In addition to CHAMPUS benefits, retirees may still use uniformed services medical facilities on a who are not themselves may also use service hospitals and clinics as space and staffing allow. Check with the When a child turns 21, if he or she e student and is therefore is a keeping CHAMPUS eligibility, the DEERS record must be updated and the child must get a new ID card. Also, don't forget that if a spouse or dependent child is not listed in the DEERS full-tim- files, CHAMPUS can't pay their claims for covered civilian health care. To learn more about DEERS enroll- call the DEERS Telephone health benefits advisor at any ment, in Center Monterey, Calif., from 6 a.m. uniformed services medical facility to 5 p.m. Pacific Time; Monday see what care may be available for numthrough Friday, at these retirees and their families. toll-fre- e bers: Persons with Disabilities Dependents of military retirees (and surviving family members of deceased active and retired service members) lose their eligibility for CHAMPUS' Program for Persons with Disabilities (formerly the Program for the Handicapped). (California only), (Alaska and Hawaii (all other only), and states). Loss off eligibility Some individuals are not eligible for Medicare on their own, but they may be eligible through a spouse or parent. If so, the person isn't covered by CHAMPUS. And it doesn't matter DEERS listings whether the person has applied for Active-dut- y and retired service Medicare. It matters only if he or she members are automatically listed in is eligible for Medicare Part A. In a recent change to the rules, perthe DEERS (Defense Enrollment under age 65 who had lost sons comEligibility Reporting System) CHAMPUS establishes This files. eligibility because a disalisting puter their eligibility for military health care bility or end-stag-e kidney disease benefits which, upon retirement made them eligible for Medicare, have from active duty, includes their own had their CHAMPUS benefits repersonal eligibility to obtain medical stored until they reach age 65. The efcare from civilian sources under fective date of this restoration of CHAMPUS (eligible family members CHAMPUS benefits is Oct. 1, 1991. There are other rules and limitations have been able to use CHAMPUS since the service member entered ac- on this restoration of benefits. Check tive military service). Dependents are with the HBA at the nearest uninot automatically listed in DEERS, formed services medical facility for however. If a member marries, be- more details. comes divorced, adopts a child, etc., he . When a retired military sponsor has or she must go to the military person- reached the age of 65 and is therefore nel office at the nearest military activi- no longer eligible for CHAMPUS ty to make any needed changes to the benefits, his or her spouse still keeps family's DEERS eligibility listings. Be CHAMPUS eligibility until he or she sure to take along documentation of personally becomes 65 years old. (Inthe dependent's relationship (marriage formation courtesy of Office of Civilian Health and Medical Programs of the license, divorce decree, birth certifiUniformed Services, Aurora, Colo.) cate, adoption papers, etc.) , 1 4J 1 . 1 --f -- i 4 -- v, t ATTENTION! Mex to the Do you have computer equipment that needs repair? 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