Government benefits; the gift that keeps on giving.
Until they decide not to.
Last month I got this nifty letter from PERS-954
“Reference (a) dictates that your pay and all benefits will be terminated after three years on the TDRL, unless your final disposition is determined at an earlier date. If your TDRL does happen to expire prior to a final disposition, once you have completed a final PPE and the Physical Evaluation Board reaches a final disposition on your case, you may be eligible for retroactive pay and benefits.”
(Reference (a) is DODI 1332.38)
They sent me this letter almost THREE YEARS after my TDRL start date.
I received this letter (actually, an email) on October 3rd and it notified me that my insurance would cut off on October 31st.
In a follow up to my last post, two weeks ago I was reassessed for my condition which caused me to be temporarily medically retired (TDRL). My evaluator determined that I was not fit to return to duty. I expressed my concern about the possibility of my insurance being terminated (in accordance with the letter above) and she incorrectly informed me “Oh, don’t worry, this will only take like a week.”
I breathed a momentary, skeptical, sigh of relief.
What I should’ve done was immediately start looking for alternate insurance.
I feel like the evaluator and I were probably talking about two different things because a week later I got an email that said:
I am reaching out to let you know that we have sent your exam to the PEB today, 10/24/2022, for adjudication. It is currently taking four to six months for the PEB to contact members with their updated ratings and findings. The PEB will email you with your updated ratings and findings.”
On Sunday 10/30, I get an email from DMDC with the subject line “Important Information About Your TRICARE Coverage”
I already knew what it was.
I logged onto milConnect and sure enough it was a TRICARE Disenrollment Letter.
So what can you do when you lose TRICARE?
1) Enroll in VA Health Care
The first step for you to take if you’re a veteran who has lost your health insurance is to enroll in VA health care. (Really, you should do this regardless of if you have other health insurance or not.)
First, determine your eligibility.
Generally, you are eligible if you served on active duty for 24 continuous months and didn’t receive a dishonorable discharge.
Read more about eligibility here.
- By phone
You can call 877-222-8387, Monday-Friday 0800-2000 EST
- By mail
Download the application, VA Form 10-10EZ here
Fill it out and mail it to:
Health Eligibility Center
2957 Clairmont Rd., Suite 200
Atlanta, GA 30329
- Apply in person
Take your filled 10-10EZ form and turn it in to your local VA medical center or clinic.
- With a VSO
There are dozens of Veterans Service Organizations out there, many of which can help you fill out your application for VA benefits.
Not only can they help you with health care, they can help you understand all of your other benefits as well such as disability compensation, VA loans, GI Bill, and VR&E.
Some of the most well known are the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW), and the American Legion.
2) Enroll in your employer-sponsored health insurance
If your employer offers health insurance, great!
I assume if you’re worried about losing TRICARE it’s because you turned down their plan.
Contact your HR department and explain that you lost TRICARE. A loss of health coverage is considered a Qualifying Life Event (QLE) so even if you initially declined your employer’s health care, this QLE should qualify you for a Special Enrollment Period.
3) Enroll in marketplace insurance
If you don’t have employer-sponsored health insurance you can obtain your own by going to healthcare.gov
Alternatively you can also go to Stride Health which shows you all of the same plans but is a relatively smoother user experience.
If your state has their own marketplace, healthcare.gov will direct you to the right website.
My first experience with Stride Health was when I started delivering for PostMates 3 years ago and they offered it as a benefit. That’s where I initially got my dental and vision insurance before I realized I qualified for FEDVIP.
I can write more about FEDVIP when I’m less panicked.
4) Short-term health insurance
Help! I need insurance for the end of the year!
It’s November, not only does that mean autumn leaves and pumpkin spice lattes, it also means Open Enrollment.
Open Enrollment means people can make changes to their health insurance plans without having a QLE. Open Enrollment is typically November 1st to January 15th. Enrolling by December 15th ensures your coverage starts January 1st, that way you don’t have a gap between when your 2022 insurance ends and when your 2023 insurance starts.
If you’re in the same boat as me, you may have lost your insurance in October. Now you’re trying to enroll in a plan and it’s telling you your coverage starts January 1st of next year.
What about November and December of THIS year?
You will still be able to enroll in health insurance, unfortunately there will be a waiting period.
If you absolutely cannot be without insurance for a month or two, there is such thing as short-term health insurance.
Some short-term health insurance providers include Everest, UnitedHealthare, Pivot Health, and IHC Health Group.
5) See if you qualify for COBRA, TAMP, or CHBP
I am putting these in here because they came up in research. I have not tried any of these programs.
According to the Department of Labor (DOL)
“The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events.”
Basically, you can continue your former employer’s insurance for a short time period. It tends to be very expensive and can be up to 102% of the premium.
This is because with employer-sponsored health insurance, your employer typically pays for a significant portion of the plan.
If you are now unemployed, you take on all of the cost plus a 2% administrative fee.
The military equivalent of COBRA is TAMP and CHCBP.
The Transitional Assistance Management Program (TAMP) provides 180 days of health care benefits after regular TRICARE benefits end. These benefits help with your transition. You also you don’t have to pay any premiums for TAMP.
“The Continued Health Care Benefit Program (CHCBP) is a premium-based. This plan:
- Gives you temporary health coverage for 18 to 36 months when you lose eligibility for TRICARE.
- Acts as a bridge between military health benefits and your new civilian health plan.
Provides the same coverage as TRICARE Select, including prescriptions.
- Gives you minimum essential coverageBasic health care coverage that meets the Affordable Care Act requirement”
From the FAQ section of milConnect it looks like you should apply for TAMP first, then apply for CHCBP.
That would all make sense except for the part where I can’t figure out how to apply for TAMP.
All I can find on the TRICARE website is that “TAMP eligibility can be viewed online via milConnect.” but milConnect just shows a bunch of FAQs for TAMP and doesn’t actually show me if I’m eligible.
I’ll explore this further but at this moment this is all I’ve got.
6) Do nothing
Doing nothing is always an option. It’s not usually a good option, but I figured I’d throw it out there.
What are the consequences if you do nothing?
You mean other than crippling medical debt if something were to happen to you?
Under the Affordable Care Act (ACA), everyone has to have health insurance or pay a penalty during tax time.
In 2017, the Tax Cuts and Jobs Act repealed the tax penalty mandate on the federal level.
California, D.C., Massachusetts, New Jersey, Rhode Island, and Vermont still have penalties at the state level.
California, in particular charges it residents $850 per adult and $425 per dependent child under 18; a family of four that goes uninsured for the whole year would face a penalty of at least $2,550.
If you are on TDRL pay close attention to when your 3 year mark will be.
There’s probably nothing you can do about it except to keep your contact information updated to ensure you get your notification letter of your PEB exam on time.
The biggest lesson learned is:
Enroll in other health insurance.
Even if you have TRICARE.
Health insurance, the G.I. Bill, even my paycheck when I was active duty have all been inconsistent. In every case there was very little I could do about any of it except to wait it out.
In my experience, government benefits should be treated like sprinkles on your ice cream.
An extra treat that’s nice to have but you shouldn’t expect or count on them.
Some of the links in this post are affiliate links. This means if you click on the link and purchase the item, I will receive an affiliate commission at no extra cost to you. All opinions remain my own.