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GAO-06-489R 1 (2006-06-30)

handle is hein.gao/gaocrptatey0001 and id is 1 raw text is: Sai Accountability * Integrity * Reliability United States Government Accountability Office Washington, DC 20548 June 30, 2006 The Honorable Pete Stark Ranking Minority Member Subcommittee on Health Committee on Ways and Means House of Representatives The Honorable Benjamin L. Cardin House of Representatives Subject: TRICARE: Enrollment of the Department of Defense's TRICARE Beneficiaries in Medicare Part B TRICARE is the Department of Defense's (DOD) health care system for active duty and retired uniformed service members and their families. TRICARE consists of four separate programs. Three of these programs-TRICARE Prime, a managed care option; TRICARE Extra, a preferred provider option; and TRICARE Standard, a fee for service option-cover active duty personnel, their dependents, and retirees under age 65. Prior to 2001, TRICARE beneficiaries would lose their TRICARE coverage when they reached age 65, and Medicare-the federal health insurance program that provides medical benefits to over 42 million elderly and disabled Americans-would become their primary health insurer. However, in 2001, the Congress expanded TRICARE by establishing a fourth program, known as TRICARE for Life (TFL). TFL provides supplementary health care coverage for TRICARE beneficiaries' who are entitled to Medicare Part A,2 and enrolled in Part B. It pays for many services that Medicare only partially covers. While TRICARE beneficiaries do not have to pay for their TFL coverage, they are required to pay premiums for Medicare Part B. DOD generally encourages TRICARE beneficiaries to enroll in Medicare Part B when they reach age 65 or when the Social Security Administration (SSA) determines that they are disabled and they have been receiving disability benefits for 24 months. Those who do not enroll in Part B when first eligible must wait, like other beneficiaries, for Medicare's general enrollment period, which is held annually, from January I to March 31, with coverage beginning on July 1 of that same year. In 'Hereafter, we use the term TRICARE beneficiaries to include military retirees and their dependents and survivors who are entitled to Medicare Part A. 2Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, and certain home health services. Part B covers certain physician, outpatient hospital, laboratory, and other services. Another component of the Medicare program is Part D, which provides prescription drug coverage for Medicare beneficiaries. GAO-06-489R TRICARE and Medicare Part B

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