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Veterans Health

Changes Coming to Tricare Dental, Vision Coverage

For the first time ever, Tricare retirees will get to choose from between a variety of dental plans, while most users will have access to vision coverage.
(U.S. Air Force/Benjamin W. Stratton)

(U.S. Air Force/Benjamin W. Stratton)

Starting in 2019, military retirees will have dental and vision coverage outside of   Tricare, while active-duty families will have access to vision coverage for the first time ever, thanks to a law passed by Congress in 2018.

New Dental Insurance Plan

In 2019, the   Tricare Retiree Dental Plan  (TRDP) is going away.
Those covered under that plan who wish to keep coverage will be required to sign up for the Federal Employees Dental and Vision Insurance Program (FEDVIP), which is the same program used by civil service members and retirees.
The new dental plan will offer coverage options from 10 insurers, with each providing at least two different levels of coverage: standard and high. The high level typically offers a greater range of services and lower co-pay amounts than the standard version, but comes with a higher monthly cost.
Under both the current TRDP and the upcoming FEDVIP, monthly premiums are based on location. The premiums for both TRDP and FEDVIP are similar, so users may not experience a price jump, depending on the plan they choose.
For example, someone getting family coverage in Zone E, which is made up of 27 states, pays $115 each month under the current TRDP, while the same person using FEDVIP would pay between $60 and $175 each month, depending on the insurance plan they choose.
Compared to TRDP, the new plans will offer a greater choice of dentists and more coverage options that retirees can tailor to their specific needs.

New Vision Insurance Plan

Even bigger news is that in 2019 most retirees and active-duty family members will be newly eligible to enroll in the FEDVIP vision insurance program.
Vision coverage is currently not part of the Tricare program. While beneficiaries now receive one free standard eye exam each year or every other year, depending on their plan and whether they are diabetic, exams for contacts are not covered, nor are glasses or contacts themselves.
But under the FEDVIP vision program, you will not only have a covered eye exam but, depending on your choice of coverage, you may be able to get glasses, contacts or both for free or a very deep discount. Tricare will continue its current eye exam coverage system for those who do not enroll in the new vision plan.
Currently, there are four different insurers available in the FEDVIP vision program. Monthly family premiums range from $19 to $43.
Like the FEDVIP dental program, you will be able to choose from a greater number of eye care providers than are currently a part of the Tricare networks, and tailor your coverage to fit your individual needs.

Enrollment Information

If you are currently enrolled in TRDP, you will have to enroll in a FEDVIP dental plan during open season or you will lose your dental insurance in 2019.
If you want to enroll in the FEDVIP vision plan, you must also do it during open season. This year’s open season runs from Nov. 12, 2018, through Dec. 10, 2018. You can make changes to your insurance each year during open season or when you experience a ” qualifying life event” such as a job change, move or birth of a child.
While the enrollment period may seem like a long way off, if you are thinking about enrolling in either of these programs, it is probably a good idea to check them out ahead of time. The large number of plans and options can be pretty confusing.
If you plan on getting major dental work done, doing your homework can possibly save you a bunch of money. The new plan may be a lot cheaper than the current one, or vice versa.
Also, if you have kids who need braces, some insurance plans under FEDVIP require you to be enrolled for 12 months before insurance will pay for orthodontic care.

For More Information

Check out the   BENEFEDS/Tricare website  for details on switching over or enrolling in the new plans. You can also check out the   Office of Personnel Management’s Dental & Vision insurance page  for plan costs and coverage.

Service Connected Matrix

There are additional benefits that you may be eligible for that are based on a favorable decision for a VA benefit and/or based on special circumstances. These are known as derivatives.

Service Connected Matrix Non Service Connected Matrix Circumstance Matrix

BENEFIT

DERIVATIVE

Non-Compensable 0 percent disability rating

·     10 point Veteran preference in federal hiring

·     No cost health care and prescription drugs for service connected disabilities
(if income limits are met)

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

Compensable 0 percent disability rating*

*Note: In some instances there are individuals who have separate and more than two zero percent service connected disabilities who are paid at the minimum 10 percent. (38 CFR 3.324)

·     10 point Veteran preference in federal hiring

·     No cost healthcare and prescription drugs for service connected disabilities
(if income limits are met)

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for VA home loan

·     Burial and plot allowance

Service connected disability rated at 10%

·     No cost health care and prescription medications for service connected disabilities

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for home loan

·     10 point Veteran preference in federal hiring

·     Vocational Rehabilitation & Employment
(with a serious employment handicap)

·     Burial and plot allowance

Service connected disability rating at 20%

·     No cost health care and prescription medications for service connected disabilities

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for home loan

·     10 point Veteran preference in federal hiring

·     Vocational Rehabilitation & Employment

·     Burial and plot allowance

Service connected disability rating at 30 – 40%

·     No cost health care and prescription medications for service connected disabilities

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for home loan  

·     10 point Veteran preference in federal hiring

·         Direct hire authority

·     Vocational Rehabilitation & Employment  

·     Additional compensation for eligible dependents
(may include aid and attendance for eligible spouse)

·     Burial and plot allowance

Service connected disability rating at 50%

·     No cost health care and prescription medications

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for home loan

·     10 point Veteran preference in federal hiring

·         Direct hire authority

·     Vocational Rehabilitation & Employment  

·     Additional compensation for eligible dependents
(may include aid and attendance for eligible spouses)

·     Concurrent receipt of military retired pay

·     Burial and plot allowance

Service connected disability rating at 60 – 90%

·     No cost health care and prescription medications

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     Waiver of VA funding fee for home loan

·     10 point Veteran preference in federal hiring

·         Direct hire authority

·     Vocational Rehabilitation & Employment

·     Additional compensation for eligible dependents
(may include aid and attendance for eligible spouses)

·     Concurrent receipt of military retired pay

·     Individual Unemployability
(must be unemployable due to service connected disabilities)

·         Dependents Educational Assistance
(unemployable condition must be considered permanent)

·         Special restorative training

·         CHAMPVA–Civilian Health and Medical Program
(unemployable condition must be considered permanent)

·         Dental care
(if rated unemployable)

·     Burial and plot allowance

Service connected disability rating at 100%

·     No cost health care and prescription medications

·     Travel allowance for scheduled appointments for care at a VA medical facility or VA authorized health care facility

·     No cost dental care

·     Waiver of VA funding fee for home loan

·     10 point Veteran preference in federal hiring

·         Direct hire authority

·     Vocational Rehabilitation & Employment

·     Additional compensation for eligible dependents (may include aid and attendance for eligible spouses)

·     Concurrent receipt of military retired pay

·     Dependents Education Assistance (must be considered permanent.)

·  Special restorative training

·     CHAMPVA–Civilian Health and Medical Program (must be considered permanent)

·     Burial and plot allowance

·     Uniformed Services ID card

Service connected disability rating at 100% with an additional separate 60 percent service connected disability rating

·     Statutory Housebound

No shutdown at VA: Congress passes department’s budget on time

A visitor leaves the Sacramento Veterans Affairs Medical Center in California in April 2015. On Thursday, lawmakers finalized a nearly $209 billion budget for VA in fiscal 2019. (Rich Pedroncelli/AP)

WASHINGTON — House lawmakers finalized the fiscal 2019 Veterans Affairs and military construction budgets on Thursday, sending the full-year spending plan to the president ahead of the new fiscal year deadline for only the second time in nine years.

The plan contains a funding boost of more than 6 percent for VA next year, pushing the department’s total budget over $200 billion for the first time. At $209 billion in total spending, the department’s budget has nearly quadrupled over the last 17 years.

The House vote — 377 to 20 — came a day after Senate lawmakers offered similar overwhelming support for the measure, and just a few hours after congressional leaders announced a plan to finalize the fiscal 2019 budgets for the Defense Department and several other non-military agencies by the end of this month, avoiding a government shutdown.

White House officials a day earlier praised Congress for their progress in completing the appropriations bills before the end of the fiscal year ― Sept. 30 ― a feat that has become a rarity in recent years.

Since the start of fiscal 2011, only one department has seen its full-year budget finalized by that deadline (VA, for fiscal 2017). It has been 22 years since Congress managed to pass all of its appropriations work on time.

Debate on the funding package — which also includes the full-year appropriations for the Department of Energy and the legislative branch — had been stalled since July over a gap of more than $1 billion in VA spending related to upcoming changes in community care programs.

Lawmakers shifted around money from other VA accounts to cover that fiscal gap after White House officials raised objections about increasing overall spending to cover the shortfall, a plan preferred by congressional Democrats.

The VA budget includes $71.2 billion in medical care services, including $8.6 billion for mental health care, $7.5 billion for homeless veterans treatment, $589 million for traumatic brain injury programs and $206 million for suicide prevention outreach.

Much of that was already approved as an advance appropriation earlier this year. Lawmakers included $76 billion in advance appropriations for fiscal 2020, to prevent possible future government shutdowns from disrupting veterans care.

Lawmakers also set aside $1.8 billion for VA construction projects next year and $2 billion for infrastructure repair throughout the VA system. Another $1.1 billion is earmarked for improvements to VA electronic health records, which are undergoing an overhaul expected to take up to a decade.

Paul Ryan

@SpeakerRyan

On military construction, the compromise bill includes $10.3 billion, a 2.4 percent increase from fiscal 2018 spending levels.

Of that, $1.6 billion is set aside for military family housing projects, $465 million for Guard and Reserve facility improvements, and $352 million for military medical facilities work.

The compromise bill also includes language to prohibiting the closure of the Guantanamo Bay Naval Station and blocking any plans to house military detainees at bases within the United States. That topic had been a friction point with President Barack Obama’s administration, but has not been an issue since President Donald Trump was elected.

President Donald Trump is expected to sign the measure into law next week.

Upcoming Events at Bedford VA and Volunteers needed

Volunteers needed Monster Mash Good afternoon, Attached, you will find the list of upcoming events that we are in need of volunteers for. Also, you will find October Festival Flyer. Please take a minute to fill it out and return by October 1, 2018. Thanks, Alexander Gagnon Edith Nourse Rogers Memorial Veterans Hospital (Bedford VA) […]

VA Study Will Compare Effectiveness of Two Leading PTSD Treatments

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Program of Comprehensive Assistance for Family Caregivers: Management Improvements Needed

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Veteran’s suicide hotline

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Veterans Crisis Line

    Welcome to the Veterans Crisis Line Website The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1-800-273-8255 and Press 1, chat online, or send a […]