medical care

What Military Families Need to Know About the Flu Vaccine

11/13/2017 By Kimber Green

It’s that time of year again, flu season.

Have you and your family gotten the flu vaccine yet?

The Centers for Disease Control and Prevention recommends that everyone over the age of 6 months gets the flu vaccine.

What Military Families Need to Know About the Flu Vaccine

Don’t let your fear of needles keep you from getting this year’s flu vaccine.

Here are the details you need to know about getting the flu vaccine as a military family.

Tricare pays for the flu vaccine, but they have strict guidelines that you must follow in order for your insurance to cover the cost.

The nasal spray that you or a family member may have gotten last year is not available this year. If you want the flu vaccine, you’ll have to get the injectable treatment. Here are 3 ways to get the flu vaccine and have it covered by Tricare.

How to Get the Flu Vaccine for Free Through Tricare

Visit a military hospital or clinic. You should call ahead and make sure that the flu vaccine is available. Some clinics have certain hours that walk-in vaccinations are done and some require an appointment. Active duty service members have priority so prepare yourself for a possible wait.

Visit an in-network pharmacy. You can search on Tricare’s website to find a local participating network pharmacy or you can call the Tricare line at (877) 363-1303.

Last December the Tricare retail pharmacy network changed so you may not be able to go to the same pharmacy you went to for your flu vaccine previously. Make sure you check if your pharmacy of choice is in network now.

For example, last year you might have gone to the CVS pharmacy in Target. Tricare no longer uses CVS. They switched to Walgreens.

You can also get your flu vaccine at Walmart, Kroger and Rite Aid to name a few.

Before heading to the pharmacy, call first. You’ll need to make sure a pharmacist will be available to give the flu vaccine, as Tricare will only cover the cost if it is given by a pharmacist.

If you get the flu vaccine by someone at an onsite clinic that is not a pharmacist, you may have to pay the full price of the flu vaccine.

Make sure when you talk to them to ask what hours the pharmacist will be available to give shots and if there is an age restriction. Some pharmacy policies do not allow them to give the flu vaccine to children under a certain age.

Visit a Tricare authorized provider. If you don’t have a primary physician, you can find a doctor through Tricare’s website. Note that you will be subject to your Tricare plan when going to see a doctor. This means you might have a copay or cost share for the visit. The shot however will be covered.

Active duty service members that do not want to get their flu vaccine from their primary care provider will need a referral to get one elsewhere.

Naval Hospital Jacksonville is offering the flu vaccine at the Naval Air Station Jacksonville Commissary on November 14 and 15.

If you are hesitant to getting the flu vaccine, remember that getting the shot is the first step you can take to protect yourself from the flu. It is required for all active duty, selected reserves and health care workers.

While everyone over the age of 6 months is recommended to get the flu vaccine, it is particularly recommended for pregnant women and people who suffer from chronic health problems such as diabetes and emphysema.

Don’t let being scared of a shot keep you from getting the flu vaccine. The flu is very contagious being spread by physical contact, coughing and sneezing. If you get the flu, you may have mild to severe sickness that could land you in a hospital. Make sure to wash your hands often to prevent the spread of this illness.

Now that you know how to get the flu vaccine for free, make time to get it done and protect yourself and your family.

What questions do you have about getting your flu shot?

New Electronic Health Records System Coming Soon for Military Families

07/10/2017 By Kimber Green

If you’ve ever transferred between military treatment facilities (MTFs), you know how frustrating it can be reciting your complete medical history over and over.

New Electronic Health Records System Coming Soon for Military Families

This new medical records system will mean less paperwork for providers and patients. You won’t have to fill out a medical history form each time you see a new military doctor or dentist.

Before February of this year, MTFs did not have a computer system that allowed them to share medical and dental records easily. It was a very frustrating process for medical professionals and patients alike. You could find yourself repeating your information from a first responder to a nurse and then again to a doctor. If you got sent to another clinic, you might repeat that information yet again.

Luckily, a new electronic health records system, known as MHS GENESIS, was introduced this year.

What is the MHS GENESIS system?

MHS GENESIS is the new electronic health records system that will keep track of health information for the Military Health System (MHS) through secure technology.

It is an integrated medical and dental electronic health record that will be able to give medical professionals an electronic record of your health information. Basically, it is an electronic copy of all your medical and dental information.

It will eventually be accessible to all medical professionals at any military treatment facility. With MHS GENESIS, you will no longer need to recite your medial history to your new doctor every time you PCS. You also won’t need to pick up your medical records or dental records before you move. Your provider will be able to see your family’s entire medical and dental history in one place.

MHS GENESIS will also mean less paperwork for providers and patients. You won’t have to fill out a medical history form each time you see a new military doctor or dentist. MHS GENESIS will have information stored on all care that has been provided for you. This also means that there will be less of a chance for inaccurate information given or received. You will no longer need to try to remember the dates of previous surgeries or vaccines for example.

More than 800 subject matter experts came together to create MHS GENESIS. This includes medical professionals such as doctors and nurses as well as computer system professionals such as information technologists. MHS GENESIS will replace all of the systems that are currently used; that’s more than 50 systems that will be narrowed down to one single system. This includes replacing DoD health care systems such as: AHLTA, Composite Health Care System, inpatient, and parts of the Theater Medical Information Program-Joint.

More than 9.4 million Department of Defense beneficiaries and about 205,000 Military Health System professionals around the world will benefit from using MHS GENESIS.

MHS GENESIS Patient Portal

The MHS GENESIS Patient Portal launched in February. It is a secure website that provides access for you and health care providers to your medical information. Through the MHS GENESIS Patient Portal you can:

Review your current health information
Schedule medical and dental appointments for both yourself and your dependents
Request prescription renewals
Send and receive secure messages with your doctor or nurse
Review medical notes and certain lab and test results
Complete the pre-visit dental health history questionnaire
View, download or print health data
Receive alerts from the MHS GENESIS Patient Portal to schedule wellness exams

When is MHS GENESIS available?

MHS GENESIS is being rolled out in waves, starting with several small military treatment facilities in the Pacific Northwest. In February the system launched at Fairchild Air Force Base in Washington.

“We are following a path of going from our smallest to our largest deployment, so we can again take the lessons learned from each deployment so we can make the next deployment even more successful, efficient, and streamlined,”

said Stacy Cummings, the program executive officer for the Program Executive Office, Defense Healthcare Management Systems.

MHS GENESIS was scheduled to go live at Naval Hospital Oak Harbor in May; Naval Hospital Bremerton in June; and Madigan Army Medical Center in July, but at the time of writing this article there have been no updates given.

Those that have used the system have said it is a flexible and user-friendly system. The plan is to have MHS GENESIS in place in all MTFs by 2022. This will connect 55 hospitals and more than 350 clinics worldwide. They will announce when each location will go live as that time approaches.

You can access the MHS GENESIS Patient Portal here once it is available to you.

Veterans Affairs Embraces MHS GENESIS

In June Secretary of Veterans Affairs David Shulkin announced that the VA would be adopting the same electronic health records system, MHS GENESIS. This will be great for service members that transition out of the military and receive medical care through the VA.

What are your questions or concerns about the MHS GENESIS health record system?

How Tricare’s Pharmacy Provider Change Impacts Your Prescriptions

12/05/2016 By Kimber Green

On December 1, 2016, Tricare removed CVS, including CVS inside Target, from the Tricare retail pharmacy network and added Walgreens and Kroger.

That means that if you currently fill your prescription at CVS, you will need to move your prescription to another network pharmacy or pay full price for that medication.

You have options when it comes to filling a prescription. If you are one of the numerous beneficiaries that need to move your prescription, consider these options when switching.

Military Pharmacies

You can have your prescription filled at a military treatment facility. There is no change to military pharmacies at this time. Medication can to be filled at military treatment facilities free of charge. Call the closest one to you to see if they have the medication you need on hand.

Civilian Pharmacies

If you choose to fill prescriptions out in town, Tricare recommends Walmart, Rite Aid, Walgreens and Kroger as the largest pharmacies with the ability to obtain specialty medication. There are more than 58,000 retail pharmacies in network. This includes other national chains as well as pharmacies in grocery stores and independent pharmacies that you can fill your prescriptions at.

TRICARE Pharmacy Home Delivery

If you have maintenance medications, medicine that you take regularly, it is free to use the Tricare pharmacy home delivery system. You can order prescriptions online, over the phone or through the mail.

Even if you choose to have an initial prescription filled at a military treatment facility, you can still have the refills sent through Tricare home delivery.

A patient care advocate will contact your doctor if you need help getting your prescription transferred. Through Tricare pharmacy home delivery, you will receive a 90-day supply of your medication. Tricare recommends that you have 30 days of medicine before ordering to ensure there is plenty of time to get you properly put into the system and that the medication arrives before you run out.

Ordering your medication through Tricare pharmacy home delivery has many benefits including: automatic refills, free delivery, free generics and the option to talk to a pharmacist at any time.

Saving money is another benefit. As of February 2016, generic medications carry a $30 retail network co-payment, while home delivery does not have one at all. Formulary brand medications filled at retail network pharmacies have a $72 copay as opposed to $20 through Tricare home delivery. Non-formulary medications could cost you $150 at a retail network pharmacy, but would only be $49 through home delivery. These prices reflect a 3-month supply of medication.

Getting Reimbursed When Using Non-Network Pharmacies

If you choose to fill your prescription at a non-network pharmacy, you will be required to pay the entire price of the medication up-front. You then file a claim to get a reimbursement. The amount you get back however depends on your status and Tricare plan.

Active duty service members will receive complete reimbursement.

Dependents on Tricare Prime will get 50% of the cost share back.

Those on any other Tricare plans can expect to pay $24 or 20% of the cost, whichever one is higher, for formulary drugs. This is only after you have met your annual deductible.

If you are filling a non-formulary prescription, you will pay $50 or 20% of the cost, whichever is higher, after meeting your annual deductible.

Claims must be filed within one year of filling the prescription at a non-network pharmacy. Through Tricare’s website, you can access the Patient’s Request for Medial Payment (DD Form 2642), which you will need to fill out and mail in.

How to Transfer Your Prescription

Transferring your prescription is easy. You simply take your prescription bottles to a new pharmacy and have them call your previous pharmacy or you can call a new pharmacy and ask them to contact your old pharmacy.

Another option is to contact your doctor and ask them to send a prescription to your new pharmacy. You can also call Tricare home delivery (855-778-1417) to see if they carry your medication and then have it delivered to you.

Final Key Points to Know

There are no other changes to the Tricare Retail Network. If you do not currently fill your prescriptions at CVS, including CVS inside Target, then you do not need to change anything with your prescriptions. There is no change to Tricare copays.

There is no grace period. If you fill a prescription at CVS after December 1, 2016, you will pay for the entire medication and then need to fill out a reimbursement form.

To learn more about Tricare’s changes to the pharmacy provider list, click here.

The Ins and Outs of the Tricare Choice Proposal

04/10/2015 By Kimber Green

As military families, we have a love-hate relationship with Tricare. Every military family has an opinion and the topic comes up quite easily in group settings. Prepare for the onslaught of Tricare talk at your next gathering as the program may completely change as early as 2017.

Understanding the Costs of the Tricare Choice Proposal

What do you think about the proposed Tricare Choice?

The Military Compensation and Retirement Modernization Commission recently released its 302-page final report that outlines recommendations to “modernize the Uniformed Services’ compensation and retirement system.” This report includes a complete overhaul of the Tricare program.

Here are the ins and outs of the proposed changes to Tricare.

Currently Tricare offers health care programs, such as Tricare Prime and Tricare Standard. You choose a program and are locked into its rules.

The Military Compensation and Retirement Modernization Commission has decided, based on surveys and town hall meetings, that military families would like more options and to be able to have more say in their medical treatment. The commission’s proposal therefore would completely do away with every Tricare plan except Tricare for Life. Tricare for Life would remain exactly the same.

A new program, Tricare Choice, would replace the current system. According to the report, Tricare Choice would

increase access, choice and value of health care for active duty family members, reserve component members and retirees by allowing beneficiaries to choose from a selection of commercial insurance plans offered through a Department of Defense health benefit program.

This being said, the proposed privatized program would allow families to choose a health care plan from a list similar to that of federal employees. The level of care and costs associated with that would be determined by the plan chosen. Options would include:

traditional fee-for-service plans
those offered by health maintenance organizations
preferred provider network options from some of the biggest names in the industry, including Blue Cross/Blue Shield, United Healthcare, Kaiser Foundation and more.

There would be new benefits such as chiropractic care, fertility treatments and acupuncture that are not covered under the current system; of course each would come at a cost.

The Tricare Young Adult program would be cut and adult dependent children under the age of 26 would be covered under their parent’s Tricare Choice plan no matter their circumstances. Unlike the current program, this would allow these dependents to stay in the program even if they are “married, not living with their parents, attending school, financially independent or eligible to enroll in their own employer’s health care plan.”

Related: Commission Recommends Combining Commissaries, Exchanges

Tricare dental plans would remain the same with a few Tricare Choice options including partial dental care coverage.

What does the Tricare Choice proposal mean to you?

For active duty members, everything remains the same. Active duty and reserve family members as well as retirees would choose a plan during annual open enrollment and be able to pick the doctors they prefer including military treatment facilities if the plan allowed it. They would pay 5 percent of premiums initially and it would increase each year until it topped out at 20 percent of costs or until they become eligible for Medicare or Tricare for Life. Co-payments would be made, even when visiting a military treatment facility. They would also pay an annual enrollment fee. The report estimates that “retirees with families would see their average total out-of-pocket costs increase from about $2,000 a year to $3,500.”

How will these new costs be covered?

The commission recommended that a basic allowance for health care, BAHC, be created to completely cover premiums, cost-shares and co-payments. The money would be directly paid to the insurance company in part and the rest would go straight to the service member. If a plan is chosen that costs less than the BAHC, the family could actually make money.

The government, of course, could potentially save money as well. The Defense Department currently has a $49 billion annual health budget. The MCRMC report estimates that this new plan would cut personnel spending for the departments of Defense and Veterans Affairs by $12 billion a year.

The report is now headed to Congress where they will decide the future of Tricare. There are 9.2 million military beneficiaries who will be waiting to hear the outcome.