Military Officer - March 2006 - (Page 31)

EXCLUSIVE MOAA Monthly Rates MEDIPLUS® TRICARE Standard Retiree Supplement Monthly Rates Under 45 Inpatient and Outpatient Plan —$300 Per Person Deductible MEDIPLUS® Retired TRICARE Prime Supplement Member or Spouse Age Nonsmoker Smoker $7.72 11.78 13.90 17.79 $7.35 Under 50 50-54 11.22 55-59 13.25 60-64 16.94 Each Child — $9.56 45-49 $11.59 $12.88 $17.39 $19.32 50-54 $16.10 $17.39 $21.25 $23.83 50-54 $29.50 $31.86 $38.94 55-59 $21.90 $23.18 $23.83 $27.05 55-59 $40.12 $42.48 $43.66 60-64 $25.76 $28.34 $27.05 $30.27 60-64 $47.20 $51.92 $49.56 Each Child Member (or Auxiliary Member) Nonsmoker Smoker Nonsmoker $10.30 $10.95 $14.17 $16.10 $9.66 Spouse Smoker Inpatient and Outpatient Plan —$150 Per Person Deductible Member (or Auxiliary Member) Nonsmoker Smoker Nonsmoker Under 45 45-49 $18.88 $21.24 $20.06 $25.96 $23.60 $31.86 Each Child $17.70 Spouse Smoker $29.50 $35.40 $43.66 $49.56 $55.46 You classify as a non-smoker if you have not smoked cigarettes, cigars, or used a pipe, chewing tobacco, nicotine chewing gum or snuff in the past 12 months. Other MEDIPLUS TRICARE Standard Supplement Plans are available. For more information, call TOLL FREE 1-800-247-2192. Premiums are based on each person’s age when coverage becomes effective, and increase on January 1 after the next highest age bracket is reached. Premiums may be increased or decreased on a class-wide basis. For your convenience, you will be billed quarterly. Examine It For 30 Days At No Risk: If for any reason you are by surgery, are covered); breast implants except when Outpatient benefits for such disorders are limited to $500 not completely satisfied with your MEDIPLUS Certificate of covered by TRICARE for reconstructive surgery due to during any period of 12 consecutive months. In addition, for Insurance after you have examined it for 30 days, you may cancer; hearing aids; orthopedic footwear; care for the Mental Illness we will pay up to 150 days of inpatient care for cancel it with no questions asked. Simply write “Cancel” on mentally incapacitated or physically handicapped if a) the covered expenses for a covered dependent child up to age 21. your Certificate and return it within 30 days to MOAA Insurance care is required because of the mental incapacitation or Pre-Existing Conditions Limitation: If you or your covered Plans. physical handicap; or b) the care is received by an Active dependents received medical treatment or advice for a health Important Information You Should Know: Your MEDIPLUS Duty Member’s child who is covered by the “Program for condition (including pregnancy) during the six months before coverage begins on the first day of the month following receipt Persons with Disabilities” under TRICARE; nursing the date the coverage takes effect, that health condition won’t be of your Enrollment Form and first premium payment, provided service, unless it is for the full-time service of a registered covered until the person has been enrolled in the plan for six you are an MOAA member. graduate nurse or a licensed practical nurse; purchase of months. We urge you to consider this limitation before Qualified Hospital: A hospital must be engaged primarily in a wheelchair, Hospital type bed, iron lung or other durable dropping any other health insurance you may have. medical care and treatment of sick and injured persons on an equipment unless approved by TRICARE (the rental of Important Information Regarding Veterans’ inpatient basis, have full surgical facilities, be under the such equipment is covered); ambulance service in excess Administration (VA) Hospitals: TRICARE Supplement supervision of legally qualified physicians and provide 24-hour of $100 per trip unless approved by TRICARE; any insurance policies pay benefits only after TRICARE has first nursing services by R.N.s to qualify. A sanitarium operated by expenses paid in full by TRICARE; drugs which do not reviewed and approved the expense. A review by TRICARE or certified by the First Church of Christ Scientist, Boston, require a prescription (except that insulin is covered); results in a TRICARE Explanation of Benefits (“EOB”). Many VA Massachusetts, also qualifies. A convalescent home; skilled dental care, except that it is covered when it is needed to Hospitals currently do not submit their claims through nursing facility; a place for rest, custodial care or for the aged; treat another (not dental) injury or sickness; any TRICARE. Only claims TRICARE processes, resulting in an or a place primarily caring for mental illness, drug addiction or confinement, service, or supply that is not covered under EOB, are subject to benefits under The Hartford’s TRICARE alcoholism does not qualify. In certain situations, an institution TRICARE; any expense applied to the TRICARE Outpatient Supplement insurance policies. If you use VA facilities for your for the treatment of nervous, mental or emotional disorders is Deductible or the TRICARE Prime Point of Service care, please be aware of this TRICARE Supplement policy considered a hospital under the MEDIPLUS TRICARE Standard Deductible; any expense applied to the Retiree Inpatient requirement. VA Hospitals also can charge the veteran a Supplements. Confined or Confinement means being an Only Supplement $200 Deductible; any expense applied Category C copayment based on a means test, per Public Law inpatient in a Hospital or Skilled Nursing Facility due to to the Retiree Inpatient/Outpatient Supplement $300/$150 99 Section 272. This law specifically applies only to the sickness or injury. per person Deductibles; any portion of the cost-share veteran and not the insurance company. The Hartford is not Termination: Your coverage, as well as your dependents’ amount which the Insured Person is not legally obligated liable for payment of these charges. coverage, will terminate only if the Master Group Policy is to pay because of payment by a TRICARE alternative This brochure explains the general purpose of the insurance described, but canceled, your premiums are not paid or you discontinue your program; expenses for which TRICARE makes full in no way changes or affects the Master Policy (Policy # AGP-1134; Policy MOAA membership. Your dependent children’s coverage will payment for the TRICARE allowed amount (this exclusion Form 7318-5 [3rd Rev][HLA][1134]) as actually issued. In the event of a continue as long as they maintain TRICARE eligibility, are does not apply to coverage expressly provided for discrepancy between this brochure and the policy, the terms of the policy unmarried and are under age 21 (23 if full-time student). expenses in excess of the TRICARE allowable amount); apply. All benefits are subject to the terms and conditions of the policy. Life and Insurance Spouse coverage will continue as long as he/she remains any portion of a TRICARE cost-share which we determine Policies underwritten by the Hartford reduction ofAccident and terms Company detail exclusions, limitations, benefits married to the MOAA member. is payable by TRICARE because the TRICARE cap has under which the policies may be continued in full or discontinued. General Exclusions and Limitations: These TRICARE been met; under the Inpatient Only Plans, outpatient Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder, MOAA. This Supplements do not cover: injury or sickness resulting from war surgical benefits are limited to $500 a year. or acts of war, whether declared or undeclared; intentionally Nervous, Mental, Emotional Disorders, Alcoholism, program may vary and may not be available to residents of all states. self-inflicted injury; suicide or attempted suicide, whether sane and Drug Addiction Limitations: The coverage The premium quoted includes compensation of 15.9% from Hartford or insane; the following services: a) routine physical exams, provided under the TRICARE Supplement does not cover Life and Accident Insurance Company received by Marsh for except when such services are rendered to a child who is less inpatient treatment for mental, nervous, or emotional providing services that may include enrollments, ongoing servicing, All marketing expenses associated with than 6 years of age or when required for school enrollment (but disorders in excess of 45 days if under age 19, or in billing and communications. plan. this program are paid by the not sports physicals) for a covered child ages 5 through 11; b) excess of 30 days if age 19 or older (or 90 days if Underwritten by: routine or well baby care and immunizations, except that these approved by TRICARE Standard) in any one calendar year. Hartford Life and Accident Insurance Company Hartford, Connecticut services are covered when rendered to a child who is less than 6 years of age; hospital nursery charges for a Switching To MEDIPLUS From Other Plans well newborn; domiciliary or custodial care; eye Employer Plans: You won’t have to satisfy a waiting Active Duty: Officers who enroll within 30 days of the date refractions and routine eye exams, unless required for period on current health conditions if you sign up for their active duty medical coverage ends or within 30 days school; eyeglasses and contact lenses (except that MEDIPLUS within 30 days after your employer-sponsored of their initial eligibility for TRICARE benefits are also surgically implanted contact lenses are covered if protection ends because you are no longer an eligible covered for all health conditions right away. approved by TRICARE); prosthesis (except that artificial part icipant in that program (if you change jobs, move or limbs and eyes, and devices which must be implanted retire, for example).

Table of Contents Feed for the Digital Edition of Military Officer - March 2006

Military Officer - March 2006 Contents From the Editor President’s Page Call For Board Nominations Your Views MOAA Directory Rapid Fire Washington Scene Financial Forum MOAA Member Services Ask the Doctor Chapter Activities Live It Up! Top Picks On the Road Again Destination: Arizona By the Numbers Cover Story: One Clean Shot From Combat to Congress Pages of History Information Exchange Advertising Index MOAA Calendar Sounding Taps Encore

Military Officer - March 2006

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.