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Compton: Veterans Affairs' Web site can help with benefits

By George Compton
Saturday, May 16, 2009

Q. Our son is coming home from Iraq and getting out of the service. Where can we find out about any benefits he could be eligible for from the VA?

A. The VA has launched a new Web site, http://www.oefoif.va.gov, for Operation Enduring Freedom/Operation Iraqi Freedom veterans about benefits. Have your son contact this office, and we will provide information on local VA assets and help with any claim.

Q. I am turning 65 and plan to enroll in Medicare and use TRICARE for Life. I want to wait until my full retirement age (66) to collect Social Security benefits. How can I pay my Medicare Part B premiums?

A. If you delay receipt of Social Security benefits after age 65, Social Security will bill you for Part B premiums each quarter.

Q. I receive my medications through TRICARE and my doctor prescribes a specific medication and I receive a generic that I do not believe is as effective. Can you explain the procedures I need to take to get the medicine I need?

A. As with most prescription plans, TRICARE uses generics when possible. Your doctor needs to provide TRICARE a statement explaining that you need a specific medicine because of “medical necessity.” One or more of the following must be addressed:

n Patient must experience, or would be likely to experience, significant adverse effects from the generic medicine.

n The generic medicine has resulted in, or is likely to result in, therapeutic failure.

n Patient has previously responded to the brand-name medication, and changing to the generic medication would incur an unacceptable clinical risk.

Be aware that TRICARE has established a new system for establishing co-pay requirements: The first tier of medications being generic with a co-pay of $3, the second tier of brand-name medications having a co-pay of $9, and now a third tier: brand-name medications that have less expensive brand-name drugs being equally effective have a co-pay of $22. Your required medication could fall into this new category. If so, you need to use the mail-in pharmacy to get the most for your money.

— George Compton, a retired Army colonel, is the veterans service officer for the county Human Services Agency.

Send your questions to Veterans Service Office, 1701 Pacific Ave., Suite 110, Oxnard, CA 93033, phone 385-6366, fax 385-6371, or e-mail george.compton@ventura.org.

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