Retiree Activities Corner

Skilled Nurse Care

TRICARE covers skilled nursing facility care for beneficiaries with certain requirements. The SNF must be Medicare-certified and have a participating agreement on file with TRICARE. A doctor’s treatment plan must indicate the need for medically necessary rehabilitation and skilled services; the patient must have been hospitalized for three consecutive days and be admitted within 30 days of discharge. TRICARE Prime, Standard and Extra beneficiaries are responsible for cost shares. For beneficiaries who are Medicare- and TFL-eligible, Medicare as first payer covers days 1-20; for days 21-100, the cost is covered between Medicare and TFL and TFL becomes first payer after day 100 if the patient continues to meet the Medicare criteria for covered care. Continued coverage under TFL after Medicare benefits have run out is not automatic. The SNF must preauthorize continued coverage with TFL indicating the patient still meets the criteria for covered care. Confusion often arises when a beneficiary has been covered by either Medicare or TFL and the family is told the patient no longer is covered as of a certain date. Non-coverage is based on medical necessity and the Medicare criteria for covered care in a SNF. Often a patient is unable to perform the activities of daily living such as dressing, feeding, walking etc. and needs supportive or long-term nursing home care. The need for ADL assistance alone does not meet the Medicare requirements nor require the services of a skilled staff. For information, call Medicare at 1-800-633-4227 or visit www.medicare.gov.

Customer Satisfaction

Army & Air Force Exchange Service shoppers expressed satisfaction with store operations in recent surveys. American Customer Satisfaction Index provides information on satisfaction with the quality of products and services available to consumers. The Exchange scored higher than ever before. AAFES also relies on a Customer Service Index. The CSI score was 77, another all-time high score for the Exchange. The CSI survey addresses customer service, pricing, sales associate availability, merchandise assortment and other key issues. AAFES, a joint command directed by a Board of Directors, is responsible to the secretaries of the Army and the Air Force. The Exchange generates non-appropriated funds for military morale, welfare and recreation programs.

Unemployment and Education

More than 25,000 unemployed veterans between the ages of 35 and 60 have applied for new benefits to cover education costs for up to one year through a joint Department of Veterans Affairs and Department of Labor program that focuses on retraining up to 99,000 veterans for high-demand jobs. A maximum of 54,000 billets will be available in FY2013. As part of a provision of the Veterans Opportunity to Work to Hire Heroes Act of 2011, veterans receive up to 12 months of assistance equal to the full-time Montgomery GI Bill rate, currently $1,473 per month. Veterans can apply until March 31, 2014. Veterans must be 35-60 years old, unemployed on the day of application, and not dishonorably discharged; start training in a VA-approved program of education offered by a community college or technical school leading to an associate degree, non-college degree or a certificate for a high-demand occupation; not be eligible for any other VA education benefit program; not be enrolled in a federal or state job-training program and not receive VA compensation at the 100 percent rate due to individual unemployability. For information, visit www.bene fits.va.gov/vow or call 1-800-827-1000.