7th MDG announces enrollment changes for retirees Published Oct. 31, 2013 By 2nd Lt. Megan Stanton 7th Medical Group DYESS AIR FORCE BASE, Texas -- New changes to enrollment policies at the 7th Medical Group will affect retirees turning 65 and retirees seeking enrollment for the first time at the facility. New enrollment to the facility is now limited to active duty servicemembers assigned to Dyess AFB and any TRICARE Prime active duty family members. TRICARE Prime eligible retirees and their dependents older than 15 who are new to the community will be asked to enroll with a civilian TRICARE network provider. The new policy will affect currently enrolled retirees and beneficiaries who become Medicare eligible on or after Nov. 1, 2013. These retirees and beneficiaries will no longer be able to enroll at the 7th MDG. Medicare eligible retirees enrolled to TRICARE Plus prior to Nov. 1, 2013 will not be affected by this change; they will remain enrolled to the 7th MDG. This policy change is driven by a mandated reduction in the number of assigned Dyess healthcare providers as well as a directed reduction of enrollees per provider in an effort to improve quality of care. Why is the 7th MDG making this change? Access to the care that is available at the 7th MDG has six priority levels based on beneficiary status outlined by Health Affairs Policy 11-005. At this time, the clinic is unable to have an open enrollment policy and must limit the number of patients assigned. With this change, the 7th MDG can only keep open enrollment to our priority one and priority two beneficiaries; active duty servicemembers and active duty family members who are enrolled in TRICARE Prime. Does this change apply to all retirees and eligible beneficiaries, or just those over 65? This change applies to eligible retirees and their dependents older than 15 who wish to enroll at the 7th MDG. However, those eligible retirees and dependents who are currently enrolled at the clinic may continue their enrollment as long as they maintain their TRICARE Prime status. This change also applies to those beneficiaries who become eligible for Medicare at age 65. These Medicare-eligible beneficiaries will no longer be able to be seen by a primary care manager at Dyess. Will beneficiaries referred off base have to pay a co-pay? Yes, TRICARE Prime retired servicemembers and their TRICARE Prime dependents pay a $12 co-pay each time they see their TRICARE network provider. Emergency room visits incur a $30 co-pay for TRICARE Prime retirees and their TRICARE Prime dependents. For Medicare-eligible beneficiaries, Medicare is their primary insurance. Can I still get my prescriptions filled at the Dyess Clinic? Yes, access to the pharmacy, laboratory and radiology services will remain available and at no cost to covered beneficiaries regardless of their assigned primary care manager. Will retirees and their family members currently enrolled at the clinic be asked to receive their care from a local provider? The changes only affect those retired beneficiaries and their dependents who wish to enroll at the Dyess Clinic for the first time and those beneficiaries turning 65 years of age who become Medicare eligible. We also encourage those not yet 65 to select a primary care manager off base before they turn 65. This will help establish them with an off-base primary care manager and facilitate their transition to Medicare. Where can I find more information about enrolling for care off base? Beneficiaries may visit the TRICARE Service Center located in the 7th MDG or call 1-800-444-5445. TRICARE enrollment information is also available at www.TRICARE.com.