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Old 03-09-2008 | 12:17 PM
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Philly
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Joined: Sep 2007
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From: C-17, DAL 737B
Exclamation Don't count on the 60 day retroactive coverage

Originally Posted by TBoneF15
yeah man. just did all this.

You have to be in the reserves/guard first, i.e. swear in, then wait in line at the MPF for 7 hours just to get an ID card that looks exactly like the one you just had and update your info in DEERS...then you can sign up online. The good part, if I remember it correctly is: it can be retroactive for 60 days once you sign up, so you don't technically go without health coverage until you can swear in. So if your kid gets sick before all the paperwork is done, you aren't screwed.
Be careful guys...I was separating 9/11/07 (ironic) and joining the reserves 9/12. I tried to sign up "early" (while on terminal leave) so coverage would be in place. You know trying to plan ahead to prevent a "gap in coverage." I looked all over the Tricare website because I was having the "not eligible in DEERS" message too. I also found that even when I signed up on 9/11, my coverage would not start until 1 Oct. When I couldn't figure it out in the plethora of web pages, I clicked on the contact us email link and asked the simple question "If I don't have a break in service, why do I have a break in coverage?" I was surprised that I was contacted by phone the following day. The guy told me that it would all be retroactive for 60 days as necessary once I got all signed up. I didn't just take his word, I picked up the phone and called the main customer service number to speak to Joe Customerserviceguy to see if the story was the same. It was--"60 days is not a problem" he said. As a result of trusting these folks I took my infant for her 3 month checkup (the expensive one with all the shots etc) after my separation date and before all my paperwork made it back to the base. The paperwork has to go to DC, Denver blah blah, and at my base at least does not happen at the speed of light. I couldn't in-process until this paperwork got back on base even though it was back-dated to show effective date of 9/12. The paperwork didn't show up until 9/21 and I inprocessed that day. Problem was that the Guard/Res portal continued to show me ineligible. I called the Tricare and they said I still showed up in their computer as ineligible etc. I made about 20 calls and had trouble log entries trying to get this fixed etc. This had to go the long and slow road to the DEERS people at the PENTAGON finally to find out what was wrong. It turned out that somewhere along the line someone entered my status as IRR instead of SELRES, but that entry did not show up to the MPF people/Portal folks who showed me that it said I was eligible. None of them could figure it out, meanwhile it is 18 Oct and still no TRS. Finally it was corrected at the Pentagon so I try to go sign up on the Portal. Then it said since it was past the 15th of Oct I could only sign up now for 1 Nov!!! Needless to say I called the same guy who originally contacted me and told me 60 day retro etc. He tried to fix it, but I had to fill out this form and that (read: runaround), but I just had to stop the bleeding. I signed up for 1 Nov just to get it started and would fight for the retro stuff. I was told to write a letter along with the TRS form titled Request for Reconsideration and Late Enrollment to explain MY tardiness in signing up. In the 25 Oct letter I told the story and asked for my coverage to be back-dated to 12 Sep. A few days went by and I got a call from a generally helpful lady that said she couldn't back-date into the previous FY, and that my DEERS record now only showed eligibility back to 1 Oct not 12 Sep in any case. I convinced her to back date me to 1 Oct for now and would reengage for the other two weeks which included the pricey Dr. visit. I am STILL fighting about this to this day, and eventually had to pay the $800 Dr's bill out of pocket to keep going to the pediatrician. Keep in mind that the billing rate is higher when billed to your insurance of which they will only have to pay their in-network contract rate. When TRS refuses to pay because you are "not eligible," you get to pay this max bill rate instead of a direct patient rate as another kick in the jimmy for good measure.

Long, long, long story short: Don't believe that it will be so easy to get the 60 days retro and don't count on enrollment happening quickly. My advice: get your checkups/routine visits etc before your separation date and don't count on the retro stuff if you can help it. Oh, and hope no one enters you as a IRR if you are SELRES!!

Best of luck--At least better than mine...Philly
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