July 26, 2016

Sgt. Shaft caricatureDear Sgt Shaft
I understand that when I reach 65, I will need to obtain Medicare parts A & B to maintain my TFL since Prime goes away. My spouse is two years older than I, so she will reach 65 prior to me. Do I understand correctly that I will need to purchase Medicare parts A & B for her while still maintaining Tricare Prime on me until I reach 65? Sounds like I am in for some astronomical medical costs during that two year period since neither of us can draw Social Security (she has never been employed in the workforce) until I’m 65 which is a requirement to avoid the $411 monthly cost of Part A. Any resources I can turn to in order to better understand this Medicare catch22 that I may be walking into. Any base services available that can give me counsel?

Doug D
Via the internet

Dear Doug
I have referred your inquiry to the powers that be at the Department of Defense. You should have your answer shortly.


Shaft Notes
The Department of Veterans Affairs, has  undertaken the most comprehensive analysis of Veteran suicide rates in the U.S., examining over 55 million Veteran records from 1979 to 2014 from every state in the nation. The effort extends VA’s knowledge from the previous report issued in 2010, which examined three million Veteran records from 20 states were available. Based on the data from 2010, VA estimated the number of Veteran deaths by suicide averaged 22 per day. The current analysis indicates that in 2014, an average of 20 Veterans a day died from suicide.

“One Veteran suicide is one too many, and this collaborative effort provides both updated and comprehensive data that allows us to make better informed decisions on how to prevent this national tragedy,” said VA Under Secretary for Health, Dr. David J. Shulkin. “We as a nation must focus on bringing the number of Veteran suicides to zero.”

The final report will be publicly released later this month. Key findings of the analysis will include:

  • 65% of all Veterans who died from suicide in 2014 were 50 years of age or older.
  • Veterans accounted for 18% of all deaths from suicide among U.S. adults. This is a decrease from 22% in 2010.
  • Since 2001, U.S. adult civilian suicides increased 23%, while Veteran suicides increased 32% in the same time period. After controlling for age and gender, this makes the risk of suicide 21% greater for Veterans.
  • Since 2001, the rate of suicide among US Veterans who use VA services increased by 8.8%, while the rate of suicide among Veterans who do not use VA services increased by 38.6%.
    • In the same time period, the rate of suicide among male Veterans who use VA services increased 11%, while the rate of suicide increased 35% among male Veterans who do not use VA services.
    • In the same time period, the rate of suicide among female Veterans who use VA services increased 4.6%, while the rate of suicide increased 98% among female Veterans who do not use VA services.

Please also see our Suicide Prevention Fact Sheet at the following link: http://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA_Stats_070616_1400.pdf

VA is aggressively undertaking a number of new measures to prevent suicide, including:

  • Ensuring same-day access for Veterans with urgent mental health needs at over 1,000 points of care by the end of calendar year 2016. In fiscal year 2015, more than 1.6 million Veterans received mental health treatment from VA, including at over 150 medical centers, 820 community-based outpatient clinics and 300 Vet Centers that provide readjustment counseling. Veterans also enter VA health care through the Veterans Crisis Line, VA staff on college and university campuses, or other outreach points.

Using predictive modeling to determine which Veterans may be at highest risk of suicide, so providers can intervene early. Veterans in the top 0.1% of risk, who have a 43-fold increased risk of death from suicide within a month, can be identified before clinical signs of suicide are evident in order to save lives before a crisis occurs.

  • Expanding telemental health care by establishing four new regional telemental health hubs across the VA healthcare system.
  • Hiring over 60 new crisis intervention responders for the Veterans Crisis Line. Each responder receives intensive training on a wide variety of topics in crisis intervention, substance use disorders, screening, brief intervention, and referral to treatment.
  • Building new collaborations between Veteran programs in VA and those working in community settings, such as Give an Hour, Psych Armor Institute, University of Michigan’s Peer Advisors for Veterans Education Program (PAVE), and the Cohen Veterans Network.
  • Creating stronger inter-agency (e.g. Substance Abuse and Mental Health Services Administration, Department of Defense, National Institutes of Health) and new public-private partnerships (e.g., Johnson & Johnson Healthcare System, Bristol Myers Squibb Foundation, Walgreen’s, and many more) focused on preventing suicide among Veterans.

Many of these efforts were catalyzed by VA’s February 2016 Preventing Veteran Suicide—A Call to Action summit, which focused on improving mental health care access for Veterans across the nation and increasing resources for the VA Suicide Prevention Program.

Suicide is an issue that affects all Americans. Recent Centers for Disease Control and Prevention (CDC) data reported in April 2016 that from 1999 through 2014 (the most recent year with data available from CDC), suicide rates increased 24 % in the general population for both males and females.

VA has implemented comprehensive, broad ranging suicide prevention initiatives, including a toll-free Veterans Crisis Line, placement of Suicide Prevention Coordinators at all VA Medical Centers and large outpatient facilities, and improvements in case management and tracking. Immediate help is available at www.VeteransCrisisLine.net or by calling the Crisis Line at 1-800-273-8255 (press 1) or texting 838255.

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