TRICARE gives vital healthcare to military folks, but what about Reservists? Reservists, who serve part-time, also get health coverage through TRICARE. But, the details can be tricky. This article will clear up everything about Reserves TRICARE benefits.
Whether you’re a Reservist or helping one with health choices, this guide has your back. It answers your questions clearly.
What Are TRICARE Benefits for Reservists?
TRICARE benefits for Reservists are similar to those for active-duty members but have some differences. If you’re in the Reserve, you might get different TRICARE plans. This depends on your duty status and how long you serve.
Reservists might not have constant healthcare when not on duty. But, there are plans for affordable, full care during training and active duty.
We’ll dive into the various TRICARE benefits for military Reservists in this section.
Types of TRICARE Plans for Reservists
1. TRICARE Reserve Select (TRS)
TRICARE Reserve Select is a premium plan for Selected Reserve members. It offers affordable, full care, even when not on duty. It covers:
- Doctor visits for both preventive and medical needs.
- Prescription drugs through the TRICARE Pharmacy Program.
- Emergency care anywhere, anytime.
- Mental health services for eligible members.
- Health and wellness programs for a healthy lifestyle.
2. TRICARE Retired Reserve (TRR)
TRICARE Retired Reserve is for members of the Retired Reserve under 60. It covers Reservists not yet on Medicare. It offers the same as TRICARE Standard and TRICARE Extra, including:
- Ambulance services.
- Medical treatments for acute and chronic conditions.
- Health screenings and preventive care.
3. TRICARE Standard and TRICARE Extra
Reservists on active duty for over 30 days get TRICARE Standard and TRICARE Extra. Both are in the TRICARE Prime network, with low costs. Yet, they differ:
- TRICARE Standard is a fee-for-service option, giving more provider choices.
- TRICARE Extra is a PPO plan with more provider options but costs more than TRICARE Standard.
4. TRICARE Prime
Reservists on duty for over 30 days can get TRICARE Prime. It’s the most complete and cost-effective plan. It’s a managed care plan focusing on primary care through a network. Benefits include:
- No monthly premiums (for active duty status).
- Free health care at military treatment facilities (MTFs).
- Emergency care if the member is away from their duty station.
Key Differences Between TRICARE Plans for Reservists
It’s important to know the differences between TRICARE plans for Reservists. This helps in choosing the right coverage. Here’s a table that outlines these differences:
| TRICARE Plan | Eligibility | Premiums | Coverage Type |
|---|---|---|---|
| TRICARE Reserve Select | Members of the Selected Reserve | Monthly premiums (varies by family size) | Comprehensive care including preventive and emergency services |
| TRICARE Retired Reserve | Members of the Retired Reserve under age 60 | Monthly premiums (higher than TRS) | Similar to TRICARE Standard and TRICARE Extra |
| TRICARE Standard & Extra | Activated Reservists (more than 30 days of active duty) | No premiums (once activated) | Access to a network of healthcare providers |
| TRICARE Prime | Activated Reservists (more than 30 days of active duty) | No premiums (once activated) | Managed care with low out-of-pocket costs, limited to military facilities |
Who Pays for TRICARE Coverage for Reservists?
The cost of TRICARE for Reservists varies. Some plans have monthly premiums, while others do not. Here’s a breakdown of costs for different TRICARE plans:
- TRICARE Reserve Select (TRS): Premiums are required but are relatively affordable. Families may have additional costs depending on the level of coverage.
- TRICARE Retired Reserve (TRR): This plan is generally more expensive. It provides health benefits until the Reservist is eligible for Medicare.
- TRICARE Prime: If activated for more than 30 days, Reservists generally pay no premiums for TRICARE Prime. They may need to pay out-of-pocket costs for things like prescriptions and co-pays.
- TRICARE Standard and Extra: There are no monthly premiums for activated Reservists. They may be responsible for a percentage of the costs for services received.
Eligibility for TRICARE Coverage as a Reservist
To be eligible for TRICARE coverage, a Reservist must meet specific criteria. Here’s a quick checklist:
- Be a member of the Selected Reserve or Retired Reserve.
- Be on active duty for 30 consecutive days or more.
- Be under age 60 for TRICARE Retired Reserve.
- Not be covered by other employer-sponsored health insurance.
Reservists should also know that their TRICARE benefits can change. This depends on whether they are activated or serving on drills.
TRICARE Coverage for Family Members of Reservists
Family members of Reservists can also be covered under certain TRICARE plans. For instance, TRICARE Reserve Select provides coverage for family members. This includes:
- Access to military treatment facilities (MTFs) when available.
- Coverage for services like hospital stays, surgeries, and immunizations.
- Prescription drug coverage through the TRICARE Pharmacy Program.
Reservists should ensure that their family members are enrolled in TRICARE. This is important if they anticipate long-term assignments.
What Happens When a Reservist is Called to Active Duty?
When a Reservist is called to active duty, they switch from their Reserve TRICARE plan to TRICARE Prime. This change makes sure they keep getting coverage without a break.
Remember, if you get active-duty orders for more than 30 days, you automatically get TRICARE Prime. This plan offers full coverage at no extra cost for your active duty time.
TRICARE Enrollment Process for Reservists
Choosing a TRICARE plan is based on your needs. Here’s a simple guide for Reservists:
- Determine eligibility: Check your Reserve status and pick the best plan for you.
- Enroll through the Defense Enrollment Eligibility Reporting System (DEERS): Update your status in DEERS for your TRICARE coverage.
- Choose a plan: Pick between TRICARE Reserve Select, TRICARE Retired Reserve, or other plans.
- Review plan options: Make sure you know about premiums, benefits, and coverage limits.
Frequently Asked Questions (FAQs)
- Can Reservists use TRICARE when not activated? Yes, but it depends on the plan. For example, TRICARE Reserve Select offers coverage even when not activated.
- Are there any out-of-pocket costs for Reservists using TRICARE Prime? When activated for more than 30 days, Reservists using TRICARE Prime usually don’t pay out-of-pocket, except for co-pays and prescriptions.
- How does TRICARE coverage change for Reservists after they retire? After retirement, Reservists can get TRICARE Retired Reserve. This plan offers healthcare benefits until they’re eligible for Medicare.
Conclusion
TRICARE is key for health coverage for Reservists and their families. It offers affordable health insurance, coverage for family members, and comprehensive care during active duty. There are many TRICARE options to fit your needs.
Knowing your TRICARE benefits is important for the best care while in the Reserve. For more info or help, contact a TRICARE representative or visit their website. Stay informed and make sure you and your family are covered!
