Did you know that TRICARE offers affordable health insurance plans to members of the Army National Guard? TRICARE Reserve Select (TRS) is available to eligible reserve component service members as part of TRICARE’s standard benefits under the Defense Health Agency’s health care program for uniformed service members and their Families. Monthly premiums are as little as about $46 per month.
TRS includes coverage for:
- In-Patient and Out-Patient Services
- Emergency and Urgent Care
- Preventative Care
- Home and Hospice Care
- Maternity and Newborn Care
- Mental Health Services
- Prescription Drugs
- Laboratory and X-Ray Services
- Medical Supplies (Including Prosthetic Devices)
To qualify for TRS, a Soldier must not be:
- On active duty orders
- Covered under the Transitional Assistance Management Program (TAMP)
- Eligible or enrolled in the Federal Employees Health Benefits program directly or through a Family member
For Soldiers who are eligible for TRS, enrollment involves three steps:
Step 1 — Check DEERS. Check to be sure all personal information for oneself and dependents is registered and current in the Defense Enrollment Eligibility Reporting System (DEERS).
Step 2 — Get signed up. Log onto the Defense Manpower Data Center (DMDC) Beneficiary Web Enrollment (BWE) using a CAC, Defense Finance Accounting Service (DFAS) account or DoD Self-Service (DS) Login. Click on Purchase Coverage. Fill out the Reserve Component Health Coverage Request (Form DD 2896-1), then print and sign it.
Step 3 — Purchase the plan. Mail or fax the DD 2896-1 and an initial payment to the TRICARE regional office. Soldiers are required to make the initial two-month premium payment by personal or cashier’s check, money order or debit/credit card. Subsequent premiums are paid by electronic funds transfer or by recurring debit/credit card charge.
Under TRS, Soldiers pay a monthly premium, annual deductible, cost share and co-payments.
A monthly premium is the amount of money paid each month by a policyholder to a health insurance provider, such as TRICARE. The current TRS monthly premium is $46.09 per month for a single Soldier plan or $221.38 per month for a Soldier plus family plan.
The annual deductible is the amount of money a policyholder will pay each year before a health insurance provider will begin to cover the cost of health care services. For example, if a Soldier has a $150 deductible, that Soldier will pay out-of-pocket for the first $150 worth of health care services. After a policyholder meets the deductible amount, the health insurance provider will begin to pay the costs on covered services.
A cost share – also known as co-insurance – is the percentage of the cost of health care service that is paid by the policyholder. Most health insurance policies will cover a higher percentage of the cost of services performed by an in-network provider (health care provider who is part of the TRICARE system) versus an out-of-network provider (health care provider who is independent of the TRICARE system). TRICARE currently requires Soldiers to pay between 15 and 25 percent of the cost of services, depending on whether the service is performed by an in-network provider or an out-of-network provider. Preventative care, such as physicals, screenings and immunizations, is covered 100 percent by TRICARE, regardless of the deductible status or whether a provider is in-network or out-of-network.
A co-payment is a flat dollar amount paid by a policyholder after every visit to a health care provider. For example, under TRS, a $15 co-payment is required with each visit to a primary care physician and a $40 co-payment is required after a visit to an emergency room. Co-payments are generally collected by the health care provider at the time of the visit.
There is no open enrollment period for TRS. Qualifying Soldiers may enroll at any time. More information is available online, including breakdowns of required deductibles, cost shares and co-payments at www.Tricare.mil/Plans/HealthPlans/TRS.
TRICARE 2018 Changes
On Jan. 1, 2018, the former three U.S. TRICARE regions (North, South and West) were consolidated into two (East and West). TRICARE East (made up of the former North and South regions) is operated by Humana Military and TRICARE West is now operated by Health Net Federal Services, LLC. Due to this consolidation, providers who were formerly in-network may now be out-of-network.
If you are currently enrolled in TRS, be sure to check the status of your primary care managers and specialty care providers at https://Tricare.mil/FindDoctor.
On Feb. 1, 2018, co-payments for prescription drugs at TRICARE Pharmacy Home Delivery and at retail pharmacies will be increasing. These changes will affect TRS beneficiaries. Prescriptions filled at military pharmacies will continue to be available at no cost. Using home delivery, co-payments for a 90-day supply of generic prescription drugs will increase from $0 to $7. Co-payments for brand-name prescriptions will rise from $20 to $24.
A full list of the 2018 TRICARE pharmacy co-payments is available online at https://Tricare.mil/PharmacyCosts. For more information on the TRICARE Pharmacy Program visit https://Tricare.mil/CoveredServices/Pharmacy/FillPrescriptions.
