Thousands of Reserve and Guard servicemembers
can now qualify to purchase more healthcare
coverage for themselves and their families under
a new Tricare program.
Tricare, the military's health care provider,
is now accepting enrollment for its new Tricare
Reserve Select health plan, said Steve Lillie,
Tricare's deputy chief of operations.
Congress authorized the new healthcare
benefit for Reserve Component members under the
fiscal 2005 National Defense Authorization Act
as a way of providing health coverage to RC
members burdened by the current war. Lillie said
the premium-based plan will be offered as an
option to more than 400,000 eligible
servicemembers who may want to purchase
"This is pretty attractive for the kind
of coverage that's offered under Tricare,"
he said. "It's an excellent comprehensive
health plan with comprehensive pharmacy coverage
at a reasonable price. I think this will be
attractive for many people compared to what they
can get through employment."
Currently, RC members ordered to active duty
for a period of more than 30 days are covered
under one or more of several Tricare programs.
"Health coverage is also provided up to 90
days prior to activation for servicemembers who
receive a 'delayed-effective-date' order,"
For the most part, TRS helps make providing
continuous health coverage a seamless process
Lillie explained that after a servicemember
is released from active duty, the Transitional
Assistance Management Program then picks up
their health coverage for 180 days, and if
purchased, TRS coverage begins immediately
"Everything is seamless until you get to
TRS because it's an optional program that
requires premiums," Lillie said. "We
can't make that completely seamless -- there are
steps that you have to follow to qualify and
To be eligible for TRS, servicemembers must
have been called or ordered to active duty in
support of a contingency operation since Sept.
11, 2001, and they must execute a "Service
Agreement" through the Guard and Reserve
Web Portal to serve in the Selected Reserves.
In addition, Guard members must have served
"under an order from the president, not
from their governor," Lillie explained. And
they must have served continuously on active
duty for 90 days or more under such an order,
unless they were injured or became ill while
He said servicemembers may be eligible for
one year of health coverage for every year of
service commitment in the service agreement, up
to a maximum of one year for every 90 days of
prior service on active duty in support of a
The Service Agreement through the
Guard-Reserve portal is a vital first step in
qualifying is to enter into continued service in
the Selected Reserve. That is done through the
member's Reserve unit. That Service Agreement
must be executed between the member and the
Reserve component before the member can purchase
TRICARE Reserve Select coverage.
Meanwhile, Lillie added, the cost for the
plan is $75 for TRS member-only coverage and
$233 for TRS member and family member coverage,
which is reasonable compared to that of civilian
The annual cap for catastrophic illnesses is
another good benefit. According to the plan,
this cap limits out-of-pocket expenses to $1,000
per year. "The typical private insurance
program might have a catastrophic cap of $4,000
or $5,000," Lillie said.
In many aspects, TRS may even be better than
some civilian health maintenance organization or
preferred provider-type insurance plans, he
TRS provides access to any provider that
treats Tricare patients without referrals
required, Lillie explained. "So it's
broader; it provides more freedom of choice than
an HMO plan," he said.
For Reserve and Guard members, Tricare
Reserve Select health coverage will be much the
same as the Tricare Standard and Extra their
families may have received while on active duty.
In addition to typical inpatient and
outpatient care, Tricare Reserve Select covers
urgent and emergency care, and ambulance
services; family healthcare; obstetrics,
gynecology and maternity services; and clinical
preventive services, including health screening
The plan also covers behavioral health care,
annual eye examinations; ancillary services,
such as laboratory and radiology; and
prescription drug coverage.
"The principal difference between their
coverage while on active duty and their Tricare
Reserve Select coverage is there is some cost
sharing for the time when they go to the doctor
or get hospitalized," Lillie pointed out.
"It's comparable to a civilian healthcare
plan, and it's identical to Tricare Standard.
"The member and the family will pay a
20-percent cost share when they visit a
non-network doctor," he said. "They
also have a deductible to satisfy at the start
of each federal fiscal year."
Lillie said the deductible for servicemembers
in the rank of E-4 and below is $50 per
individual or $100 per family. The deductible
for servicemembers E-5 and above is $150 per
individual or $300 per family.
"Our reservists and guardsmen who are
called to duty and their families deserve this
great new benefit for their service to their
country," said Lillie. "We are glad
that we can offer Tricare Reserve Select to
qualified members and their families. It is good
for them and good for the Reserve and National