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Medical Insurance for Army Reservists

A brief overview...
  • Eligible members of the Army Reserve can purchase health insurance through Tricare Reserve Select
  • Tricare Reserve Select, known as TRS, requires a monthly premium of $50.75 for members only and $205.62 for members and their families
  • The Defense Enrollment Eligibility Reporting System determines who is eligible for Tricare Reserve Select
  • Tricare Reserve Select health insurance is similar to the Tricare Standard and Extra medical plans

Tricare Reserve Select is a health insurance plan for members of the Army reserves and selected reserves. If you are a member of the selected reserve and not currently on active duty, you and your family are eligible for TRS. However, if you are currently enrolled in the Federal Employees Health Benefits Program or you are eligible for the program, you do not qualify for TRS.

Navy reserve voluntary training units and members of the individual ready reserve do not qualify for TRS.

The program requires you to pay a monthly premium, a copay, an annual deductible and cost-sharing for some medical services. TRS is just like any other health insurance program where you make monthly premium payments that allows you to access medical care at a discounted cost.

The program offers a network of healthcare providers offering medical services. If you choose to stay inside this network for medical services, your copay is less than what you would pay if you choose an out-of-network provider.

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Minimum Essential Coverage Under the Affordable Care Act

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The Affordable Care Act, also known as Obamacare, requires that every eligible American obtain some form of basic health care coverage or face paying a monthly fee for every month without coverage. The Tricare Reserve Select program exceeds the minimum essential coverage standards under the ACA.

However, if you receive care directly from military hospitals or clinics only, you do not meet the ACA’s minimum essential requirement. Additionally, if you are a reserve or guard member and you receive line-of-duty care only, you do not meet the minimum essential requirement.

Cost-sharing and Tricare Copays

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How much you pay in cost-sharing and copays depends on the type of medical service you receive. As of Jan. 1, 2017, you will pay $25 per ambulatory care visit for both a network and non-network provider.

For mental health services, you will pay $18.20 per day for inpatient treatment and 15 percent of the negotiated rate for outpatient treatment. Inpatient hospitalization is $18.20 per day for both network and non-network providers.

There is no cost share or copay for hospice or home health care. The annual deductible you pay before the insurance company pays its part is $50 per person for the rank of E4 and below and $150 per person for the rank of E5 and above.

Defense Enrollment Eligibility Reporting System (DEERS)

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DEERS is the worldwide database reporting system used to establish the eligibility of all service members, retired service members and dependents of service members. If you are an active duty or retired service member, you are automatically registered in DEERS.

However, if you would like to enroll a family member in the Tricare Reserve Select Program, you must first manually register that family member in the DEERS system. Once they are registered, you must update their eligibility record separately from yours. You can update DEERS online at https://www.dmdc.osd.mil/appj/bwe/indexAction.do.

Tricare Reserve Select vs. Tricare Standard/Extra

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The Tricare Standard and Extra programs are fee-for-service plans for non-active duty beneficiaries. The programs do not require enrollment, and you are free to choose your own provider whether in-network or out-of-network.

With Tricare Reserve Select, you must qualify for the program, and you must purchase the plan to take part in the program. The deductibles for both programs are the same, but the Tricare Standard and Extra programs are only available in the United States whereas Tricare Reserve Select is available worldwide.

Other Types of Tricare Plans

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Tricare offers several different health insurance plans for servicemen and women. Plans include Tricare Prime for active duty and retired service men and women, Tricare for Life, Tricare Retired Reserve, and Tricare Young Adult. However, the entire Tricare healthcare system is an enormous and complex maze of acronyms, coverage options and varying degrees of copays and deductibles.

If you feel like you are totally confused by the system, you are not the only one. Several surveys concluded that most service men and women did not understand Tricare and its coverage options for themselves and their families.

When you are trying to compare the various Tricare programs, find out as much as possible about Tricare first, then move on to the programs that best fit your healthcare needs.

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  1. http://www.goarmy.com/reserve/benefits/health-care.html
  2. http://www.military.com/benefits/tricare/guard-and-reserve/tricare-reserve-select-overview.html
  3. https://tricare.mil/About/MEC
  4. http://www.military.com/benefits/tricare/guard-and-reserve/tricare-reserve-select-coverage.html
  5. https://www.dmdc.osd.mil/appj/bwe/indexAction.do
  6. https://www.tricare.mil/Plans/ComparePlans
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