Retired Guard and Reserve Health Care Options – Tricare & Private Health Insurance

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Retired Guard and Reserve Health Care Options
Members of the Guard and Reserves have different health care options than active duty servicemembers and active duty retirees. While still serving in the Guard and Reserves, members are eligible for Tricare Reserve Select, which is a premium-based health insurance program. Its cost is very affordable, coming in at roughly $22/mo for a member, or…

Members of the Guard and Reserves have different health care options than active duty servicemembers and active duty retirees. While still serving in the Guard and Reserves, members are eligible for Tricare Reserve Select, which is a premium-based health insurance program. Its cost is very affordable, coming in at roughly $22/mo for a member, or around $228/mo for a family plan.

Retired Guard and Reserve Health Care Options

There are very reasonable annual deductibles, coming in at $150 for an individual, and $300 for a family (lower for E-1 through E-4). The maximum out of pocket cost (also referred to as the Catastrophic Cap) is also very reasonable, coming in at $1,044 per family, per fiscal year. These rates are much more affordable than many plans you will find through an employer, and are much lower than what you would find on one of the healthcare exchanges (the maximum out of pocket expenses for plans on the exchanges often range from around $6,000 for an individual, up around $12,600 for a family plan).

Unfortunately, once you retire from the Guard or Reserves, you lose access to Tricare Reserve Select. You can still participate in a Tricare Reserve Select health care plan, but you would have to transfer to another plan. Let’s take a look at some of your health care options once you retire from the Guard or Reserves.

Note: Click here to learn about your health care options after leaving active duty.

Guard and Reserve Health Care Options in Retirement

Retired members of the Guard and Reserves have several retirement plans available to them, depending upon their age, and believe it or not, where they live. Let’s break this down by age because it isn’t until age 60 that retired members of the Reserve Corps are eligible to receive Tricare Prime, the same military health care offered to active duty retirees. Prior to age 60, retired members of the Reserve Component are referred to as “Gray Area Retirees” because they are eligible for some military retirement benefits, but not all of them (notably the pension and Tricare Prime).

Retiree health care options – under age 60

Once a member retires from the Reserve Component, he or she loses access to the subsidized Tricare Reserve Select plan. They become eligible to participate in the Tricare Retired Reserve plan, which is similar to Tricare Reserve Select, but without any subsidies, and a higher Catastrophic Cap. The retiree must pay 100% of the premiums if they wish to participate in the plan. And it’s fairly expensive, at least compared to what you may be used to.

Without subsidies, Tricare Retired Reserve comes in at roughly $444/mo for the individual and about $1,066/mo for a family plan. The Catastrophic Cap for Tricare Retired Reserve is $3,655 per family, per fiscal year. This is more expensive than Tricare Reserve Select, but it may or may not be more affordable than anything you can find through an employer or on one of the health insurance exchanges.

Guard and Reserve retirees may also be eligible for some special military health care programs if they were on active duty at the time of their retirement (even if they did not earn active duty retirement benefits).

These programs may include:

Non-military health care options – under age 60

It may pay to shop around for less-expensive health insurance if you find the premiums for Tricare Retired Reserve to be too expensive. The obvious choice is to check with your employer if they offer health insurance. You may be also able to find a less-expensive health care option on the Health Care Exchanges. eHealthInsurance.com has a lot of great options on the Exchanges (this is the website I used to find my health insurance before I joined the Guard and became eligible for Tricare Reserve Select).

An alternative option is using a Christian Health Sharing Ministry, such as Liberty HealthShare, MediShare, or a similar organization. These organizations are similar to health insurance and satisfy the federal mandate to maintain health care coverage. I recommend reading reviews of these Christian health sharing ministries to understand how they work and to see if they will be a good option for your needs.

Instant Health Insurance Quotes

Retiree health care options – age 60-65

Guard and Reserve retirees generally aren’t eligible to receive health care benefits until they turn age 60, at which time they would be eligible for Tricare Prime, which is the same health insurance plan open to active duty military members and retirees. This includes access to health care at a Military Treatment Facility on a space-available basis. However, retirees are only eligible for Tricare Prime if they live within a certain distance of a military installation or regional health care center. If the retiree lives out of the area, they would only be eligible to receive Tricare Select. Tricare Prime and Select both have monthly premiums and associated copays, but there are some important differences.

Retiree health care options – age 65+

At age 65, Reserve Corps retirees are eligible to receive Tricare for Life, which is a Medicare Supplemental Insurance Program. There are no monthly premiums for this plan.

*Retirees living overseas. I recommend you contact the Tricare customer service line to find the best option for you. There are different rules and programs for retirees living overseas, and each situation is unique.

Retired Military Dental Care

Retired members of the Guard and Reserves are eligible for dental care as military retirees once they reach age 60. Prior to November 2018, Military dental care was previously run under the Tricare Retiree Dental Program (TRDP). However, it has since transitioned to the Federal Employees Dental and Vision Insurance Program (FEDVIP).

Until age 60, Reserve Component retirees have the option of obtaining dental insurance through their employer, through a private insurance plan, or they can self-insure for dental care.

You can learn more about retired military dental insurance options here.

Finding the Right Plan for You

Your choice can almost be made for you, depending on your age, and where you live. The biggest question mark for most people is how to handle health insurance coverage as a Gray Area Retiree. If you find yourself in this situation, I would sit down and compare Tricare Retired Reserve with the options available through your employer, or through one of the healthcare exchanges (eHealthInsurance.com lists everything you will find on the exchanges, but in my opinion has a more user-friendly interface and better tutorials that explain your options).

Once you reach age 60, it makes sense to go with Tricare Prime or Select. Once you reach age 65, you are no longer eligible for Prime or Select and must move to Tricare for Life if you wish to continue receiving health care through the military.

More help is available: You can always contact a Tricare Ombudsman who can help you decide which plan is best for your situation. There should be one at each Military Treatment Facility, or you can contact Tricare, and they will have someone explain things to you and help you choose.

Here are some plan details, and links to the website:

Tricare Reserve Select – Premiums (~$50/ mo for member; ~$205 for family plan):

Tricare Retired Reserve – Premiums (~$391/ mo for member; ~$961 for family plan):

  • Available to Retired members or the Guard or Reserves
  • Equivalent to TRICARE Reserve Select, however, there are no premium subsidies, so you pay the entire cost of premiums.
  • Available until age 60, at which time you are eligible to TRICARE Prime or Select
  • Link to TRICARE Retired Reserve website.

Tricare Prime – Premiums ($50/ mo for member & dependent):

  • $12 copay off-base
  • MTF – space available, but no Copay
  • Prescriptions
    • Formulary – free
    • Local pharmacy – variable
  • Only available until age
  • Only available within 40 miles or 30 minutes from a military base (cost-cutting measure) There are waivers for this.
  • Link to Tricare Prime website.

Tricare Select:

Tricare for Life age 65:

Hopefully, this helps you understand your options and points you in the right direction!

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About Ryan Guina

Ryan Guina is the founder and editor of The Military Wallet. He is a writer, small business owner, and entrepreneur. He served over 6 years on active duty in the USAF and is a current member of the IL Air National Guard.

Ryan started The Military Wallet in 2007 after separating from active duty military service and has been writing about financial, small business, and military benefits topics since then. He also writes about personal finance and investing at Cash Money Life.

Ryan uses Personal Capital to track and manage his finances. Personal Capital is a free software program that allows him to track his net worth, balance his investment portfolio, track his income and expenses, and much more. You can open a free Personal Capital account here.

Featured In: Ryan's writing has been featured in the following publications: Forbes, Military.com, US News & World Report, Yahoo Finance, Reserve & National Guard Magazine (print and online editions), Military Influencer Magazine, Cash Money Life, The Military Guide, USAA, Go Banking Rates, and many other publications.

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  1. Joanne W. Porcher says

    I am a retired Air Force Reservist of 30 years. I retired at age 60. I receive my check from the Air force monthly, what are my benefits with Tricare 4 life. I received information but have never asked what my benefits are. I turned 70 on February 18, 2020. I have been retired for 10 years now. I am still employed at my civilian job, and was scheduled to retire in June of this year after working there for 39 plus years. I presently receive SS Checks. I am in the Medicare system. Please let me know if I have any benefits with Tricare or it is only in effect after I retire from my civilian job.

  2. Mary Pelzer says

    Hi Ryan,
    What is the latest regarding the widow of a diseased 20 year Army veteran? I want to marry a civilian who served 2 years in Vietnam in the Army Medical Corp.

    Will I get dropped out of Tricare For Life?

    Thank you for your help!!

  3. Joe says

    Thank you for the information. I have 5 more years before I can retire from the Air Force reserves. I was going to retire as soon as I was eligible, but may have to stay since the cost of retired insurance is so ridiculously high.

  4. Pamela Rickey says

    Hi Ryan,

    Thank you for putting together such detailed information. It is helpful to see it all in one place. However, I am afraid the section for ages 60-64 is very inaccurate. There is a plan, called Tricare Plus (not Tricare Prime) that is available to those who may live close to a military hospital or clinic, BUT only if that particular military hospital has chosen to participate. And, if the retiree chooses the Tricare Plus plan, that is the only hospital (military or otherwise) they can go to, unless they are given a referral for treatment they cannot receive through that hospital. On the plus side, there are no premiums or out-of-pocket costs.

    There are some restrictions as to who can enroll in Tricare Plus, such as, you cannot enroll if you are already enrolled in Tricare Prime.

    The main plans available to the 60-64 age group are Tricare Prime or Tricare Select. With Tricare Prime, you are not treated at a military hospital. Tricare assigns an in-network physician as your primary care physician. There is an annual enrollment fee of $297 for an individual or $594 for a family (cost for 2019). There are also co-pays but no deductible or out-patient services. All care not able to be provided by the primary care physician must be done through referrals by the PCP. For care outside of the PCP or referrals, there is a point-of-service option, but the cost of doing so is much higher. For example being hospitalized without the referral would leave the insured with 50% of the cost and does not count towards the out-of-pocket cap.

    Tricare Select is another option. There is no enrollment cost and the insured can go to any doctor or specialist without referral. The insured pays an annual deductible ($150 individual or $300 family) and slightly higher co-pays on doctor visits, as long as they stay in-network. Going out-of-network has higher co-pays. Out-of pocket hospitalization cost and some other treatments, such as mental health care is much higher with Tricare Select. However, both Tricare Select and Tricare Prime have a catastrophic cap of $3000. Several companies offer Tricare supplemental plans for those with Tricare Select, usually covering 100% of what Tricare does not pay after meeting a deductible.

    Reserve and Guard retirees who live overseas are also eligible for Tricare Select Overseas, but not Tricare Prime Overseas.

    I hope this is helpful.

  5. Arvil W. Burnettek4dfl says

    I joined the National Guard in 1952 and I left in 1973 (20 years). The only active duty time was about 400 days. I am paid a retirement pay and Tricare health insurance. My age now is 84 years old. I would like to know if I could get help such as a ramp to get into my home and some type of powered wheelchair.

    • Ryan Guina says

      Hello Arvil,

      Thank you for your question. The best thing to do is to contact a veterans benefits counselor at the VA or with a Veterans Service Organization. They have counselors who offer free, individualized claims assistance. They can review your claim, your service periods, medical conditions and other factors and help you apply for benefits or an upgrade to your current rating.

      I wish you the best, and thank you for your service!

  6. Steve says

    Got a problem sir. The folks at DEERS and Tricare tell me I’m eligible for Tricare, but when I try to sign up it tells me I’m ineligible. I am a Former Member USAFR receiving retirement pay, but I can’t retire due to some glitch in the system. I was discharged in ’06, and was never assigned to Retired Reserve list. I’m now 60.5 y.o., and according to the application process since I’m not retired I’m ineligible for Tricare. Can someone give me a straight answer?

    • Ryan Guina says

      Hello Steve, Thank you for contacting me. I recommend contacting Air Force Personnel Command (AFPC) to verify they have your retirement information recorded correctly on their end. That information should transfer to DEERS, DFAS, and other agencies. If they do have your information registered correctly, then they should be able to point you to the next organization in the chain and help you get to the bottom of this. I wish you the best, and thank you for your service!

  7. Kenneth Sullivan says

    Sir,

    Hello and good day to you

    I am a gray area retired reservist and have 3.5 years to go to full retirement(AGE 60)

    The last time I checked on G.A. ret. Reserve , the price was $969 a month……Really!?! Even a retired O-6 would have a problem with this premium and as a result of this outrageously expensive price, my wife opted to stay on her own medical plan and told me to get individual coverage thru Tricare

    I read on one page of this forum that the individual Tricare premium was $361 and then down on the next page it reads $391?

    Also, if I signed up for gray area retiree Tricare, would it be Tricare standard?

    What is the difference between Tricare standard and Tricare premium?

    Also, what is Tricare Reserve Select?

    I noticed you are with the Illinois Air Guard

    Are you in Springfield?

    I am an Illinois native currently living and working in California

    I appreciate this forum you have offered to assist us Reserve and Guard brothers and sisters to inform us about our military benefits

    Thank you and thank you for your service

    Ken

    USAR SSG ret.

    • Ryan Guina says

      Hello Kenneth, Thank you for contacting me. Gray area retirees are eligible for TRICARE Retired Reserve, which is different than TRICARE Prime or TRICARE Standard (though it’s closer to TRICARE Standard in its form). Because it’s different, you would need to compare premiums and doctor and service availability in your location to make sure it’s a good plan for you.

      The premiums listed on this site may have changed, so I recommend verifying with TRICARE before buying a plan. The current monthly premiums for an individual are $388.79/mo as of July 18, 2016 (rates will most likely change on October 1, 2016).

      These premiums appear high because the military only offers subsidized premiums for those who are actively serving in the Guard or Reserves. Those who are no longer actively serving can still participate in the plan, but they don’t receive any subsidies. In other words, they pay the same price the government pays.

      I agree, close to $1,000 per month for a family plan, or close to $400 per month for an individual is a lot of money. However, it may not be much more expensive than other non-subsidized health care options, or even some employer sponsored health care plans. Most health care premiums are based on age and whether or not the individual is a smoker.

      I recommend looking at some of the other options available, including through your employer (if employed and your employer offers health care), through your spouse’s employer (if you are eligible to be on her plan), through the Affordable Care Act exchanges (subsidies may be available depending on your income), or through an independent health insurance provider. I have used eHealthInsurance to find my last few health care plans. Unfortunately, health care is expensive, just about every place you get it. I hope this points you in the right direction. I wish you the best, and thank you for your service!

      • JG says

        “, through the Affordable Care Act exchanges (subsidies may be available depending on your income)”

        Subsidies will not be available since he qualifies for Tricare Reserve Retired. I already checked into this with the Affordable Care Act office. That was one of the loopholes adversely impacting Gray Area retirees.

  8. Nate @ LendEDU says

    I have a friend who is getting out of the military next month. He and his wife are really concerned about how much losing TriCare Reserve Select is going to affect them financially. I will be sure to pass this information along to them. Thanks!

  9. Walter Stewart says

    I will be age 60 this July 2015. When will I receive my packet to go to the nearest base and get my Retirees ID Card and one for my wife. I was told Three months before I am age 60. All my information is on DEERS and any time I moved from one address to the other. I always made sure that DEERS was updated with my information.

    • Ryan Guina says

      Walter, Thank you for contacting me. I would go with the information you have received. You can also call DEERS to verify when you should receive the packet, and which information or documentation you should bring with you.

  10. Anthony Darmiento says

    Ryan, please get the word out to Ret-2 gray area Reservists that they would not qualify for the Affordable Care Act subsidy since they are “eligible” for Tricare Retired Reserve (TRR). I contacted the ACA office and they stated even if I was to disenroll from TRR that I would still not qualify for the subsidy.

    That begs the question why did the political drafters of the Affordable Care Act legislation not factor in low income earners who are in Ret-2 gray area status ?

  11. Anthony says

    Can a retired reserve member (before age 60) qualify for subsidies for the Affordable Care Act if he decides to buy healthcare on the federal exchange? He would have an annual income that is less than $45,000.

    • Ryan Guina says

      Anthony, Great question. I believe the veteran would be able to do so, as I am not aware of any restrictions for the subsidy that revolve around having access to health care through other means. The key is going to be the number of people in the household. Here is the income chart for eligibility for subsidies.

      If there is only one person in the household, the individual could qualify for a subsidy with income up to $46,680. So he would just make the cutoff. I hope this helps. Best of luck, and thanks for your service!

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