Table of Contents
- What Is Tricare Reserve Select?
- Tricare Select Top Five Facts You Need to Know
- Eligibility & Costs
- Enrollment Basics
- Important Tricare Reserve Select Resources
- Advantages & Disadvantages
If you’re a reservist or Guardsman in search of an affordable and comprehensive health care offering, then Tricare Reserve Select may be the best plan for you and your family. Established by the 2005 National Defense Authorization Act, Tricare Reserve Select aims to offer a military-sponsored health insurance option to members of the Selected Reserve and their families.
What Is Tricare Reserve Select?
Tricare Reserve Select is a premium-based insurance plan, which means that individuals or families must pay an up-front cost (a premium) in order to keep their health insurance policy active. For inactive Reservists or Guardsmen, the plan is an alternative to procuring health insurance on the open market, where costs are typically higher. Additionally, service members and their families with Tricare Reserve Select can switch their coverage to other Tricare plans, such as Tricare Prime or Tricare Select, if and when the service member is activated.
Tricare Select Top Five Facts You Need to Know
- Affordable, comprehensive health care: Compared to other comprehensive health plans in the open marketplace, this is a low-cost option for members of the Selected Reserve with global coverage.
- Must be purchased: Unlike other Tricare plans for active-duty personnel, this plan must be purchased like other premium-based health insurance plans. Enrollees pay monthly premiums, as well as an annual deductible and co-payments.
- Freedom of choice among providers: Beneficiaries are free to choose among any Tricare-authorized providers; however, choosing in-network providers will reduce out-of-pocket costs.
- Only for inactive Reservists and Guardsmen: Tricare Select is only available to inactive members of the Selected Reserve who are ineligible for the Transitional Assistance Management Program or the Federal Employees Health Benefits Program. Once activated, service members and their families will be eligible for premium-free Tricare health care.
- Possibility for gaps in coverage: Transitioning back and forth between active and inactive status, and therefore between Tricare Reserve Select and a premium-free Tricare plan, can result in gaps in coverage. It is, therefore, the responsibility of the service member to take a more active role in managing their health care coverage and communicating with Tricare to anticipate and prevent potential gaps in coverage.
Eligibility & Costs
Am I Eligible for Tricare Reserve Select Coverage?
If you or a family member are part of the Selected Reserve (which includes active Air Force, Army Reserve, National Guard, Navy full-time support personnel and Marine Corps active reservists) and are not on active-duty orders, you are likely eligible.
Groups that are not eligible for Tricare Select Reserve are those covered under the Transitional Assistance Management Program (e.g., service members separating from the service), those enrolled in the Federal Employees Health Benefits program (e.g., civilian federal employees) and members of the Individual Ready Reserve.
Retired members of the Reserve component are no longer eligible for Tricare Reserve Select but may transition into Tricare Reserve Select Retired, which is the same insurance coverage without any cost subsidies for the monthly premiums. In other words, it costs a lot more each month. Here are health care options for retired Reservists.
Once retired Reservists and Guard members reach age 65, they will become eligible for Tricare for Life.
Tricare Reserve Select Costs
As a premium-based health plan, the main costs of Tricare Reserve Select are monthly premiums, an annual deductible, and cost shares for Tricare-covered services. The monthly premium rates for 2021 are $47.20 for an individual or $238.99 for the service member plus family.
Cost shares, or co-payments, range from $15-$63 for covered in-network outpatient services (e.g., primary-care or specialist visits, urgent care) and are traditionally 20% of the cost of the service if the provider is out-of-network.
There is also an annual deductible, which varies depending on your rank. For those in the junior enlisted ranks (E1-E4), the 2021 deductible is $52 for an individual and $105 for a family. Those ranked E5 and above have an individual deductible of $158 or a family deductible of $317.
Finally, the catastrophic cap, or the maximum amount you will have to pay out-of-pocket, is $1,058 for Tricare Reserve Select. Keep in mind that monthly premium payments are not applied toward the annual catastrophic cap.
First Time Enrollment
If you are eligible to purchase Tricare Reserve Select coverage, enrollment can be conducted over the phone or online at any time during the year. Keep in mind that enrolling yourself or family members in any Tricare plan first requires an updated DEERS profile. Eligible service members will have to complete a Reserve Component health coverage request form along with payment to the specified regional contractor (see Important Tricare Reserve Select resources below).
Re-enrollment Following Activation
When Reservists or Guardsmen are activated, they and their families become eligible for Tricare plans designed for active-duty personnel without paying premiums. In this case, a service member’s Tricare Reserve Select coverage would end and transition over to Tricare Prime or Select. Later, when the service member deactivates and loses eligibility for premium-free Tricare, they can re-enroll in Tricare Reserve Select so as to ensure no gaps in coverage. This requires the same enrollment steps as above.
Important Tricare Reserve Select Resources
The regional contractors for Tricare Reserve Select are:
- Tricare East (Humana Military): 1-800-444-5445
- Tricare West (HealthNet): 1-844-866-9378
- Overseas (International SOS): See website for regional phone directory
Advantages & Disadvantages
While there are clear advantages to Tricare Reserve Select — namely its low cost and worldwide accessibility — there are a few disadvantages that beneficiaries should be aware of prior to enrollment.
Tricare Reserve Select: Advantages
- Global coverage: This plan is available to eligible beneficiaries worldwide. Additionally, beneficiaries can seek health care at military treatment facilities on a space available basis.
- Freedom of choice: Beneficiaries can choose from any Tricare-authorized provider for health care. Selecting in-network providers will lower out-of-pocket costs.
- Referrals not required: While some health care services may require pre-authorizations, referrals are not mandated under this plan, reducing the paperwork burden for beneficiaries.
- Affordable comprehensive health care: This plan is more affordable than many comparable health care offerings in the civilian marketplace and is, therefore, a good option for many eligible Reservists or Guardsmen and their families.
Tricare Reserve Select: Disadvantages
- Imperfect transitions during and after activation: Although, on paper, the transition from Tricare Reserve Select to premium-free Tricare and back again in the event of activation should be seamless, in reality, this is rarely the case. Reservists and Guardsmen are often levied with the personal responsibility of maintaining detailed records about their activation and (especially) deactivation dates and communicating with Tricare in order to ensure no gap in coverage. For Reservists or Guardsmen who are frequently activated, this can pose a recurring issue and require them to closely monitor their coverage and anticipate any gaps.
- Ineligibility for Reservist or Guardsmen federal employees: As the legislation currently stands, members of the Selected Reserve who are concurrently federal employees, and therefore eligible for the Federal Employee Health Benefits Program, are ineligible for Tricare Reserve Select. This essentially forces some 110,000 Reservists and Guardsmen to pay more for their health insurance. However, this issue was introduced in Congress and a change was passed into law as Section 701 of the Fiscal Year (FY) 2020 National Defense Authorization Act (NDAA). Effective 2030, service members who are also eligible for the FEHB program will still be eligible for Tricare Reserve Select.
Editor’s Note: This is Ryan Guina, the founder of The Military Wallet chiming in. As a member of the Air National Guard, I can attest to the imperfect transitions between Tricare Reserve Select and Tricare Prime.
I have been activated for more than 30 days on three separate occasions since joining the Guard more than five years ago. The transition from Tricare Reserve Select to Prime and back usually goes smoothly, but not always. In one instance, I had an almost two-month break in coverage due to a problem with my orders. Thankfully, the Tricare customer service representative I spoke with was understanding, and one of my claims that occurred during this transition period was backdated. But it could have turned out differently.
If you experience this situation, make sure you open a case with Tricare, keep good notes and speak with your supervision at your unit. This is just one of many opportunities for improving Tricare.