TRICARE HELP: ‘Gray-area’ reservists have outlet for Tricare - Getting out, military health issues - Navy Times

TRICARE HELP: ‘Gray-area’ reservists have outlet for Tricare

Q. As a “gray-area” retiree under age 60, am I eligible for Tricare Reserve?

A. There are two relatively new Tricare programs for reservists. One is Tricare Reserve Select, designed for drilling reservists — those who are currently serving in Selected Reserve units and are not mobilized for active duty — and their family members. You’re not eligible for that one.

The other is Tricare Retired Reserve, designed specifically for gray-area retirees like yourself. Your family members also are eligible.

TRR provides comprehensive health coverage for emergency care, outpatient visits, preventive care, hospitalization, maternity care, mental and behavioral health services, prescription drugs and more. Beneficiaries may schedule appointments with any Tricare-authorized providers, regardless of whether they are network or non-network.

Beneficiaries do not need referrals for any type of care, though they may need to get prior authorization from the managed-care contractor for their Tricare region for some types of services.

TRR requires payment of monthly premiums: $402.11 for an individual and $969.10 for an individual and family. TRR also has an outpatient deductible that must be met each fiscal year (Oct. 1-Sept. 30) before Tricare cost-sharing begins. The deductible is $150 for an individual and $300 for a family.

As of Jan. 1, TRR premium payments no longer may be paid by check or money order; only automatic payments via credit/debit cards or electronic funds transfer will be accepted.

One last note: To be eligible for TRR, you must not be enrolled in — or even eligible for — the Federal Employees Health Benefits program.

Q. Can a person who is about to turn 21 and hasn’t attended a higher education institution for a year — but is joining the armed forces — still continue to be a beneficiary on his sponsor’s Tricare?

A. Dependent children become ineligible for ordinary Tricare at age 21 unless they are enrolled full time in college, in which case they may remain in ordinary Tricare under a parent’s sponsorship until age 23.

But in both cases, dependent children may remain on Tricare under a parent’s sponsorship until they reach age 26 under a relatively new program called Tricare Young Adult — which requires payment of monthly premiums — as long as they are unmarried and do not have access to any other health care coverage, such as through an employer.

But if the individual in question joins the military, health care coverage begins the day he or she enters active duty. Ë

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice anytime at www.militarytimes.com/tricarehelp.