Tricare

  When life changes for TRICARE beneficiaries, their health plan options may also change. These types of changes are called TRICARE Qualifying Life Events, or QLEs. A QLE may allow families to enroll in or change their health plan coverage outside the normal open enrollment season.  A toolkit is now available with QLE information and resources, including graphics, screensavers, Q&As, TRICARE 101, a video, and more. These tools can help answer many questions you might have about QLEs, from what they are to what actions need to be taken. Here is a link to the Toolkit on the Military Health System website:  Qualifying Life Events Toolkit | Health.mil

 Some examples of QLEs are: moving, retiring, children becoming adults, divorce or annulment, a Reserve member being activated/deactivated, death of a spouse or child (visit Tricare’s Survivor page at Survivors | TRICARE), etc.  If you have questions, you can call Tricare West at 877-988-9378.

What are Tricare options for Guard/Reserve Personnel?

 When it comes to TRICARE, Guard and Reserve (G/R) choices can be more complicated than choosing between TRICARE Prime and Select (P/S).  When activated for more than 30 days, G/R members and their families become eligible for all TRICARE programs and the costs will mirror the costs for active duty servicemembers and their families.

While serving as a drilling G/R member, and not covered by the Federal Employee Health Benefit (FEHB) program, members and their families are eligible for TRICARE Reserve Select (TRS) and TRICARE Young Adult (TYA). Members in the Individual Ready Reserve (including Navy Reserve Voluntary Training Units) do not qualify to purchase TRS.  TRS costs, while higher than TRICARE P/S, are still significantly lower than the average employer provided health care plan.  In addition to the monthly premiums and annual deductible, TRS enrollees will incur coinsurance payments for health care services after the deductible has been met. Enrollment fees, annual deductible, and copays apply to the catastrophic cap; monthly premiums do not.

Gray Area retirees (GARs) are G/R members who have qualified for retired pay, have retired from their service (stopped drilling), but are not yet eligible for retired pay (typically at age 60). GARs may be eligible for retired pay prior to reaching age 60, but TRICARE P/S eligibility is not attained until the G/R member reaches age 60 and retirement processing has been completed by service and pay agency (DFAS or Coast Guard) and is reflected in the Defense Enrollment Eligibility Reporting System (DEERS).

GARs without an employer-provided health care plan have TRICARE Retired Reserve (TRR) as an option until reaching age 60. TRR is not cheap, but may well be less expensive than finding a plan on the government or open market exchanges.

G/R retirees and their spouses remain eligible for TRICARE P/S programs until individually reaching age 65 when they “age out” of TRICARE and must enroll in Medicare. Like active-duty retirees, once enrolled in Medicare Parts A and B beneficiaries are eligible for TRICARE for Life (TFL).

Plan Costs*

TRICARE Reserve Select

·         Enrollment fee/premiums: $46.70/month individual; $229.99/month family

·         Annual deductible, E-1 to E-4: $56 individual; $112 family

·         Annual deductible, E-5 and above: $168 individual; $336 family

TRICARE Retired Reserve

·         Enrollment fee/premiums: $502.32/month individual; $1,206.59/month family

·         Annual deductible (network): $168 individual; $336 family

* Costs are from 2022