If you are in the reserves or National Guard, your Tricare health care options change depending on your status.
When activated for more than 30 days, you’ll have the same fee-free Tricare Prime coverage that applies to all active duty members. But what about the rest of the time?
You might already have an employer-based insurance plan, but what if you lose your job? If you don’t have an employer plan, Tricare Reserve Select offers a good alternative to procuring expensive health insurance on the open market.
Fortunately, with Tricare Reserve Select, members of the selected reserves have access to low-cost, premium-based insurance. Here’s a guide to Tricare Reserve Select to help you determine if the program is right for your family.
Table of Contents
- What Is Tricare Reserve Select?
- Five Things to Know About Tricare Reserve Select
- Eligibility and Costs
- Enrollment Basics
- Important Tricare Reserve Select Resources
- Advantages and Disadvantages
What Is Tricare Reserve Select?
Tricare Reserve Select is a premium-based healthcare plan available to non-activated reservists, National Guard members and their families.
You can use Tricare Reserve Select insurance anywhere in the world.
Tricare Reserve Select is similar to commercial health insurance, in that it has copays, deductibles and premiums.
One unique feature about Tricare Reserve Select is you don’t have to wait for Tricare open season to enroll or change your plan, according to the Tricare website. It’s a premium-based plan, When activated for more than 30 days, you can easily switch your coverage to a Tricare Prime program, including Tricare Prime, Tricare Prime Remote, Tricare Prime Remote Overseas or Tricare Overseas. You can also switch family members to a standard, remote or overseas Tricare Prime or Tricare Select program, Tricare Young Adult or the U.S. Family Health Plan.
Five Things to Know About Tricare Reserve Select
- Affordability: Compared to other comprehensive health plans in the open marketplace, this is a low-cost option for members of the selected reserve. Unlike many health insurance plans, Tricare Reserve Select covers you even when you’re overseas.
- Premium-Based: Unlike some other Tricare plans, you must proactively purchase Tricare Reserve Select. Enrollees pay monthly premiums, as well as an annual deductible and co-payments.
- Freedom of Choice: You won’t have to see a primary care manager (PCM) or need a referral for any health care with Tricare Reserve Select, according to the Tricare website. Choosing in-network providers will reduce out-of-pocket costs.
- Qualifications: Tricare Reserve Select is only available to selected reserve members who are ineligible for the Transitional Assistance Management Program or the Federal Employees Health Benefits Program. You can’t enroll or stay in the plan if you’re on active-duty orders.
- Coverage Gaps: To avoid coverage gaps when transitioning between active-duty orders and non-active status, call Tricare to verify your enrollment before using your insurance, if possible.
Eligibility and Costs
Am I Eligible for Tricare Reserve Select Coverage?
If you are in the selected reserves and not on active duty orders, you are eligible for Tricare Reserve Select.
You are ineligible for Tricare Reserve Select if:
- You’re eligible for the Transitional Assistance Management Program (service members separating from the service).
- You’re concurrently a civilian employee and eligible for the Federal Employees Health Benefits Program.
- You’re a member of the Individual Ready Reserve (IRR), including Navy Volunteer Reserve Training Units (VTUs).
Retired reservists aren’t eligible for Tricare Reserve Select but may transition into Tricare Retired Reserve. Here are health care options for retired Reservists.Once retired reserve and National Guard members reach age 65, they will become eligible Tricare for Life.
Note: Compare costs and coverage options between Tricare Reserve Select and any employer-based options before making your final health care program decision.
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 2023 are $48.47 for individual plans and $239.69 for family plans. The quarterly costs are $1,654 for individual plans and $4,134 for family plans.
Cost shares range from $16 to $68 for covered in-network outpatient services. For out-of-network visits, you must pay cost shares of 20%.
There is also an annual deductible, which varies depending on your rank. For those in the junior enlisted ranks (E1-E4), the 2022 deductible is $56 for an individual and $112 for a family, according to the Tricare Reserve Select cost sheet. Service members who are E-5 and above have a $168 individual deductible or a $336 family deductible.
Note: Though Tricare has announced 2023 premiums, it has yet to announce deductibles and cost shares for Tricare Reserve Select 2023 as of mid-November 2022.
Finally, the catastrophic cap – the maximum amount you must pay out-of-pocket in a calendar year – is $1,120 (2022 rate) for Tricare Reserve Select. Monthly premium payments don’t count toward catastrophic caps.
First Time Enrollment
To get coverage, eligible service members will have to complete a reserve component health coverage request form, which you can fill out here. You’ll must also make a premium payment to the appropriate Tricare regional contractor.
Re-Enrollment Following Activation
When activated, reservists and National Guard members become eligible for Tricare Prime. Family members can choose between Tricare Prime, Prime Remote and Tricare Select. To see which is best for you, check out our article comparing Tricare Prime vs. Tricare Select.
When you deactivate, re-enroll in Tricare Reserve Select. Otherwise, you and your family may have a gap in health care coverage. To re-enroll, follow the same enrollment steps listed 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 the website for the international phone directory
Advantages and Disadvantages
With its low cost and worldwide accessibility, Tricare Reserve Select has clear advantages for many members of the selected reserves.
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. Selecting in-network providers will lower out-of-pocket costs.
- Referrals Not Required: While many health insurance options stipulate PCM referrals, you don’t need them to seek health care with Tricare Reserve Select.
- Affordable Care: This plan is more affordable than many comparable health care offerings in the civilian marketplace.
Tricare Reserve Select: Disadvantages
- Activation and Deactivation Headaches: You must call Tricare to enroll in Tricare Prime when you activate, then back to Tricare Reserve Select again when you deactivate. While this should be a seamless transition, problems or delays with your orders can create coverage gaps.
- Federal Employees: If you are concurrently a federal employee and eligible for the Federal Employee Health Benefits Program, you can’t get Tricare Reserve Select. Federal employees who are otherwise eligible for Tricare Reserve Select will be able to buy it starting Jan. 1, 2030, according to recent legislation.
This is Ryan Guina, the founder of The Military Wallet chiming in. The transition from Tricare Reserve Select to Prime and back usually goes smoothly, but not always. Once I had a nearly two-month break in coverage due to a problem with my orders when I came off active duty. The Tricare customer service representative I spoke with was understanding and Tricare backdated one of my claims that occurred during this transition period. But, it could have turned out differently if I hadn’t been paying attention. Keep track of the dates on your orders during periods of transition. If possible, double-check your enrollment status before using your insurance after changing status. If there are any issues, call Tricare to report the problem and open a case as soon as possible.