TRICARE Reserve Select

1
TRICARE Reserve Select

• Version 3
• August 2006

2
TRICARE Reserve Select (TRS)

• Premium-based health plan that qualified National
  Guard/Reserve members may purchase
• Three premium tiers
• Tier 1 Contingency operation
• Tier 2 Certified Qualifications
• Tier 3 Other Selected Reserve Member
• Must be in the Selected Reserve and sign a
  Service Agreement

Your personnel office determines if you qualify
and your TRS premium tier.
3
Two-step Process

• Step 1 Qualify
• National Guard/Reserve personnel office validates
  qualifications and identifies premium tier
• Step 2 Purchase
• Member submits completed TRS Request Form and
  correct payment to regional contractor

4
Step 1Qualify (Tier 1)
Meet all the following Tier 1 conditions

• Called or ordered to active duty under Title 10
• more than 30 days in support of a contingency
  operation
• Served on active duty for 90 days or more
• unless lt 90 days because of line-of-duty
  condition
• Execute a Service Agreement to serve in Selected
  Reserve through the entire period of coverage
• within 90 days after deactivation
• IRR members have up to one year to secure a
  billet in the Selected Reserve and qualify

Only opportunity to purchase TRS (Tier 1) unless
you re-qualify through another period of active
duty.
5
Step 1Qualify (Tier 2)

• Qualifies during Open Season, after a qualifying
  life event, or upon accession to the Selected
  Reserve
• Certify one of the following conditions
• An eligible unemployment compensation recipient
  as determined by state law
• Employer does not offer a health plan to anyone
• In a category of employees not offered a health
  plan (not based on membership in Selected
  Reserve)
• Self-employed as reported to IRS

Must execute Service Agreement and be in Selected
Reserve
6
Step 1Qualify (Tier 3)

• Qualify during Open Season, after a qualifying
  life event or upon accession to the Selected
  Reserve
• Meet qualifying conditions
• Member of the Selected Reserve
• Not qualified for Tier 1 or Tier 2

Must execute Service Agreement and be in Selected
Reserve
7
Maximum Period of Coverage
May qualify for one year of TRS if you served
less than 90 days due solely to an injury,
illness or disease incurred or aggravated while
on qualifying active duty.
8
Step 2Purchase Coverage

• Print TRS Request Form
• www.dmdc.osd.mil/Guard-ReservePortal
• Select type of coverage
• TRS member-only
• TRS member-and-family
• Submit completed TRS Request Form and correct
  premium payment to regional contractor

You must be qualified by Personnel for TRS
coverage before you can complete Step 2.
9
Tier 1 Purchasing Deadlines

• Received by regional contractor 30 days before
  start of coverage
• 30 days before end of TAMP

Exception IRR members have one year from end of
TAMP to transfer to Selected Reserve. Form and
payment must be received by regional contractor
60 days after transfer into Selected Reserve.
10
Tiers 2 3 Purchasing Deadlines

• 2006 Special Open Season Aug. 1 - Nov. 25
• Postmarked by Sept. 25 Coverage begins Oct. 1,
  2006
• Postmarked by Nov. 25 Coverage begins Jan. 1,
  2007

11
TRICARE Regional Contractors
If you live overseas, contact Humana Military for
assistance.
12
2006 TRS Premiums

• Total annual premium
• 3,487 Member-only coverage
• 10,834 Member-and-family coverage
• First months premium due with TRS Request Form
• Premium amounts are adjusted annually

Payment due in advance of each months coverage
13
TRS Open Season (Tiers 2 3 only)
Open season is scheduled each Fall and all
actions are effective on Jan. 1 of the next year.
14
Comprehensive Coverage

• Similar to TRICARE Standard and TRICARE Extra
• Emergency and urgent care
• Immunizations and health screenings
• Maternity
• Behavioral/mental health
• Vision
• Prescription drug coverage
• TRICARE-authorized providers
• Military treatment facility, space-available only

For details about TRS-covered services, refer to
your TRICARE Reserve Select Handbook.
15
What You Pay for Covered Services
Non-network providers may also charge up to 15
above the TRICARE allowable charge. For more
details about costs for covered services, visit
www.tricare.osd.mil/tricarecost.
16
Qualifying Life Events

• Change in family composition
• Marriage, newborn, etc.
• Change in employment status
• Results in a change in employer-sponsored health
  insurance
• Change in health coverage status

Some exceptions apply for IRR members. See
www.defenselink.mil/ra
17
TRS Survivor Coverage
18
Termination of Coverage

• Failure to pay premiums
• You are still responsible for overdue amounts
• May request voluntary termination
• Tier 1at any time
• Tiers 2 3only during Open Season or with a
  qualifying life event.
• May only re-purchase TRS if you re-qualify
• For one of three premium tiers

Contact your regional contractor for questions
about terminating your coverage.
19
Summary TRS Tiers 2 3

• Open Season (Fall)
• (late OctoberNov. 25)
• Qualify for Tier 2 or Tier 3
• Execute Service Agreement during open season
• TRS form postmarked by Nov. 25
• Coverage begins Jan. 1

• Qualifying Life Event
• Qualify for Tier 2 or Tier 3
• Submit proof of qualifying life event
• Execute Service Agreement
• Submit TRS Request Form

Some exceptions apply for IRR members. See
www.defenselink.mil/ra
20
Who to Call for Help and Information
Contact your National Guard/ Reserve personnel
office for help with Step 1Qualify, or for help
with qualifying life events.
Reserve Affairs Web site www.defenselink.mil/ra
Guard-Reserve Portal www.dmdc.osd.mil/Guard-Reser
vePortal TRS Web site www.tricare.osd.mil/reser
ve/resesrveselect
Contact your regional contractor for help with
Step 2Purchasing Coverage, and for customer
service after your TRS coverage begins.