If you are a Guard or Reserve member being called up to active duty for more than 30 days, you and your family are eligible for TRICARE benefits the day you are mobilized. Coverage is under the TRICARE Extra or Standard programs.
Congress recently passed a major change to TRICARE coverage eligibility for Reserve and Guard members. This new law will allow you to enroll in TRICARE for single or family coverage.
Are you eligible?
You qualify if you are a Reserve or National Guard member and you are receiving unemployment compensation or if you are not eligible for health care benefits under an employer-sponsored health benefits plan.
How much will this cost? The cost to the member hasn't been determined yet. The new law stipulates that the Secretary of Defense must set guidelines for the enrollment process and premium costs.
How do you enroll?
The new law stipulates the Secretary of Defense will provide at least one open enrollment period each year. During an open enrollment period, an eligible Reserve or Guard member may enroll in the TRICARE program, change, or terminate an enrollment in the TRICARE program.
These "enrollment dates" have not been determined yet.
Family members of reservists and guardsmen activated under orders for 179 days or more have the option to enroll in TRICARE Prime, the military's version of a health maintenance organization. They will receive care in a military medical treatment facility or be assigned to a network provider in their area with no cost-shares or deductibles.
TRICARE Prime is the only one of the TRICARE options that requires pre-enrollment on the part of the family members. Enrollment information can also be found on the TRICARE Website or by contacting a local TRICARE benefits counselor. Enrollment has to occur by the 20th of the month in order to be eligible for care on the 1st of the following month.
For instance, reserve component members who might be mobilized in coming weeks must have their enrollment forms in to TRICARE by Feb. 20 in order for their families to start receiving care on March 1 under the Prime option. The family would be covered under TRICARE Standard or Extra until enrolled in Prime.
The most important thing you can do is make sure all your information in the Defense Enrollment Eligibility Reporting System (DEERS) is accurate. Since DEERS is the system used to determine eligibility for military health care, family members could be denied care if DEERS information is incorrect or incomplete.
Activated reservists are given a chance to review and make changes to their families' DEERS enrollments during the mobilization process.
Personnel will verify eligibility for DEERS benefits when you apply for your DD Form 1172, Application for Uniformed Services Identification Card. You must present marriage and birth certificates for all children ages 21 and under (ages 21and over if handicapped, 21-22 if in college) and present a copy of your orders for identification purposes.
Activated Reserve component members and their families are also eligible to enroll in the TRICARE Dental Program. Reserve members who had previously enrolled in the program are automatically removed when mobilized because they receive dental care from military providers while on active duty.
Reserve members in the Dental Program pay monthly premiums of $19.08 for one family member or $47.69 for a family enrollment. If the reserve sponsor is called to active duty, the premiums fall to the active-duty rates of $7.63 per month for one family member or $19.08 for multiple family members.
Families who had previously declined TRICARE dental coverage but who wish to enroll after their sponsors are mobilized will be able to join at active-duty rates during the first 30 days. Enrollment forms and information are available online.
The above are the major health benefits available to deploying servicemembers and their families; for more, be sure to check with TRICARE.
