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TRICARE Early Eligibility for Reserve Component

Future soldiers recite the Oath of Enlistment during the 56th Annual Torrance Armed Forces Day Parade in Torrance, Calif., May 16, 2015. (Thomas Crough/U.S. Army photo)
Future soldiers recite the Oath of Enlistment during the 56th Annual Torrance Armed Forces Day Parade in Torrance, Calif., May 16, 2015. (Thomas Crough/U.S. Army photo)

If you have received delayed-effective-date active duty orders with a reporting date some time in the future, did you know you and your family might already be eligible for health care coverage under TRICARE?

If your orders are for more than 30 days of active duty and in support of a contingency operation (either within the fifty states or overseas), you and your family may be eligible for certain TRICARE medical and dental benefits even before you report for active duty. This early eligibility period may start up to 90 days prior to your reporting date, depending on your orders.

You should be notified of your eligibility when your orders are issued. To verify eligibility for the early benefit, you may check your status on the Guard-Reserve Portal, speak with your unit administrator or call DEERS at 1-800-538-9552. Eligibility is directly related affected by the accuracy of your DEERS information. Please update DEERS with any changes in your duty status, family status or address. We also suggest you do an annual verification at www.tricare.mil/deers/ even if no changes have occurred.

A claim for using your TRICARE benefit can be filed as soon as DEERS shows eligibility. The provider may or may not submit the claim for you. If a claim was declined due to incorrect eligibility, you can contact TriWest for reprocessing once eligibility is updated in DEERS.

You, the Reserve Component member, will not be responsible for cost-shares. Family members who receive covered care will still be responsible for paying a share of the maximum allowable cost under TRICARE Standard and TRICARE Extra. The costs are dependent upon if the provider is in the TRICARE network. All annual deductibles are currently waived under the TRICARE Reserve Family Demonstration Project if you, the service member have been activated under a contingency program.

If your orders are cancelled prior to reporting for active duty or if you are released before reporting, eligibility for you and your family will end on the order cancellation date.

You have the option of enrolling your family for coverage under the TRICARE Dental Program. As a servicemember, your TDP coverage will end once you are ordered to active-duty for more than 30 days and given the early eligibility benefit. During activation you will have the same benefits as an active duty service member. If you had TDP coverage before activation, you will be automatically re-enrolled upon deactivation.

Your family members are eligible to enroll, or remain enrolled, in the TDP, regardless of the service member's enrollment. Active-duty family members (including activated Guard and Reserve) pay a reduced monthly premium for the TDP. Initial enrollment requires a 12-month commitment, and then continues on a month-to-month basis.

Once you report for active-duty, you, the service member, must enroll in TRICARE Prime or Prime Remote. Your family members may be eligible to enroll in either TRICARE Prime or Prime Remote for Active Duty Family Members (TPRADFM) if they meet certain requirements and if all information is accurately updated in the DEERS system. Please visit www.triwest.com or www.tricare.mil for additional information on these programs.

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This content provided by TriWest Health Care Alliance.

For general information about TRICARE, call one of the many toll-free TRICARE information lines found at the TRICARE Contact Us web page.

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