Members of the Retired Reserves below age 60 -- so called "gray area" retirees are not eligible for the same TRICARE Prime or Standard health care benefits as those who retire from active duty service. However, gray area retirees are eligible for the TRICARE Retired Reserve and TRICARE Retiree Dental Program.
TRICARE Retired Reserve
TRICARE Retired Reserve is a premium-based plan available worldwide for retired Reserve members, their families and survivors who qualify.
NOTE: TRICARE Retired Reserve meets the requirements for minimum essential coverage under the Affordable Care Act.
Eligible Beneficiaries include:
- Retired Reserve members who are:
- Members of the retired Reserve of a Reserve Component who are qualified for non-regular retirement under 10 U.S.C., Chapter 1223
- Under age 60
- Not eligible for, or enrolled in, the Federal Employees Health Benefits (FEHB) program
- Family members of qualified Retired Reserve members
- Survivors of retired Reserve members if:
- The sponsor was covered by TRICARE Retired Reserve when he or she died.
- They are immediate family members of the deceased sponsor (spouses cannot have remarried).
- TRICARE Retired Reserve coverage would begin before the date the deceased sponsor would have turned 60 years old.
Visit the TRICARE Retired Reserve website to learn more about cost and coverage under TRR.
Health Care for Retired Reserve Over 60
Reserve Component (RC) retirees become eligible for TRICARE benefits when they reach age 60 and begin receiving retirement pay. TRICARE eligibility remains in force until age 65. Upon reaching age 65, TRICARE ends, and you become eligible for Medicare and TRICARE For Life. You should contact your Health Benefits Advisors/Beneficiary Counselor and Assistance Coordinators (BCAC) at MTFs or stop in at your TRICARE Service Center for more assistance. Locate the BCAC for your state.
TRICARE For Life
If you or a family member become entitled to Medicare Part A, whether due to a disability or when you turn 65, you are eligible for TRICARE For Life (TFL). There are no TFL enrollment fees, but you are required to pay Medicare Part B premiums. When using TFL, TRICARE is the second payer after Medicare in most cases. Get more information about TFL.
Dental Care After Retirement
Once you retire, you lose eligibility to TRICARE dental. To retain dental insurance you have to enroll in the TRICARE Retiree Dental Program (TRDP). The TRDP provides comprehensive dental coverage for Uniformed Services retirees and their family members. Under contract with the U.S. Department of Defense, the Federal Services division of Delta Dental Plan administers the TRDP.
The TRDP is a voluntary dental benefits program with enrollee-paid premiums. Covered services under the TRDP are offered worldwide.
When you reach age 65 (or otherwise become eligible for Medicare) you must enroll in Medicare as described above. Most people over 65 also sign up for Medicare Part D, which is the Medicare Pharmacy benefit along with Part B, the medical insurance benefit. With your TRICARE Pharmacy eligibility it may not be in your best financial interest to purchase Medicare Part D. If you have TRICARE, you don’t need to join a Medicare Prescription Drug Plan. However, if you do, your Medicare drug plan pays first, and TRICARE pays second.
When you become eligible for Medicare Part D:
- You'll receive a letter in the mail.
- It will explain how your TRICARE prescription drug plan works with Medicare Part D.
For most TRICARE beneficiaries, there is almost NO advantage to enrolling in a Medicare prescription drug plan. Before deciding whether or not to enroll in a Medicare prescription drug plan, you should compare it with your TRICARE prescription drug plan. Be sure to compare:
- Monthly premiums
- Drug coverage
If you do decide to enroll in a Medicare prescription drug plan:
- TRICARE will pay second after Medicare
- You can enroll during your Initial Enrollment Period or the Open Enrollment Period each year
- The Open Enrollment Period is November 15th - December 31st, with prescription drug coverage beginning the next January 1st
If a sponsor dies after retiring from active duty (either regular or a medical retirement), surviving family members remain eligible for TRICARE with the same health plan options and costs they had before their sponsor passed away.
Surviving spouses remain eligible for TRICARE unless they remarry and children remain eligible until they age out or lose eligibility for TRICARE for other reasons.
Contact your TRICARE regional contractor for assistance.
Supplemental Health Insurance for Reserve Retirees
One short stay in the hospital could offset the cost of several years of supplement health insurance. Even though you are covered by TRICARE, a supplemental insurance policy is a good idea for retirees. Here's why:
- TRICARE does not cover all costs.
- TRICARE has a yearly deductible to be paid.
- TRICARE has a yearly cap on non-covered expenses; the cap is extremely high, and you are responsible for the cost of non-covered items up to that amount.
If you are covered by health insurance with your new employer, you may use TRICARE as your supplemental insurance for that policy. Check with your TRICARE advisor concerning your particular circumstances and those of your family.