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TRICARE For Reservists and Family While on Active Duty or Mobilization Orders

NRA News, March 2004
By CAPT Tom McAtee, USNR (Ret)

As a result of the Emergency Supplemental Appropriations Act for Defense for FY 2004 and the National Defense Authorization Act for FY 2004, several temporary enhancements have been made to health care services for Reserve Component members and family members. Why the term “temporary”? Because, many of the enhancements are only valid through 31 December 2004, unless extended by law. This information is of importance to those anticipating mobilization orders or contemplating going on active duty for more than 30 days. Additionally, those being demobilized should review coverage under the Transitional Assistance Medical Program.

Generally, medical coverage (Reservist/family members) is based upon the number of days ordered to active duty instead of the type of orders, such as AT, ADT, or ADSW. The exception to this rule are orders expressly specifying “in support of a contingency operation” whether involuntary or voluntary.

Summary of the temporary enhanced health care

Reservist care: Regardless of duration of orders or IDT, the individual Reservist is covered. For orders over 30 days, the Reservist is automatically enrolled in TRICARE Prime. For orders of 30 days or less, the Reservist’s coverage is for appropriate medical and dental care for an injury or illness incurred in line of duty. Temporary enhancements for the Reservists:

  • Medical or dental screening and care. Whenever a Reservist receives notice that he/she will be called or ordered to active duty for a period of more than 30 days, medical and dental screening and care will be provided to meet applicable standards for deployment. This care is provided before entry on active duty. Eligibility for such care must be specified in orders. Valid through 31 December 2004, unless extended by law.
  • Early eligibility date for TRICARE benefits. Whenever a Reservist is issued active duty orders (for more than 30 days), in support of a contingency operation, with a delayed effective date for reporting to duty, he/she shall be eligible for TRICARE as if on active duty on date of issue, or 90 days prior to report date, whichever is later. Valid through 31 December 2004, unless extended by law.

Family care: Health care for eligible family members is dependent on length of orders and whether those orders were issued in support of a contingency operation. If the sponsor’s orders are:

  • Not in support of a contingency operation. If orders are specified for a period of more than 30 days, medical care is provided under TRICARE Standard or Extra effective upon entry on active duty. Cost share and deductible apply. If orders specify a period of active duty of 179 days or more, enrollment in TRICARE Prime is available.
  • In support of a contingency operation. As mentioned previously under “Reservist care,” medical care may begin even before entry on active duty. This also applies to family members of a Reservist ordered to active duty for more than 30 days in support of a contingency operation. Family members may enroll in TRICARE Prime, Extra, or Standard. Specifics of each TRICARE option may be reviewed at www.tricare.osd.mil.

Transitional care: Reserve Component members who served on active duty for more than 30 days, in support of a contingency operation, are authorized coverage under the Transitional Assistance Medical Program (TAMP). Reservists and eligible family members will be covered for a period of 180 days beginning on the date of separation. Coverage may be under TRICARE Prime, Extra, or Standard. Valid through 31 December 2004, unless extended by law. If not extended, TAMP coverage will be adjusted to 60 days for those with less than six years of active service or 120 days for those with over six years.

Dental care: Dental care is not provided to eligible family members based on orders. The TRICARE Dental Program (TDP) is a premium-based program with single and family plans available. Enrollment is voluntary with worldwide coverage. Selected Reservists and IRR personnel are eligible to enroll. The 2004 per-month rates are: $22.66 for a family of a Reservist on active duty, and $56.66 for a family of a Selected Reservist or IRR member not on active duty. The plan may be reviewed by going to www.ucci.com or by calling 1-800-866-8499.

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