TRICARE Reserve Select (TRS) is a premium-based health plan that qualified National Guard and Reserve members may purchase. The TRS health care plan as you know it now will be restructured effective October 1, 2007 based on changes from the John Warner National Defense Authorization Act for Fiscal Year 2007 (P.L. 109-364).
A key change to the restructured TRS plan is how you qualify for the program. Beginning October 1, 2007, TRS is available to all members of the Selected Reserve regardless of any active duty served, with one exception:
If you are eligible for the Federal Employees Health Benefits (FEHB) program (as defined in Chapter 89 of Title 5 U.S.C) or currently covered under FEHB, either under your own eligibility or through a family member, you are excluded from purchasing the restructured TRS plan.
To qualify for TRS, you must be a member of the Selected Reserve of the Ready Reserve, and you cannot be eligible for or enrolled in the FEHB program. Once you qualify, you may purchase the plan at any time throughout the year, there are no tiers or open seasons. Qualifying for and purchasing TRS is a 2-step process:
Step 1: Qualify
- Log on to the Guard and Reserve Web Portal.
- Click on the "TRICARE Reserve Select" box.
- Select the type of coverage that you want to purchase: TRS Member-Only or TRS Member-and-Family
- Certify that you are not eligible for or enrolled in the FEHB program
- Select when you want your coverage to begin
- Print and sign the TRS Request Form (DD Form 2896-1)
Step 2: Purchase
Mail or fax your completed TRS Request Form along with the first month's premium payment to your regional contractor by
the applicable deadline.
Mail with one month’s premium payment to:
TriWest Healthcare Alliance
PO Box 42048
Phoenix, AZ 85080-2048
Fax with automatic payment or electronic funds transfer to:
1-866-441-8843
Your coverage begins on the first day of the first or second month (whichever you select on the TRS Request Form) following the postmark of your TRS Request Form. For example, if your form is postmarked in July, you may choose for your coverage to begin on the first day of the next month, August, or on the first day of the second month, September.
TRS covered services will not be changing, and continues to be comparable to TRICARE Standard and Extra. You'll still be able to access a wide variety of services from any TRICARE-authorized provider network or non-network. Additionally, you'll be eligible for TRICARE's prescription drug coverage.
Monthly Premiums
Your monthly premium rate is determined by the type of coverage you purchase: TRS Member-Only or TRS Member-and-Family. TRS premiums
are adjusted annually effective January 1. The listed premiums will remain in effect for 2008.
| Monthly Premium | |
| TRS Member-Only | $81 |
| TRS Member-and-Family | $253 |
Premiums can be paid by check, money order or cashier's check (payable to TriWest), or by Visa®/MasterCard® by using the Online Payment option. After the initial premium payment, Triwest will bill you by the 10th of each month. Payments are due no later than the 30th of each month, and payments are applied to the following month of coverage. Do not miss payment; failure to pay overdue amounts by the deadline will result in termination of coverage and debt collection.
Annual Outpatient Deductible
The annual outpatient deductible is the amount you must pay out of pocket before government cost-sharing begins. Your monthly
premiums do not apply to the annual deductible. Your annual deductible is:
| Sponsor’s Rank | Member-Only | Member-and-Family |
| E-4 and below | $50 | $100 |
| E-5 and above | $150 | $300 |
Health Care Costs
The chart below outlines the costs for covered
services for TRICARE Reserve Select coverage.
The costs shown in this chart are for care received outside of a military treatment facility (MTF). While MTF care is usually free of charge, there may be minimal charges applied for inpatient care. Please check with your local MTF for details.
| Ambulance Services | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Ambulatory Surgery (Same Day) |
$25.00 |
| Behavioral Health (Inpatient) | $20.00 per day ($25.00 minimum charge) |
| Behavioral Health (Outpatient) |
Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Birthing Center | $25.00 |
| Clinical Preventive Services | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Durable Medical Equipment, Prosthetic Devices and Medical Supplies | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Emergency Services | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Family Health Services (Family Planning and Well-Baby Care) | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Home Health Care | $0 |
| Hospice Care | $0 |
| Hospitalization (Inpatient Visit) | $15.15 per day ($25.00 minimum charge) |
| Immunizations | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Laboratory and X-Ray Services | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Maternity Care | $25.00 minimum charge per admission. No separate cost share for separately billed professional charges. |
| Newborn/Adoptee Care | $15.15 per day ($25.00 minimum charge) |
| Outpatient Visits | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Routine Pap Smears | Cost sharing begins after annual deductible is met. Costs are determined by the type of provider you
see: Non-network providers: 20% of allowable charges Network providers: 15% of negotiated fee |
| Skilled Nursing (Inpatient) | $15.15 per day ($25.00 minimum charge) |
Note: Network providers are not available overseas, so if you are using TRS in an overseas location, only the non-network provider costs will apply.
Changes in Family Composition
You may change the type of TRS coverage, TRS Member-Only or TRS Member-and-Family, with a qualifying life event:
- Marriage
- Birth or adoption
- Placement of child in the legal custody of the member by order of the court
- Divorce or annulment
- Death of a spouse or family member
- Family member loses eligibility (e.g. child turns 21 or 23 if enrolled in college)
Sponsors must report all qualifying life events to a military personnel office and record the information in the Defense Enrollment Eligibility Reporting System (DEERS).
To change the TRS coverage, download a new TRS Request Form from the Guard and Reserve Web Portal, complete the form, and submit it to your regional contractor (postmarked) within 60 days of the qualifying life event. The change in coverage is effective the date the qualifying life event occurred.
Changes to your TRS coverage that don't involve a change in family composition, (e.g., eligibility for other health coverage) can
be made at any
time during your enrollment in TRS.
If a National Guard and Reserve member is covered by TRS on the day of his or her death, surviving family members may purchase or continue TRS coverage for an additional six months from the date of the member's death.
- If TRS Member-and-Family coverage is in effect at the time of death, DEERS will automatically convert the TRS Member-and-Family coverage to TRS survivor coverage.
- If TRS Member-Only coverage is in effect at the time of death, the coverage will terminate and survivors may purchase TRS survivor coverage within 60 days.
- Survivors are responsible for paying appropriate monthly premiums.
For assistance with TRS enrollment, premium billing and payments, accessing health services or covered benefits, National Guard or Reserve members may contact their TRICARE regional contractor. Members may also subscribe to the TRICARE Management Activity e-mail update service at www.tricare.mil/tricaresubscriptions to have TRS-related information sent to their e-mail address as new information becomes available.
TRICARE North Region Contractor
Health Net Federal Services Inc.
TRICARE Reserve Select Enrollment
P.O. Box 870162
Surfside Beach, SC 29587-9762
1-800-555-2605
https://www.hnfs.net/bene/home
TRICARE South Region Contractor
Humana Military Healthcare Services Inc.
P.O. Box 105389
Atlanta, GA 30348-5389
1-800-444-5445
www.humana-military.com
TRICARE West Region Contractor
TriWest Healthcare Alliance
P.O. Box 42048
Phoenix, AZ 85080-2048
1-888-TRIWEST (1-888-874-9378)
www.triwest.com
Overseas
Humana Military Healthcare Services Inc.
P.O. Box 105838
Atlanta, GA 30348-5838
1-800-444-5445
www.humana-military.com
Overseas provider locator support and other information are available at Overseas TRICARE Area Offices. See chart below.
| TRICARE Europe Includes Europe, Africa and the Middle East | TRICARE Area Office Europe Unit 10310, APO, AE 09136 Commercial Phone 00-49-(0)630-267-6312/6314 DSN 496-6312/6314 www.europe.tricare.osd.mil |
| TRICARE Pacific Includes Japan, Korea, Guam, the Western Pacific and the Far East | TRICARE Area Office Pacific PSC 482, Box 2749 FPO AP, 96362 Toll free number: 1-888-777-8343, option 4 http://www.wpsic.com/index.shtml |
| TRICARE Latin America and Canada Includes all of Latin America, Canada, Puerto Rico and the Virgin Islands | TRICARE Area Office Latin America & Canada Attn: LATLAC - B38802 (DIR) Fort Gordon, GA 30905-5650 Commercial Phone 1-706-787-2424 DSN 773-2424 TLAC toll free #: 1-888-777-8343, option #3 http://tricare15.army.mil/indexReg15.htm |
TRS Program information at www.tricare.mil
