TRICARE Benefits Improve for Reservists and Their Families

The National Defense Authorization Act for 2005 (NDAA 2005) improves the overall health benefits available to members of the Guard and Reserve and their families, and it makes permanent several of the TRICARE benefits authorized “temporarily” under 2004 defense legislation.

Here is a look at what TRICARE providers need to know about the improvements:

• For Reserve Component members with delayed effective date orders to serve on active duty in support of a contingency operation for more than 30 days, the new legislation permanently authorizes TRICARE eligibility for up to 90 days prior to member’s activation date for eligible members and their families.
• The legislation makes permanent the 180-day transitional period after deactivation in which certain Reserve Component members and their families receive TRICARE health benefits under the Transitional Assistance Management Program (TAMP). Members must now have a comprehensive physical examination within 12 months before the scheduled date of separation from active duty service.
• The legislation authorizes a waiver of the TRICARE Standard and TRICARE Extra deductibles for Reserve Component family members whose sponsors are ordered to active duty for more than 30 days. Plus, it authorizes TRICARE to pay nonparticipating providers up to 115 percent of the TRICARE maximum allowable charge, enhancing continuity of care for these family members with their civilian providers.

Another provision will enable members of the Reserve Component (those called after Sept. 11, 2001, to serve for more than 30 days in support of a contingency operation, who served or will continuously serve for 90 or more days) to purchase TRICARE Standard health care coverage for themselves and their family members after they demobilize and after their TAMP benefit ends.

The member must sign an agreement to continue serving for a period of one year or more in the selected reserve after their active duty ends. For every 90 days of consecutive active duty service, the member and family members may purchase one year of TRICARE Standard coverage for the same period they commit to serve in the selected reserves.

The option to purchase TRICARE Standard coverage will not be implemented until April 26, 2005.

More information about these changes authorized under the NDAA 2005 will be available on the TRICARE Web site at www.tricare.mil and the reserve affairs Web site at www.defenselink.mil/ra.