TRICARE Reserve Select Plan Changes Oct. 1|
Posted 8/23/2007 Updated 8/23/2007
by Brian P. Smith
TriWest Healthcare Alliance
8/23/2007 - GRAND FORKS AIR FORCE BASE, N.D. -- On Sept. 30, 2007, the three-tiered TRICARE Reserve Select program will end. Beginning October 1, qualified National Guard and Reserve members will have access to a streamlined TRS program with simplified enrollment requirements and a new premium structure. Current members (except those with survivor benefits) must re-enroll in TRS before Sept. 30 to ensure continuous coverage.
Members of the Selected Reserve may purchase coverage under the new TRS program if they are not eligible for, or already enrolled in, the Federal Employees Health Benefits program.
The New TRS Program
All TRS enrollees will need to log on to the National Guard and Reserve Web Portal (www.dmdc.osd.mil/appj/trs/index.jsp) to:
* Verify eligibility
* Select "Purchase Coverage" and choose individual or family coverage
* Print the TRS Request Form (DD Form 2896-1)
* Sign and submit the form and one month's premium payment to TriWest Healthcare Alliance (P.O. Box 42048, Phoenix, AZ 85080-2048), the TRICARE West Region contractor.
The member's monthly payment may change--the new TRS program has only one monthly premium for individual coverage (currently $81) and one monthly premium for family coverage (currently $253) instead of six different premiums for three different tiers. Members previously enrolled in Tier 2 or Tier 3 can save up to 57% on their monthly premium. The Department of Defense may adjust the premium each Jan. 1.
After Oct. 1, changes will also include:
* A continuous open TRS enrollment period--qualified members may purchase coverage at any time when not on active duty orders
* Continuing coverage--after the loss of a non-premium TRICARE program (for instance, losing coverage coming off of active duty), eligible beneficiaries must enroll in TRS within 60 days to avoid a break in coverage
* A choice of coverage start date--for example, if the enrollment form (with payment) is mailed to TriWest and postmarked Nov. 29, the member can choose to start coverage on either Dec. 1 or Jan. 1.
Coverage Under TRS
Health care coverage under TRS is similar to coverage under TRICARE Standard and Extra and includes deductibles, cost-shares and a $1,000 cap on the yearly maximum out-of-pocket expenses for covered medical services. TRS enrollees (individuals and family members) have the freedom to access care from any TRICARE-authorized, certified or network provider or hospital and may request care at a military treatment facility (MTF) on a space-available basis.
TRS enrollees have access to pharmacy and dental benefits.
The TRICARE pharmacy program is administered by Express Scripts, Inc. (www.express-scripts.com/TRICARE) and has minimal co-payments. The pharmacy program is part of the TRICARE coverage and will not require a separate enrollment fee or monthly premium to use the benefits.
Qualified Reserve Component members may purchase TRICARE Dental Program coverage, administered by United Concordia Companies, Inc. (www.tricaredentalprogram.com).
TRS program information can be found online at www.TRICARE.mil (Overview > TRICARE Plans) and on the National Guard and Reserve Resource Center on www.TriWest.com (follow the links for Guard & Reserve). For eligibility questions, see a Reserve Component point of contact (www.defenselink.mil/ra/html/tricare.html).
* Current TRICARE Reserve Select enrollees must re-enroll with TriWest before Sept. 30 to ensure continuous coverage
* Reservists eligible for coverage under the Federal Employees Health Benefit program are not eligible for coverage under the restructured TRS program
* Enroll by printing out, signing and mailing in the TRS Request Form (DD Form 2896-1) from the National Guard and Reserve Web Portal (https://www.dmdc.osd.mil/appj/trs/index.jsp)
* Contact TriWest Healthcare Alliance 1-888-TRIWEST (874-9378) or www.triwest.com
* Reserve Component points of contact can be found at http://www.defenselink.mil/ra/html/tricare.html
TriWest Healthcare Alliance partners with the Department of Defense to do "Whatever It Takes" to support the health care needs of 2.9 million members of America's military family. A Phoenix-based corporation, TriWest provides access to cost-effective, high-quality health care in the 21-state TRICARE West Region. TriWest is also a proud Corporate Team member of America Supports You. Visit www.triwest.com for more information.