Tricare Benefits Improved Significantly For Reservists
October 29, 2004
The National Defense Authorization Act for fiscal 2005, signed by the President yesterday, improves significantly the overall health benefits available to guardsmen, reservists and their families and makes permanent several of the Tricare benefits authorized temporarily under defense legislation last year while extending secretarial authorization for others.
Our reservists and guardsmen who are called to duty and their families deserve these great new benefits for their service to their country, said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. We welcome these new Tricare provisions as a means to improve active and reserve component force readiness and to enhance family member access to care.
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 members activation date for eligible members and their families. It also makes permanent a 180-day transitional Tricare health benefit after deactivation for Transitional Assistance Management Program (TAMP) eligible members and their families. Members must also now receive a comprehensive physical examination prior to separating from active duty service.
The legislation also authorizes waiver of the Tricare standard and extra deductibles of reserve component family members for members ordered to active duty for more than 30 days and authorizes Tricare to pay nonparticipating providers up to 115 percent of the Tricare maximum allowable charge, which enhances continuity of care for these family members with their civilian providers. In order to ensure seamless implementation of these provisions, Tricare has extended the Tricare Reserve Family Demonstration Project through Oct. 31, 2005. The demonstration, which began on Sept. 14, 2001, was due to end Nov. 1, 2004.
Members of the reserve component 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, are now given the opportunity to purchase Tricare standard healthcare coverage for themselves and their family members after they demobilize. 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 member may purchase one year of Tricare standard coverage for the same period they commit to serve in the selected reserves. Members will be able to purchase the new Tricare standard coverage on a self-only or self and family basis. The Tricare standard coverage under this program will begin once the members eligibility for 180 days of transitional Tricare coverage under the TAMP program ends. Members who served on active duty in support of a contingency operation for 90 days or more on or after Sept. 11, 2001, and were released from active duty before Oct. 28, 2004, or within 180 days of that date, may enter into an agreement to serve continuously in the selected reserve for a period of one or more years and begin participation in this program at that time. These members must enter into this agreement to serve in the selected reserve within one year of Oct. 28, 2004.
Congress requires implementation of the new Tricare standard enrollment program by April 26, 2005. Winkenwerder stated, We have already begun working on these provisions and will implement them on time.
Additional information on the new permanent Tricare provisions to include start dates, benefits and requirements under each of the new permanent provisions will be posted on the Tricare web site at http://www.tricare.osd.mil/ and the reserve affairs Web site at http://www.defenselink.mil/ra as soon as each is ready to begin.