NEW TRICARE POLICIES FOR FAMILY MEMBERS OF NATIONAL GUARD AND RESERVES ANNOUNCED
March 12, 2003

Dr. William Winkenwerder, Jr., assistant secretary of defense for health affairs, and Thomas F. Hall, assistant secretary of defense for reserve affairs, announced today policy changes that will enhance the Tricare Prime and Tricare Prime Remote (TPR) programs for members of the National Guard and Reserves and their family members.
Starting March 10, 2003, Guard and Reserve family members, if their sponsor is on active duty (federal) orders for more than 30 days, will be eligible to enroll in Tricare Prime and enjoy the access standards and cost shares associated with the Prime benefit.

“Previously, sponsors had to be eligible in the Defense Enrollment Eligibility Reporting System (DEERS) and activated for 179 days or more before family members were eligible to enroll in Tricare Prime,” Winkenwerder said. “The Department of Defense (DoD) recognizes the contributions and sacrifices made by these families each and every day. Our commitment is to continue making improvements to the Tricare benefit to enhance access and quality of care these families receive.”

Guard and Reserve family members who reside with their sponsors in a Tricare Prime Remote location at the time of the sponsor’s activation can now enroll in the Tricare Prime Remote for Active Duty Family Members (TPRADFM) program.

For family members to be eligible to enroll in the TPRADFM program, sponsors and their family members must reside at a location that is at least 50 miles or more in distance, or approximately a one-hour drive from the nearest military treatment facility (MTF). Sponsors and family members also must be identified as eligible in DEERS.

“It’s important that we take care of the families of our Reserve Component members,” Hall said. “We want to ensure that our mobilized National Guard and Reserve members aren’t worried about who’s caring for their families while they’re gone, and to return them to families whose health care needs have been met by the Military Health System.”

Contract changes are underway at Tricare Management Activity to implement the new TPRADFM policy. Once the changes are accomplished, family members of the Guard and Reserve sponsors activated for more than 30 days may start using the TPRADFM benefit, which has no co-payments, deductibles or claim forms to file, and which offers providers who meet rigorous standards for providing quality health care.

Guard and Reserve family members who choose not to enroll in either the Tricare Prime or TPRADFM program may still use the Tricare Standard and Extra benefits, with applicable cost shares and deductibles.

Guard and Reserve sponsors need to verify that DEERS information for themselves and their family members is accurate and up-to-date. They are encouraged to contact DEERS at the Defense Manpower Data Center Support Office toll free at (800) 538-9552. Sponsors and family members may also update their addresses in DEERS on the Tricare Web site at http://www.tricare.osd.mil/deers/default.cfm.

Future updates regarding benefits for members of the Guard and Reserve and their family members will be posted on the Tricare Web site at http://www.tricare.osd.mil/reserve/.