1. TRICARE Reserve Select
(Effective: June 2017)
NORTH REGION
Suggested handouts:
TRICARE Reserve Select flyer
TRICARE Choices for the National Guard and Reserve flyer.
Additional resources available on the TRICARE SMART site:
TRICARE for National Guard and Reserve Passport
Welcome to today’s briefing about TRICARE Reserve Select (TRS). The TRS program information highlighted in this briefing is based on the changes from the National Defense Authorization Act (NDAA) for fiscal year (FY) These changes include restructured premiums and qualifications.
In today’s presentation, we will discuss how you can purchase coverage if you qualify. Later on we will briefly touch on covered services available under TRS and explain how to get more information.
Please hold all questions until the end.
[Reference: TRICARE Operations Manual, Chapter 24, Section 1]

2. Blue Cross Select Silver Saver
Health Care
TriCare
Premiums 1 June 2017
Soldier: $47.82
Soldier + Family: $210.83
Blue Cross Select Silver Saver
1 June 2017
Single: $215.21/mo
Family of 4: $343.02/mo

3. TRICARE Reserve Select (TRS)
Premium-based health plan qualified National Guard and Reserve members may purchase
You are qualified to purchase TRS if you are:
A member of the Selected Reserve and;
Not eligible for or enrolled in the Federal Employees Health Benefits (FEHB) program
TRICARE Reserve Select (TRS) is a premium-based health plan. National Guard and Reserve members may qualify to purchase enhanced TRS coverage if they are:
A member of the Selected Reserve of the Ready Reserve
Not eligible for or enrolled in the Federal Employees Health Benefits (FEHB) program; this means you can not be covered under FEHB by a spouse or other family member

4. Continuous Open Enrollment
If you qualify, you may purchase TRS coverage to begin in any month throughout the year
Coverage begins on the first day of the first or second month after the postmark date of your TRS Request form
You choose which month coverage begins
You must pay the first two months to start TRS
After the first payment, premium payments are only accepted automatically by:
Electronic funds transfer (EFT) or
Recurring debit/credit card (Visa/MasterCard)
All qualified National Guard and Reserve members may purchase TRS coverage. There is no designated period for enrollment.  
Coverage begins on the first day of the first or second month following postmark of your TRS Request form.
For example, if your TRS Request form is postmarked in July, you may select coverage to begin on the first of the next month, August, or you may select your coverage to begin the first of September.

5. Continuous Coverage
You must qualify for and purchase TRS no later than 60 days after loss of other TRICARE coverage to ensure no break in health care coverage
TRS is effective immediately following the termination of other TRICARE coverage
Member’s qualification for TRS must be reflected in DEERS; member must not be eligible for or enrolled in the FEHB program
Qualified members may purchase TRS coverage with an effective date immediately following the termination of coverage under another TRICARE program, for example TRICARE Prime if you have been activated. To maintain health care benefits without a break in coverage, TRS must be purchased no later than 60 days after the loss of non-premium TRICARE coverage. TRS coverage begins the day after non-premium TRICARE coverage ends.
Note: Although coverage is retroactive for those 60 days, any claims submitted before your enrollment is processed are denied because DEERS shows you are ineligible. These claims must be resubmitted. Services where a DEERS check occurs at the point of service—at pharmacies or care at an MTF—are shown in DEERS as ineligible. They are either denied (MTF and TRICARE Mail Order Pharmacy) or you will have to pay the full cost (retail pharmacy).
Many National Guard and Reserve members who qualify for TRS may also qualify for 180 days of premium-free TRICARE coverage under the Transitional Assistance Management Program (TAMP). Since TRS will follow TAMP with no break in coverage, your completed TRS Request form and correct payment must be received or postmarked no later than 60 days after the termination of TAMP or non-premium TRICARE coverage.
Remember, your qualification for TRS must be reflected in DEERS, and you must not be eligible for or enrolled in the FEHB program.

6. Comprehensive Coverage
Similar to TRICARE Standard and TRICARE Extra:
Emergency and urgent care
Immunizations and health screenings
Maternity care
Behavioral health care
Annual eye exams
Prescription drug coverage
TRICARE-authorized providers
Military treatment facility, space-available basis only
TRICARE Reserve Select offers comprehensive health coverage similar to TRICARE Standard and TRICARE Extra. Covered services include, but are not limited to, the services listed here.
You can access care from any TRICARE-authorized provider, hospital or TRICARE network or non-network pharmacy. You may also seek care from any MTF on a space-available basis only.
Once enrolled, you’ll receive a copy of the TRICARE Reserve Select Handbook with details about covered benefits, costs and how to access care. You can also visit for more information.
For details, refer to your TRICARE Reserve Select Handbook

7. What You Pay for Covered Services
Annual Deductible
Minimum amount you pay each fiscal year before
cost-sharing begins
Sponsor rank E4 and below:
$50 Individual
$100 Family
Sponsor rank E5 and above:
$150 Individual
$300 Family
Outpatient Cost-share
After the annual deductible
15% Network provider
20%* Non-network provider
Catastrophic Cap
Maximum amount you pay each fiscal year
$1,000 per family
Annual Deductibles: You are required to meet an annual deductible for outpatient services each fiscal year before TRICARE will begin sharing the costs of outpatient services.
Sponsor rank E4 and below:
$50 per individual
$100 per family
 Sponsor rank E5 and above:
$150 per individual
$300 per family
* The federal fiscal year is Oct. 1−Sept. 30.
Cost-Shares: After the annual deductible has been met, you pay 15 percent for care received from a TRICARE network provider. You pay 20 percent for covered services, supplies or equipment received from a non-network TRICARE-authorized provider.
A separate cost-sharing structure applies to pharmacy. See for details. TRS members can refer to their TRICARE Reserve Select Handbook.
Catastrophic Cap: Your catastrophic cap limits your annual out-of-pocket expense on cost-shares and annual deductibles. The catastrophic cap for TRICARE Reserve Select is $1,000 for deductibles, and cost-shares are based on allowed charges for you and your family. Monthly premium payments do not apply to the catastrophic cap.
* Non-network providers may also charge up to 15% above the TRICARE-allowable charge. For more details about costs for covered services, visit

8. Catastrophic Cap Catastrophic Cap Per FY -TRS: $1,000 per family
Your catastrophic cap is the maximum amount you pay each fiscal year, October 1 - September 30. After you reach your catastrophic cap, you won’t have to pay anything more in most cases. But there are some exceptions.
The cap applies to all covered services:
annual deductibles (if applicable)
pharmacy copayments
enrollment fees/monthly premiums (if applicable)
other cost shares based on TRICARE-allowable charges.
The cap does not apply to services not covered by TRICARE or to any amount that non-participating providers may charge above the TRICARE maximum allowable charge for services
01 MAY 2017

9. Changes to TRS Coverage
Change in family composition
Marriage, divorce, newborn, etc.
Take one of the following actions
Purchase new coverage
Change type of coverage
(e.g., member-only to member-and-family)
Terminate coverage
If change impacts type of coverage (e.g., member-only to member-and-family), premium increase or decrease is effective based on date of change
Life-changing events that affect your family composition include:
Birth or adoption of a child
Placement of a child in the legal custody of the member by an order of the court
Divorce or annulment
Death of a spouse or family member
Last family member becomes ineligible (e.g., child ages out)
You must take one of the following actions to change your TRS coverage:
Purchase new coverage
Change in type of coverage
Terminate existing coverage
When you experience a change to your family composition you must take specific actions on your TRS coverage. If the qualifying life event changes your type of coverage, for example, member-only coverage becoming member-and-family coverage, you will be responsible for paying the change in premium.
You must report all changes in family composition to a military personnel office with Real-Time Automated Personnel Identification System (RAPIDS) capability to appropriately update DEERS. You must also submit a TRS Request form to your regional contractor no later than 60 days after the date of the qualifying life event. The effective date of coverage is the date the qualifying life event occurred (e.g., date of marriage, date of birth).

10. TRS Survivor Coverage
Coverage may continue for up to six months beyond the date of the member’s death:
If member-and-family coverage is in effect at the time of death, DEERS will transfer to TRS survivor coverage
If member-only coverage is in effect at the time of death, TRS coverage will terminate, and survivors may purchase coverage within 60 days
Coverage termination date is recorded in DEERS as six months after the date of death
Monthly premiums apply: Effective 1 Jan 2017
One family member—Member-only premium amounts $47.82
Two or more family members— $210.83
If a National Guard or Reserve member dies during a period of TRS coverage, survivors may be covered for up to six months beyond the date of the member’s death.
If TRS member-and-family coverage was in effect on the date of the death, eligible surviving family members may purchase and continue TRS coverage for up to six months. Surviving family members must continue to pay monthly premiums. If there is only one surviving family member, member-only premium amounts will apply. If two or more family members remain, the member-and-family premium amounts will apply. Premiums will continue to apply unless the family requests disenrollment/termination of coverage.
If TRS member-only coverage was in effect on the date of the death, eligible surviving family members may purchase TRS for up to six months. The effective date of coverage will be the day following the date of the death. The request for coverage must be submitted to your contractor within 60 days from the date of the service member’s death.

11. Qualifying for and Purchasing TRS
Step 1 – Qualify
Log on to the Guard and Reserve Web Portal at
Complete the TRICARE Reserve Select (TRS) Request form (DD Form )
Print and sign the form
Step 2 – Purchase
Submit completed form with premium payment to regional contractor within specified deadline
Qualifying for and purchasing TRS coverage is a simple two-step process.
Step 1: Qualify
First log on to the Guard and Reserve Web Portal (Web site listed on slide) and click the “TRICARE Reserve Select” button. Complete the TRICARE Reserve Select (TRS) Request form (DD Form ) by selecting your type of coverage, either member-only or member-and-family. Be sure you check the box certifying that you are not eligible for or enrolled in the Federal Employees Health Benefits (FEHB) program. Print and sign the personalized TRS Request form.
Step 2: Purchase
Mail your completed TRS Request form with your premium payment if you are paying by check, money order or a one time credit card payment to your regional contractor. The appropriate mailing address will be listed on the form. If you are paying by electronic funds transfer, no premium is necessary at this time.
Note: If you are not able to complete or print the form, there may be a problem with your information in the Defense Enrollment Eligibility Reporting System (DEERS) or a problem with your eligibility. Contact your National Guard or Reserve personnel office for assistance. A list of National Guard and Reserve points of contact is listed under TRICARE at If you experience a technical problem, contact the Defense Manpower Data Center Support Office at
Qualification for TRS must be visible in DEERS before you can complete Step 2.

12. Disenrollment from TRS
You must submit a TRS Request form to disenroll from TRS.
Do—Log on to the Guard and Reserve Web Portal to complete the TRS Request form
Do—Mail your completed TRS Request form to your TRICARE regional contractor
Don’t—Stop paying premiums. You will be charged for overdue premiums
If you decide you no longer want TRS coverage, do not just stop making payments.
You must take action to terminate/disenroll from TRS:
Log on to the Guard and Reserve Web Portal at
Complete the TRS Request form.
Mail your completed TRS Request form to your TRICARE regional contractor.
The contractor will initiate your request within 10 days of receipt of the termination request and return any excess premium amounts paid.
You can request to disenroll/terminate coverage at any time. A one-year TRS purchase lockout from the effective date of the termination will apply to all family members under the sponsor’s Social Security number. A termination of coverage request initiated by the member is effective the last day of the month the request was postmarked/received.

13. Termination of TRS Coverage
Failure to pay premiums
You are still responsible for overdue amounts.
Loss of Selected Reserve status
Gain eligibility for other TRICARE program
May purchase TRS again if you qualify at time of purchase
Your TRS coverage will be automatically terminated if you and your family members become eligible for a non-premium TRICARE program (e.g., TRICARE Prime). When your eligibility for the non-premium TRICARE program ends, you must re-enroll in TRS within 60 days to continue uninterrupted TRICARE coverage.
Members who lose Selected Reserve status are no longer qualified for TRS, and coverage will be terminated immediately upon notification of the status change.
Your payment is due no later than the 30th day of each month. Your payment will apply to the following month of coverage. Failure to pay monthly premiums on time will result in termination of coverage, but you must still pay any overdue amounts. (This may result in up to two months of overdue premium payments.)
Termination of coverage due to non-payment will also result in a TRS purchase lockout for one year or until the overdue premiums are paid, whichever is longer.
Contact your regional contractor for questions about terminating TRS coverage.

14. Who to Call for Help and Information
Contact your National Guard or Reserve personnel office for help with DEERS
Contact your regional contractor for help with purchasing coverage, and for customer service after your TRS coverage begins
DEERS Updates:
Reserve Affairs Web site:
Guard-Reserve Portal:
TRICARE Web site:
Several resources are available if you want more information or need assistance.
Contact your National Guard or Reserve personnel office for help with DEERS. For information and assistance with qualifying life events, visit a local personnel office with Real-Time Automated Personnel Identification System (RAPIDS) capability to appropriately update DEERS.
For more information about purchasing TRS or for TRS customer service after your health care coverage starts, contact your regional contractor.
(Note: Regional contractor’s phone numbers are listed on the following slide.)

15. TRICARE Regional Contractors
North Region
Health Net
South Region
Humana Military
West Region
TriWest
1-888-TRIWEST ( )
If residing overseas, contact Humana Military for assistance.
The TRICARE regional contractors administer TRS in each TRICARE region and overseas. Submit your TRS Request form to the regional contractor serving your area. The mailing address will be indicated in Block 4 of the personalized TRS Request form, which you can print from the Guard and Reserve Web Portal. If you live overseas, send your form to Humana Military, the South Region contractor.
Note: The addresses below are provided to the speaker for reference.
North Region:
Health Net Federal Services, LLC
TRICARE Reserve Select Enrollment
P.O. Box
Surfside Beach, SC
South Region:
Humana Military Healthcare Services, Inc.
P.O. Box
Atlanta, GA
West Region:
TriWest Healthcare Alliance Corp.
P.O. Box 42048
Phoenix, AZ

16. In Conclusion… Questions? Comments or feedback? Visit www.tricare.mil
YOUR MILITARY TRICARE SPECIALIST
TBA
- LOCATION: RFSC – LANSING, MI
Please provide feedback on this presentation at the Web site listed.

17. TriCare Dental Program (TCP)
Delta Dental
Jun 2017
Single: $30.92
Indiv+1: $60.52
Family: $127.68
TCP/United Concordia
1 May 2017
Soldier: $11.10
Family Member (Not Sponsor): $27.76
Family : $72.18
Sponsor and Family: $83.28
1 May 2017

18. TriCare Dental Program (TCP)
Service
Without Coverage You Pay
In-Network2
Out-Of-Network
You Pay
Your Savings
1 adult cleaning (D1110)
$152 $0
$74
$78
1 exam (D0120)
$85
$45
$40
1 set of bitewing x-rays (D0272)
$121
$65
$56
1 filling (amalgam) (D2140)
$250
$25
$225
$98
1 crown (D2752)
$985
$258
$727
Total
$1,593
$283
$1,310
$1,063
$530
01 MAY 2017

19. TriCare Dental Program (TCP)
The TDP has an annual maximum of $1,500 per person, per enrollment year for non-orthodontic services (payments for certain diagnostic and preventive services are not applied); an orthodontic lifetime maximum of $1,750 per person, per lifetime (orthodontic diagnostic services are applied to the $1,500 annual maximum) and a dental accident maximum of $1,200 per person, per enrollment year.
01 MAY 2017

20. TDP Dental Cost Shares Diagnostic, preventive & sealants: 0%
Basic restorative: 20%
Endodontic, periodontic, oral surgery:
Pay grades E-1 through E-4: 30%; All others: 40%
Prosthodontic, implant, orthodontic & other restorative: 50%
Annual deductible $0
For more in depth information on TDP
01 MAY 2017

21. Life Insurance TriCare SGLI MetLife $400,000 thru ETS = $29.00/ mo
$400,000 for 20 yrs = $109.99/mo
SGLI
$400,000 thru ETS =
$29.00/ mo
01 MAY 2017

22. Met Life
SGLI: $50,000/4.50 per month
No age bracket
01 MAY 2017

23. Other Companies Most Companies ask questions like
Do you smoke/chew
Your Ht/Wt
If you Sky dive, bungee jump, rock climb…
Medical issues and family history
The more you put, the more the monthly cost COULD be.
Company plans are term, meaning for 10 years you can get a $250,000 plan for $100 plus a month
01 MAY 2017

24. SGLI Premiums Eff: July 2014
Coverage Amount
Monthly premium rate
TSGLI Premium
Total Monthly Premium Deduction
400,000
$28.00
$1.00
$29.00
350,000
$24.50
$25.50
300,000
$21.00
$22.00
250,000
$17.50
$18.50
200,000
$14.00
$15.00
150,000
$10.50
$11.50
100,000
$7.00
$8.00
50,000
$3.50
$4.50
01 MAY 2017

25. Military Pay Monthly Drill Pay (E4/6yrs)
$331 for one weekend per month (4 periods)
Can cover all insurance for single, almost all for dependents
Two-week annual training is at least an extra $1100 per year after taxes

26. Cost savings between Tricare and Civilian coverage
Based off an E4 with 6 yrs earning $331 per month, 4 period drill
A single Soldier would save an average of $183 each month using these benefits. Their drill pay check will cover all this.
A married Soldier with a family would save on average $130 each month using these benefits. Their drill pay check will cover this.
*Remember, your AT pay check is not counted in the payment cost
(about $1100 per AT)
* This also does not include if you are putting into TSP
01 MAY 2017

27. Questions
25 NOV 2014