ARLINGTON, Va. - Many of the estimated millions of Americans without health insurance are that way because they can’t afford the premiums. It’s a dilemma that Guardmembers don’t have to face because low-cost, quality health insurance is available to them.
TRICARE Reserve Select (TRS) provides a health plan option to members of the Selected Reserve and their families when they are not on active-duty status. It delivers coverage similar to TRICARE Standard and Extra to eligible members and features continuously open enrollment.
The Army Reserve’s top general calls it a "steal.” The National Guard’s Enlisted Association says "where can you get health care for your entire family for just ($180) a month?” An Ohio National Guard private calls it "untouchable.” Another Soldier said it’s "one of the many often unmentioned benefits of Guard service.”
So it’s no surprise that increasing numbers of Guardmembers are purchasing TRS, especially in these tough economic times.
"Numbers are definitely increasing, particularly among ages 18 to 34,” said Dr. Richard Bannick of TRICARE Management Activity’s Health Program Analysis and Evaluation Division in a news release earlier this year. It stated that nearly 105,000 reservists and family members currently have TRS coverage.
As of July 31, the Army Guard had 16,888 total plans (6,385 individual and 10,503 family plans) covering 43,851 people, which was up from 32,581 reported in March, said Bonnie J. Powell, deputy director of Communications and Customer Service for the TRICARE Management Activity.
The Air Guard had 6,443 plans (2,881 individual/3,562 family) on the books covering 15,534, which was up from the March number of 11,843.
Originating in 2005, Congress expanded TRS in 2006 into a three-tiered premium structure based on active-duty time served. Congress then streamlined it in 2007 by merging the three tiers into one. If that wasn’t enough, premiums were reduced in January by 44% to $47.51 for individual coverage and by 29% to $180.17 for family coverage.
Satisfied customers
Pfc. Andrew Freeman, a combat engineer with Ohio’s 216th Engineering Battalion, purchased TRS in March, because he wanted to continue his TRICARE Standard insurance he had while on active duty.
"This plan, in my opinion, is untouchable compared to any – I mean any other health care plan out there – point blank,” he said via e-mail. "I would recommend this plan to any Soldier and their family.”
Immediate maternity coverage with no waiting period was important for him and his wife, Andi.
Like Freeman, when Mississippi Guardsman Spc. Clayton Wall came off active duty in November, he purchased the TRS family plan for price and versatility.
"It was easier than rejoining my employer's plan,” said Wall via e-mail. "Also, I discovered that the premiums were competitive, and once they were reduced in January, cheaper. Since I will be going on and off active duty for training for a while, it seemed easier to use TRS rather than go on and off my employer's plan.”
Wall, who lives in Meridian, Miss., found great benefit in the maternity coverage that covered his wife’s emergency C-section that cost over $10,000. He only paid $35.
"I haven't had any trouble finding providers in the network. Of course, there is a Naval Air Station in town and several National Guard armories in the area. It has paid all our claims and I've had no trouble there.”
For Guardmembers not living near military hospitals, civilian medical facilities and providers can be used but a deductable applies. "Michelle,” a customer service rep at TRICARE West, said that when not using a military medical facility or doctor, the plan functions like TRICARE Standard, where deductibles and cost shares apply.
How does TRS compare?
At a popular online insurance comparison and sales site, the health plan topping the list for a 32-year-old living in the Midwest was $74 a month. It had a $2,000 deductable, was in a preferred provider network, with 30 percent copay and $30 office visits. Add $10 a month if you smoke. For someone 10 years older, the monthly premium goes to $120 for a nonsmoker – $142 for a smoker. TRS’s individual plan costs $47.51 a month for all ages and tobacco preferences.
In a December 2007 the Government Accounting Office report on military health care, the cost-sharing provisions of the TRS plan were compared to that of Blue Cross/Blue Shield Standard plan. The TRS deductable was $100 less and the catastrophic limit per family (the maximum out-of-pocket expense enrollees are responsible in a calendar year) was $1,000 for TRS compared to $4,000 for the BC/BS Standard. The hospital inpatient deductable or copay was at least four times greater with BC/BS.
Guardmembers can apply for TRS online athttps://www.dmdc.osd.mil/appj/trs/
For more information about TRS visit the TRICARE Web site athttp://www.tricare.mil/trs
Tricare flyer:http://www.tricare.mil/tricaresmartfiles/Prod_417/TRS_Flyer_L.pdf