Military Healthcare for Reserve IA Sailors and Families
Military healthcare can be an intimidating topic, especially for Reserve Component (RC) families coming from civillian healthcare or for any family that is relocating during the IA Sailor's mobilization to an area where the usual TRICARE services are unavailable. This page provides the need-to-know info for military families, covering three main topics:
- Available plans (when the IA Sailor is ordered to Active Duty (AD) for 30 or more days)
- Pre-activation early eligibility for TRICARE
- TRICARE after mobilization and deactivation
When Activated for more than 30 consecutive days
When the service member is activated (called or ordered to AD for more than 30 consecutive days under federal orders) the service member becomes eligible for the same health and dental benefits as active duty service members. The service member will enroll in one of the following Prime options upon arrival at the final duty station:
If the service member is enrolled in the TRICARE Dental Program when called to AD, the coverage is automatically terminated. The service member is now covered by active duty dental benefits and receives dental care at military dental treatment facilities and through the TRICARE Active Duty Dental Program.
The service member’s family becomes eligible for the same TRICARE benefits as active duty family members when the service member is on active duty for more than 30 consecutive days. The family can use any of the following plans depending on where they live when the service member is activated.
If the service member’s family is enrolled in the TRICARE Dental Program
, their coverage continues uninterrupted and their premiums are reduced to the "active duty family member" rates. If not already enrolled, they can enroll in the TRICARE Dental Program at any time.
Pre-Activation or "Early" Eligibility
If the service member is issued delayed-effective-date active duty orders for more than 30 consecutive days in support of a contingency operation, Guard and Reserve members may qualify up to 180 days early for active duty TRICARE benefits. This "pre-activation benefit" begins on the date the orders are issued, but not earlier than 180 days before reporting to active duty.
This early eligibility program is totally dependent on the RCs and the service member’s personnel units updating the Defense Enrollment Eligibility Reporting System (DEERS) with this delayed effective date order information.
Family members of RC member’s eligible for early coverage, who are eligible in DEERS, are also qualified for this program. Family members have the option to enroll in TRICARE Prime during this period. The RC member will not enroll in TRICARE until they reach their final deployment location. In this early eligibility period RC members' medical care will be taken care of by a Military Treatment Facility (MTF) (per BUMEDINST 1300.3A), if the member resides within 50 miles of a Military Installation. If the member resides more than 1 hour from an MTF, care must be sought from TRICARE Network Providers (if Available). To find a list of Network Providers in your area contact your regional Managed Care Support Contractors: South 1-800-444-5445, North 1-877-874-2273, West 1-888-874-9378.
Service members identified as eligible for the early benefit are not eligible for the Reserve Dental program, managed by United Concordia. In this early eligibility period RC service members’ dental care is treated the same as active duty dental care. If the member resides less than 50 miles from a Dental Treatment Facility (DTF) the service member must contact that DTF. If the service member resides more than 50 miles from a DTF the service member must contact United Concordia prior to visiting the dentist for an authorization 866-984-2337 to ensure there are not out-of pocket costs.
When the service member leaves active duty, or deactivates, the family’s health plan options may be different if the service member was called to active duty in support of a contingency operation. If activated in support of a contingency operation:
- Sponsor is immediately covered by the Transitional Assistance Management Program (TAMP) for 180-days. TAMP coverage begins on the first day after leaving active duty service. Family members are also covered during the TAMP period.
- After TAMP ends, service members may qualify to purchase TRICARE Reserve Select for personal and family coverage.
- If service members don't qualify for TRICARE Reserve Select, another option is to purchase the Continued Health Care Benefit Program.
- Service members continue to be covered under active duty dental benefits during TAMP. After TAMP ends, TRICARE Dental Program coverage will automatically resume (if previously enrolled) and monthly premiums resume until the 12-month minimum enrollment period is reached.
- If the service member’s family is enrolled in the TRICARE Dental Program, their coverage continues uninterrupted, however their premium payments will revert back to their original rates.
If the service member was not activated in support of a contingency operation, the family does not qualify for TAMP and active duty benefits (including dental) end immediately.