TRICARE Retired Reserve (TRR)

Army Reserve: Retired

Benefit Fact Sheet

Summary:

TRICARE Retired Reserve (TRR) is a premium-based, health plan available worldwide for purchase by qualified Retired Reserve members and their eligible Family members. TRR delivers the TRICARE Standard/Extra benefit to all covered individuals. This population of Guard and Reserve retirees is commonly referred to as "Gray-Area Retirees."

Eligibility:

Retired Army Reserve Soldiers and their Family members or survivors may qualify to purchase TRICARE Retired Reserve if they are:

  • Qualified for non-regular retirement under 10 USC, Chapter 1223
  • Under the age of 60
  • Not eligible for, or enrolled in, the Federal Employees Health Benefits (FEHB) Program

Family members of qualified Retired Reserve members 

Survivors of retired Reserve members may qualify if ALL of the following applies:

  • The sponsor was covered by TRR on the date of his or her death
  • They are immediate Family members of the deceased sponsor (Spouses cannot have remarried)
  • TRR coverage would begin before the date the deceased sponsor would have turned 60 years old.

Note: Survivor coverage is not affected by FEHB eligibility.

Retired Reservists ineligible for TRR may be eligible for TRICARE for Life

Benefit Highlights:

Enrollment: Retired Guardsmen and Reservists may purchase TRICARE Retired Reserve (TRR) to begin in any month of the year. The application form must be postmarked or received no later than the last day of the month before coverage is to begin. If a Service member/Family member loses coverage under any other TRICARE health care plan and qualifies for TRR, they may purchase TRR with no break in coverage. The application must be received no later than 30 days after the loss of other TRICARE coverage. The effective date begins on the day of loss of prior TRICARE coverage.

Survivors of TRR sponsors may continue TRR coverage until the day the sponsor would have become eligible for retiree benefits (typically age 60). If survivors do not want TRR coverage, a written letter or form DD 2896-1 must be postmarked or received no later than 60 days after the date of the sponsor's death. Premiums will be refunded if there have been no claims for health care submitted during this 60-day period.

TRR follows TRICARE Reserve Select (TRS) procedures. Coverage is similar to TRICARE Standard and TRICARE Extra and is available overseas. Cost shares, deductibles, and catastrophic caps similarly follow TRICARE Standard/Extra that apply to active duty Family members for all individuals (including the Guard/Reserve member) covered under TRR.

Monthly premiums, payments above the TRICARE-allowable charge, and payments for non-covered services are not credited toward the TRR Catastrophic Cap ($3,000 per family, per fiscal year).

Annual Outpatient Deductible: You must meet the annual outpatient deducible each fiscal year (October 1 - September 30) before cost sharing begins:

  • $150 per individual
  • $300 per Family

Cost Shares: You're responsible to pay a cost share based on the type of care and type of provider you see (network vs. non-network). Non-network providers may charge up to 15% above the TRICARE allowable charge. You are also responsible for these extra charges. 

Some inpatient cost shares are subject to change each fiscal year (FY), October 1st through September 30th each year. The costs below are effective October 1, 2013.

Type of Care

Network Provider

 Non-Network Provider

Ambulatory Care (Same Day Surgery)

20% of the negotiated rate

25% of the allowable charge

Behavioral Health

Inpatient: 20% of the total charge, plus 20% for separately billed services

Outpatient: 20% of the negotiated rate

Inpatient:

  • High Volume Hospital-25% of the hospital-specific per diem
  • Low Volume Hospital-$218 per day or 25% of the billed charges, whichever is less

Outpatient: 25% of the allowable charge

Home Health Care    

$0

$0

Hospice Care

$0

$0

Inpatient Services, such as:

  • Hospitalization
  • Skilled Nursing* 

$250 per day or 25% of billed charges, whichever is less, plus 20% for separately billed services.

$744 per day or 25% of billed charges, whichever is less, plus 25% for separately billed services.

Maternity Care

Global fee for office visits and hospitalization for delivery planned in a hospital: $250 per day or 25% of billed charges, whichever is less, plus 20% for separately billed services

Office visits for delivery planned in a birthing center, home or other setting: 20% of the negotiated rate

Global fee for office visits & hospitalization for delivery planned in a hospital: $744 per day or 25% of billed charges, whichever is less, plus 25% for separately billed services.

Office visits for delivery planned in a birthing center, home or other setting: 25% of the allowable charge

Newborn Care

The lower of the number of hospital days minus 3 multiplied by $250 or 25% of the negotiated rate, plus 20% for separately billed professional charges.

The lower of the number of hospital days minus 3 multiplied by DRG per diem copayment or 25% of billed charges, plus 25% for separately billed professional charges.

Outpatient Services (which include):

20% of the negotiated rate

25% of the allowable charge

Monthly Premiums

Type of Coverage

2014

Member Only

$390.99 per month

Member and Family

$956.65 per month

Disenrollment: Members lose TRR eligibility when the sponsor turns 60, becomes eligible for FEHB Program coverage, or fails to pay. To voluntarily disenroll, TRR members must complete the Reserve Component Health Coverage Request form and print and mail to the regional/overseas contractor - available at: http://www.tricare.mil/Forms.aspx

Additional Information:

For more information, visit the TRICARE Retired Reserve web site:  http://www.tricare.mil/Welcome/Plans/TRR.aspx

Information for Guardsmen and Reservists: http://www.tricare.mil/~/media/Files/TRICARE/Publications/BrochuresFlyers/NGR_Choices_Brochure.ashx 

TRICARE for Life: http://www.tricare.mil/Welcome/Plans/TFL

TRICARE Application: https://www.dmdc.osd.mil/appj/trs/

Document Review Date: 7 March 2014