TRICARE Retired Reserve (TRR)

Army Reserve: Retired

Benefit Fact Sheet

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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." If purchased, TRICARE Retired Reserve is minimum essential coverage under the Affordable Care Act.

Beginning in January 2016, DFAS will provide IRS Form 1095-C to all U.S. military members, and IRS Form 1095-B to all Retirees, Annuitants, former Spouses and all other individuals having TRICARE coverage during all or any portion of tax year 2015. An IRS Form 1095 documents you (and your Family members, if applicable) have the minimum essential coverage. These forms will document the information that DFAS will provide to the IRS on yourself and your authorized Family members. The forms will be required to be reported with your 2015 federal tax return. DFAS will provide you with IRS Form 1095 series forms no later than 31 January 2016. 

Eligibility:

Retired Army Reserve Soldiers and their Family members or survivors may qualify to purchase TRICARE Retired Reserve (TRR):

  • Retired Reserve members who are:
    • Members of the retired Reserve of a Reserve Component who are qualified for non-regular retirement under 10 U.S.C., Chapter 1223
    • Under age 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 if:
    • The sponsor was covered by TRICARE Retired Reserve when he or she died.
    • They are immediate Family members of the deceased sponsor (Spouses cannot have remarried).
    • TRICARE Retired Reserve 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.

Purchasing TRICARE Retired Reserve is a two-step process that you must complete online.

Step 1: Qualify

  1. Log on to the DMDC Reserve Component Purchased TRICARE Application
  2. Select "Purchase Coverage" and follow the instructions.
  3. Print and sign the completed Reserve Component Health Coverage Request Form (DD Form 2896-1).

You must have a Common Access Card (CAC), DFAS (MyPay) Account, or a DoD Self-Service Logon (DS Logon) Premium (Level 2) account to log in.

If you don't qualify, you won't be able to complete or print the form.

Step 2: Purchase

You may purchase the plan at any time throughout the year. Mail or fax your completed Reserve Component Health Coverage Request Form (DD Form 2896-1) along with the initial payment of two month premiums to initiate coverage to your regional contractor within the specified deadline.

Regional Contractor addresses and fax numbers can be found here.

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 are 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, 2015.

Type of Care

Network Provider

 Non-Network Provider

Ambulance Services

20% of the negotiated rate

25% of the allowable charge

Ambulatory Care (Same Day)

20% of negotiated fee

25% of the allowable charge

Behavioral Health (Inpatient)

20% of the total charge plus 20% for separately billed services

  • High-volume Hospitals: 25% hospital specific per diem, plus 25% for separately billed services
  • Low-volume Hospitals: $229 per day or 25% of the billed charges, whichever is less, plus 25% for separately billed services
  • Residential Treatment Center: 25% of the allowed amount
  • Partial Hospitalization: 25% of the allowed amount, plus 25% of the allowable charge for separately billed professional services
  •  

    Behavioral Health (Outpatient)

    20% of negotiated fee

    25% of the allowable charge

    Clinical Preventive Services

    $0 for colorectal, breast, cervical and prostate cancer screenings; immunizations; and well-Child visits for Children under age 6.

    For all other preventive services: 20% of negotiated fee

    $0 for colorectal, breast, cervical and prostate cancer screenings; immunizations; and well-Child visits for Children under age 6.

    For all other preventive services: 25% of allowable charge

    DME, Prosthetic Devices, Medical Supplies

    20% of negotiated fee

    25% of the allowable charge

    Emergency Services

    20% of negotiated fee

    25% of the allowable charge

    Home Health Care    

    $0

    $0

    Hospice Care

    $0

    $0

    Hospitalization (Inpatient Care)

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

    $810 per day or 25% for institutional services, whichever is less, plus 25% for separately billed professional charges

    Immunizations

    $0

    $0

    Laboratory and X-ray

    20% of negotiated fee

    25% of the allowable charge

    Maternity (office visits and hospitalization for delivery planned in a hospital in an inpatient setting)

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

    Note: This is one global fee for all of the maternity care and delivery.

    $810 per day or 25% for institutional services, whichever is less, plus 25% for separately billed professional charges

    Note: This is one global fee for all of the maternity care and delivery.

    Maternity (office visits for delivery planning in a TRICARE-authorized birthing center)

    20% of negotiated fee

    25% of the allowable charge

    Maternity (office visits for delivery planned at home or other setting)

    20% of negotiated fee

    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 for institutional services, plus 20% for separately billed professional charges

    The lower of the number of hospital days minus 3 multiplied by $810 or 25% of billed charges for institutional services, plus 25% for separately billed professional charge

    Outpatient Visit

    20% of negotiated fee

    25% of the allowable charge

    Skilled Nursing (Inpatient)

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

    25% for institutional services, plus 25% cost share for separately billed professional charges


    Monthly Premiums

    Type of Coverage

    2016

    Member Only

    $388.79 per month

    Member and Family

    $957.44 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/Resources/Forms/Disenrollment.aspx

    A 12-month purchase lockout will apply, which means you will not be able to purchase TRICARE Retired Reserve again for up to one year. Certain events could cause you to be involuntarily disenrolled. http://www.tricare.mil/Plans/Enroll/TRR/EndingCoverage.aspx

    Additional Information:

    For more information, visit the TRICARE Retired Reserve web site: 
    http://www.tricare.mil/trr

    TRICARE Retired Reserve Enrollment page
    http://www.tricare.mil/Plans/Enroll/TRR.aspx

    TRICARE Retired Reserve Cost Shares
    http://www.tricare.mil/Costs/HealthPlanCosts/TSE/RET.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/tfl

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

    Document Review Date: 30 March 2016