TRICARE Reserve Component Eligibility

1. TRICAREReserve Component Eligibility TRICARE Regional Office-South Information Brief Carmen DeLeon-Dingman BSN, RN Nurse Consultant-Case Management/Special Needs

2. TRICAREReserve Component Eligibility U.S. Uniformed Services Reserve Components are: Army National Guard Army Reserve Naval Reserve Marine Corps Reserve Air National Guard Air Force Reserve Coast Guard Reserve When activated on federal orders for more than 30 consecutive days, Reserve Component Members (RC Members) have the same health care benefits as Active Duty Service Members Reservist on “Delayed-Effective-Date Activation Orders” may qualify for active duty health benefits for up to 90 days before, if in support of a contingency operation like OIF/OEF. Contact Unit for when eligibility begins.

3. Reserve Component Eligibility • TRICARE eligibility is determined by the Uniformed Services and recorded in the Defense Enrollment Eligibility Reporting System (DEERS) DEERS records will indicate the dates of eligibility • Activated RC members will automatically be enrolled in TRICARE Prime • Family members are eligible for TRICARE health coverage and it is the sponsors responsibility to ensure family members are registered in DEERS • Once eligible family members are registered in DEERS they are immediately eligible for TRICARE Standard and TRICARE Extra options. If they choose TRICARE Prime options they will need to enroll.

4. Reserve Component Eligibility • To enroll in TRICARE, RC members must be in DEERS and must submit a completed enrollment form along with payment of any fees if applicable • Dependant on when the RC members enrollment form is received will determine when TRICARE coverage will begin for the family members • Applications received prior to the 20th of the month will begin coverage on the 1st of the following month • Enrollment forms are available at the TRICARE Service Centers (TSC) or online at www.tricare.mil/enrollment/index.cfm • Completed enrollment forms should be returned to the Regional contractor for processing

5. Additional benefits • RC members are eligible for all TRICARE covered benefits Extended Care Health Option (ECHO) ECHO Home Health Care Autism Demonstration Project EHHC Respite Care ECHO Respite Care • To be enrolled in ECHO, RC members must be enrolled in Exceptional Family Members Program (EFMP) per service guidelines • EFMP is a mandatory enrollment program for active duty (AD) personnel who have a special needs family member • Documentation will be needed to ensure the AD Sponsor is in EFMP through their branch of service Contact the Managed Care Support Contractor (MCSC)for more information

6. Additional benefits Retroactive Enrollment will be considered for emergency cases that should be placed under immediate case management, MTF Commanders (for Prime service area residents) and the Regional Directors ( for non-Prime service area residents) may approve exceptions on a case by case basis for retroactive enrollment with an effective date not earlier that the 1st day of the month the application for enrollment in TRICARE was submitted Contact the MCSC for more information

7. Additional benefits Transitional Assistance Management Program (TAMP) - Provides transitional health care coverage for certain uniformed service members who separate from active duty - Each branch of service determines eligibility for TAMP - RC members need to verify their eligibility for TAMP benefits for themselves and their family members by contacting their nearest personnel office or ID card issuing facility - RC members need to make sure that the contingency operation they supported is correctly coded in DEERS - If Service member is eligible for TAMP coverage can be up to 180 days after the their active duty coverage benefit ends -TAMP coverage is TRICARE Standard/Extra by default - Service members and their family will need to re-enroll in TRICARE Prime if they wish to continue Prime coverage during TAMP - Under TAMP, family members are not eligible for coverage under TRICARE Prime Remote

8. POC Carmen DeLeon-Dingman BSN, RN Nurse Consultant-Case Management/Special Needs TRICARE Regional Office-South 210-292-3205 DSN 554 www.carmen.deleon-dingman@tros.tma.osd.mil

9. TRICAREReserve ComponentTelephone Confernce TRICARE Survivor Benefits

10. OVERVIEW • Active Duty Survivor Benefits • Survivor Benefits under Transitional Assistance Management Program • TRS Survivor Benefits • TRICARE Dental Program Survivor Benefits • TRICARE Retiree Survivor Benefits 10

11. Active Duty Survivor Benefits Sponsor dies while serving 30 days or more. Including sponsors who die while on delayed effective date active duty orders. Un-remarried spouse remains eligible as active duty family member for three years following death (transitional status). After three years the status reverts to retiree status. Children remain TRICARE eligible as active duty family members until they age out unless they marry or join the military first. NOTE: Surviving family members of Reserve Component sponsors who die while serving on active duty for 30 days or less, on active or inactive duty training, or traveling to/from training become eligible for TRICARE retiree benefits. 11

12. Survivor Benefits under Transitional Assistance Management Program If covered by TAMP when the sponsor died, surviving family members remain covered until the end of the 180-day TAMP period. 12

13. TRICARE Reserve SelectSurvivor Benefits 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: One family member—Member-only premium amounts Two or more family members—Member-and-family premium amounts

14. TRICARE Dental ProgramSurvivor Benefits Applies to family members of the Selected Reserve and IRR (special mobilization only) regardless if the sponsor was on active duty or not • Available to currently enrolled in TDP as well as previously enrolled surviving family members • The enrolled family members will continue to receive benefits for three years from the month of sponsor’s death • Automatically disenrolled from TDP and re-enrolled in TDP Survivor Benefit Plan • Government pays 100% of TDP Survivor Benefit premium for three years • After three years eligible for TRICARE Retiree Dental Program.

15. TRICARE Retiree Survivor Benefits • If your retired National Guard or Reserve sponsor dies after becoming eligible for TRICARE (attained age 60 and is drawing retired pay), then TRICARE continues to provide coverage for surviving family members. • Un-remarried widowed spouses remain eligible for TRICARE unless they remarry. • Unmarried children (biological or adopted) remain eligible up to the normal age limits. NOTE: If retired sponsor dies prior to age 60 eligible family members become TRICARE eligible as survivors on the day the member would have turned 60.