Thirty years ago, Congress decided the nation could no longer afford to offer military volunteers a robust draft-era GI Bill, so it concocted VEAP, the most unpopular veterans’ education benefit of the last century.
Last year, Congress decided the nation couldn’t afford to open active-duty Tricare benefits to all drilling reservists, so it created Tricare Reserve Select (TRS). Time will tell if TRS is the reserve health care equivalent of VEAP, but advocates for reservists and families fear it might be.
Certainly some reservists among the estimated 20 percent who lacked health care coverage before mobilization will see TRS as a welcome option. Many more eligibles could find it to be too expensive, too restrictive and too complex.
“I don’t think many will” sign up, said Joyce Wessel Raezer, director of government relations for the National Military Family Association. “We will all know better once we see the premiums [in late March]. But a lot of people will ask about it. A lot will get bogged down in the process and never make it through. And then some folks will sign up for it under the impression that it’s the same as Tricare Prime, and be very unhappy.”
Officials tasked with launching TRS share some of those worries.
“We veteran Tricare experts consider this to be, technically, one of the most complex benefits that we’ve ever rolled out,” said Dr. Jody Donehoo, project manager for implementing new reserve health initiatives for the Tricare Management Activity in Falls Church, Va. He and colleagues explained details of TRS to military health care administrators attending the 2005 Tricare conference in Washington in late January.
When TRS begins April 26, thousands of Reserve and National Guard members previously deactivated from post-9/11 deployments, and thousands more soon to complete deployments, will gain access to a scaled-down version of Tricare Standard, the fee-for-service insurance plan.
To qualify, they must have been mobilized under contingency orders of 30 days or longer and have served at least 90 days’ continuous active service. For every 90 days served, they will be eligible for a year of TRS. So a year’s continuous deployment could qualify them for four years of TRS coverage, for members and their families.
Coverage comes at a cost, however. Members must make a binding agreement to remain in the Selected Reserve for the duration of TRS coverage. They also will pay monthly premiums, with rates to be announced, that will cover 28 percent of TRS costs. The Congressional Budget Office last year estimated member-only premiums at $50 a month and family at $183.
If a reservist stopped payment, perhaps because of new health benefits offered by a civilian employer, TRS coverage would end but the extended service obligation would stand.
TRS users also will pay the usual Tricare Standard fees, co-payments and annual deductibles. They will not be eligible for Tricare Prime, the military managed-care program, or have access to military treatment facilities or base pharmacies. They will be eligible to get discounted drugs through mail order and Tricare’s network of commercial pharmacies.
TRS also won’t include many “extras” of Tricare Standard, such as the Program for Persons with Disabilities, which provides financial help for families impacted by mental retardation or a serious physical disability.
Congress seemed ready to enact a more generous plan last year, making permanent a temporary program to open Tricare to any drilling reservist who lacked employer-provided health insurance. But as lawmakers shaped a final plan, the Bush administration urged lawmakers to shape any extended health benefit for drilling reservists in a way that assists wartime retention. This accounts for the complexity and rigid deadlines.
Reservists must decide to enroll in TRS before leaving active duty, which likely will mean making quick decisions at de-mobilization sites. If they depart without a “preliminary” TRS agreement, eligibility expires.
Most deployed reservists and families are eligible for Tricare for six months after mobilization. Congress made that temporary postmobilization benefit permanent last year. TRS coverage will start after transition coverage, so on the 181st day after leaving active service.
By then, TRS applicants must have a final TRS agreement with their services, which would involve finding a Selected Reserve unit that needs the reservist for the duration of TRS coverage. If a four-year contract is sought, but the service can guarantee only two years in drill status, the TRS final agreement must be reduced to two years.
Raezer described the sign-up process as “Byzantine.”
“It’s ‘Do this here — and this here — at this time.’ All these little steps. And the personnel system has to work with the health care system or the whole thing falls apart.”
Her big fear, she said, is that spouses who only recently became familiar with Tricare Prime, and reservists who still aren’t familiar, will mistake TRS for the more prized program. That would be a big error considering the higher cost and service commitment.
Confusion should be less of a problem for reservists demobilized before April 26. They will have until Oct. 28 to study TRS and sign up.
Michael Elliott, a Tricare public affairs specialist, said communicating all the details, deadlines and consequences of TRS enrollment will be a big challenge. But a plan is in place, he said, that includes a mass mailing, a TRS Web site with application form, a toll free number and more.
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