TRICARE for Gray Area Retirees

| September 23, 2019

In most cases, while in the Selected Reserve, a Reservist is eligible for TRICARE Reserve Select. Once a Reservist transfers from the Ready Reserve (Troop Program Unit/Selected Reserve) to the Retired Reserve, he or she qualifies for TRICARE Retired Reserve.

Based on the TRICARE website, this is available globally, is premium-based, and is open to eligible Retired Reserve members under 60. If the member is enrolled in the Federal Employees Health Benefits (FEHB) program, he wouldn’t be able to enroll in TRICARE Retired Reserve. Family members are also eligible to enroll.

It’s also available to survivors based on specific conditions, from TRICARE:

* 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.

* Survivor coverage is not affected by FEHB eligibility.

This benefit is available until the member turns 60. If you’re in the Retired Reserve and in this category or know someone who is, TRICARE has details on qualification and application for this benefit.

Category: Retired Issues, Veteran Health Care, Veterans Issues

Comments (28)

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  1. Wilted Willy says:

    I really don’t know if I qualify for any benefits with the VA or not? I know I qualified for a VA mortgage years ago. That is the only benefit I ever got from the VA??

    • MustangCryppie says:

      I think you are.

      My brother only did about 3 years as a draftee during Vietnam. He did do 16 months in country which I don’t think matters in this case. No combat injuries or any other for that matter.

      He uses the VA on a space available basis and he is perfectly happy with it.

      Pretty sure President Bush opened up the VA to most, if not all vets. I know I was surprised when my brother told me he goes to the VA.

      I’m sure others can add much more to this.

    • Starbux says:

      As long as you left without any punitive discharge you are eligible. There is a tier system of priorities. The highest priority goes to major combat wounded vets than it goes to anyone who was injured in combat. There is recent non-injured combat veteran status for everyone who deployed to theater and that is a no questions in theory care for 5 years after separation than you put into the next category. The final tier and lowest priority are every other veteran eligible. Based on the tiers depends on the amount you will have as a copay. You can get the copays waived if you income qualify. I know some changes have occurred, but have not really looked into them. I used VA as my primary care for about four years, than switched to Tricare Reserve select which was a much better plan after my OIF/OEF plan with them expired putting me into the bottom tier.

      My take on their care at least when I relied on it, was that it depended on the state you lived in. Oddly enough there is no standardization. It seems individual facilities make their own interpretations. Some states like Nevada, in Las Vegas I thought had top notch care. They have like four satellite clinics in addition to a large new main hospital that they built about five years ago. Then I moved to New Mexico and they were so so. For one they kept billing me a copay for services even though I was under the OIF program. They would remove it every time I would call their billing department, but it was always a hassle. Until recently New Mexico only had a main hospital in Albuquerque. Now they have one sattelite clinic. They still do not offer urgent care like Vegas sort of did. Getting an appointment for anything takes almost two months. You can go to the emergency room but will wait for hours. Its gotten a little better. Now I am on the reserve plan and is much less hassle as I can pretty much go anywhere in town to be seen.

  2. Comm Center Rat says:

    I retired from the Army Reserve several years ago and was enrolled in TRICARE Retired Reserve for six months. It’s a excellent health insurance plan, but expensive (currently a $1,083.40 monthly premium for member + family coverage).

    Now as an civil service retiree I’m enrolled in the Federal Employee Health Benefit (FEHB) program and my cost is the exact same premium as when I was an active employee (about 1/3 the cost of TRICARE Retired Reserve).

    Although I already collect military retired pay I can’t wait to turn 60 and become eligible for TRICARE Select (no enrollment fee). I’m still partly in the Gray Area, but I see light at the end of the tunnel!

    • thebesig says:

      I’m a grey area retiree. Retired from the Armny Reserve with over 7,400 retirement points.

      I live very close to a VA CBOC, and the hospital is not that far away. I’m close to a highway onramp, and the VA hospital is close to an offramp. Since I’m priority group one, I don’t pay for services or prescription. They did pretty good when they removed my tonsils. Earned me an overnight stay at the VA hospital.

      I won’t get getting my military retired pay until I turn 60, but I’m fine with getting the VA compensation. Will be able to keep both once the military retired pay kicks in.

      • Comm Center Rat says:

        You’re braver than me thebesig. I don’t allow VA doctors to do any cutting on my carcass. If I require an invasive procedure I go to a regional medical center and only after vetting the physician(s) recommended by my civilian primary care provider.

        I do use a VA medical center for podiatry care, immunizations, imaging, and laboratory tests and I’m pleased with the quality of care provided.

      • C. Cook says:

        Don’t bet the farm on getting both, you can’t double dip from the va, I’m retired and 10% disabled. Can’t draw both monies, so they make my 10% tax free. Check with your va rep about it.

        • thebesig says:

          My disability percentage is among the category that allows for keeping both. You’re under 50%, you currently can’t double-dip.

          However, they’re trying to get that changed so that everybody with a disability rating would be able to keep both.

    • Skyjumper says:

      Comm Center Rat, something that the Fed retirement councilor might not tell you, is that you DO NOT have to drop your FEHB coverage when you retire and go on TRICARE. Normally if you drop your FEHB coverage, you can never pick it back up.

      You can put your FEHB coverage (I had BCBS) into suspension and if you ever change your mind, you can get back in during Open Season.

      If you have any questions about this, contact a TRICARE Beneficiary Counseling Assistance Coordinator at a military base near you. The one base (National Guard)near me helped me out.

      I have had bladder cancer three times since I turned 65 (now 71 and going strong ;)). ALL exams and surgeries, etc. have been totally covered by Medicare & TRICARE For Life without me having not being charged a penny.

      Also, Hondo could not have been any more righterer (grin) by his statement below. I encourage ALL vets to get registered with the VA system. You will be assigned to one of eight priority groups. Even though you might not be able to get any benefits because of your income being too high, when you retire, most vets will be eligible at that time because of your income being lower. Some of the benefits that effect most older vets that are available at little to no cost are eye glasses, hearing aides, lower drug costs (some free if military service injury connected), etc.

      https://www.va.gov/health-care/eligibility/priority-groups/

      https://www.tricare4u.com/wps/portal/tdb/tricare4u/benefits/benefits/!ut/p/z1/jZDLDoJADEW_hi0tGHB0N4oy4PuB4GwMGhxIgDGA8vsSdWOiaHdtzmnTCxwC4Hl4S0RYJTIP06bfc_Og2-gwRG2yGK8tpPpco4vBjlmOAf47gDZiAwxH5nY161hEB_6Pj1-K4n9-C8Db1_vAH8iSMZNpBKcEbYLUNIyJM-zpG7f7Atpe_HXEBS5SeXzmSfNjhwjgRXSOiqhQr0UzjqvqUvYVVLCua1VIKdJIPclMwU9KLMsKgncSLpnnBZgsM5-Ud9-x3uQ!/dz/d5/L2dBISEvZ0FBIS9nQSEh/

      • Comm Center Rat says:

        Thanks for your advice and the TRICARE link Skyjumper! I was not aware of the option to put my FEHB into “suspension” when eligible for TRICARE coverage. When I retired from the federal government (VA) I was a “remote” work-from-home employee and never received retirement counseling services. I always appreciate the tips and guidance provided by the TAH network.

  3. 5th/77th FA says:

    I’m kinda up there with my man WW. My brother that retired after 27 & 1/2 yrs being wing wiper has pushed me to go see the VA and sign up. Hadn’t done it, covered by BCBS thru the Company and now signed up on Medicare. Trying not to use up resources that could be used for a Vet that is more qualified/deserving/in need of help than me.

    • Wilted Willy says:

      I agree FA, I am lucky enough to get my full medical taken care of by my retirement from AT&T after 30 years. So I really don’t need anything from the VA? I just wonder if I am missing out on anything?
      Thanks,
      Willy

      • Mason says:

        I’d encourage both to go. Never know what you might need down the road. I talked my dad into it. Luckily I did, because he lost his union job about the same time and was having major medical issues that necessitated his early retirement (with no medical plan). Now the only thing they don’t do for him is dental.

        Don’t think of it as taking treatment options away from more deserving people. Think of it as taking them away from people like WW’s brother. The massive VA bureaucracy (second largest government agency after DoD) needs something to do. When it can’t find qualified vets it invents them, or facilitates the phony’s inventing claims.

        Now one of these days I’ll actually follow my own advice…

      • Hondo says:

        WW: if you ever served in Vietnam, IMO you should get registered with the VA system. Numerous health care conditions are “presumptive” due to potential Agent Orange exposure for anyone who ever set foot in-country in Vietnam – including several types of cancers.

        It’s not unheard of for commercial firms to “change the rules” for retiree medical care coverage when funds get tight (e.g., impose premiums or raise dramatically existing premiums). Having the VA as a backup – particularly if you end up with (or have) one of the cancers that are presumptive for AO exposure and you served in Vietnam – might be a decent fallback option in that case.

      • Comm Center Rat says:

        Willy the only thing you’re missing out on is the free entertainment at a VA Medical Center or outpatient clinic waiting area. There you’ll witness a parade of veterans in military and patriotic themed hats, t-shirts, and leather vests regaling one another with the severity of their many ailments. Occasionally, an impatient vet will act the fool and be escorted from the premises kicking, screaming, and threatening to bring harm to VA personnel. If you have some time to kill and want to see some Oscar worthy acting performances I highly recommend you visit a VA medical facility and enjoy the spectacle.

        • Wilted Willy says:

          Amen CCR, I love to people watch, it is better than going to the movies! People of Walmart is one of my favorite websites. I would really suggest a visit! It is hours worth of fun!!

      • Ex-PH2 says:

        So far, I have only seen AD people in uniform and a few old fogies like me, but not wearing and “I’MAVIETVET”or other bling, at my local VA FHCC. Might be due to the fact that it also serves a Navy base.

        But I agree, Willy: get yourself enrolled in VA healthcare, as a ‘just in case’ thing. You can get your flu shot (basic vaxx) for free at Walgreen’s, if you don’t want to travel to the FHCC, and it’s just a backup plan in case the other stuff you have goes south.

        • thebesig says:

          Folks wore their ballcaps showing the campaign they were in or their service. Out of all of those wearing ballcaps, I was the only one wearing a “Keep America Great” hat. The others were military-themed.

  4. Duane says:

    I think there’s a HUGE misunderstanding on what Tricare is versus VA care. I’m a gray area vet (for another 11 months anyhow), and once I can make the switch we will be looking at Tricare since it will save us close to $4K in premiums over what my FEHB coverage is running. I’m also under VA care since I have some permanent damage to my knees and feet after 30 years of service, so this gives me several different options. With Tricare you can (normally) still see your regular Doctors and labs – not the VA. For us, paying a once a year fee for dues to Tricare will be far, far easier on the bank account than the monthly FEHB dues, and will give us exactly the same coverage. The other benefit for us is that once I hit 65 I can go Tricare for life and not pay anything, saving us even better, yet still allowing us the options of who we see for care.

    • ninja says:

      “The other benefit for us is that once I hit 65 I can go Tricare for life and not pay anything”.

      I mat be wrong, but I think once you hit 65, you have to pay for Medicare based on your income/tax returns. TRICARE For Life is Secondary.

      • 5th/77th FA says:

        ninja, Medicare is charging me based on what I earned by tax returns for FY 2017. They also penalized me because I didn’t sign up when I was 65. Didn’t know I was supposed to, was still working, and paying for BCBS. Was informed that come this Nov, they will adjust that to FY 2018 earnings and so on down the line. Until I come off the payroll for good in Nov I’m having to pay for both AND they are taking Medicare payments out of the SS check and my payroll check. Nobody at the Company or SS/Medicare can explain either how it actually works.

        As screwed up as everything the gubmint touches gets, whyinhell do the demon rats/progressives or whatever the hell they want to call their socialistics selves these days want to put the entire system of healthcare into gubmint hands.

        • ninja says:

          Thank You for the feedback, 5th.

          Just as I thought. When one hits 65, one has to pay for Medicare and the monthly preminums are based on Income Tax returns.

          There is no charge for TRICARE FOR LIFE. It is Secondary Health Insurance to Medicare.

          I may be wrong on this one, but I think once an individual starts drawing SSN, those Medicare preminums are taken out of one’s SSN Monthly payments.

          Pocahautus has yet to answer as to who will foot the bill for Universal Health Care. At least Sanders was honest on the cost as well as who would pay the bill.

          And because of their beliefs, I will be voting for the Trumpster. Again.

          Thank You again, 5th.

          😊👍

      • Comm Center Rat says:

        As usual ninja, you are correct sir! You must pay Medicare Part B premiums to be eligible for Tricare For Life (TFL). In the US and US Territories, TFL is the secondary insurer after Medicare however, overseas TFL is the primary insurer.

        • ninja says:

          Thank You, CCR!

          Back to Duane:

          So I guess, Duane, that in reality, you may end up paying paying MORE for health care preminums when you turn 65, especially if you are already paying a yearly preminum for TRICARE, that is, if you have TRICARE Prime.

          You WILL have to pay something when you turn 65.

  5. When I retired in 2007 at age 62, I was in cobra and had 18 months medical coverage before it would run out so I applied for va coverage but was informed that since I didn’t serve in Viet-Nam, I was not eligible for va medical coverage because then potus bush cut some of the va funding. A Korean War Coast Guard Vet whom was one of our condo residents told me that I was full of beans about the cuts and after one of his visits up to the Rivera Beach Fl. va, he then tells me that I was right after inquiring about it at the va. Am happy with my “B” secondary United Health care supplement F plan. One thing to add. When I got out of active duty, I could have used the va, but I had nice health insurance where I worked and the va at the time was open to most of the Vets. This was back in 1966.

  6. Top W Kone says:

    I know a lot of Reserve guys who would get out now (they have their 20 year letter), but stay in for the tricare reserve select ($300ish a month)

    If they would let the gray area retired keep the reserve select price a big chunk of senior NCO’s and mid level officers would get out and make room for others

  7. Steve says:

    I am 53 with 26 yrs and being non retained in December. I have been hanging on and staying in mainly because of TRS insurance for my family. The cost is $230 a month and is awesome insurance. Looked into the retired reserve Tricare and the monthly cost goes up to over 1200/mo. We can’t afford that increase. I will be loosing my monthly military pay plus adding the higher insurance premium on each month. Retirement will cost me approximately 1500/mo over the next 7 years until I reach age 60. Not sure that is fair after all the sacrifices away from family and years of service I gave our Country.
    I would love to see a change with this..
    Thay should allow all retired reservists that retires with a good 20 years on record continue to get Tricare Reserve Salect at the normal active rates until we reach age 60.
    Extremely unfair the way it is set up now for everything we have done for our Country.