Reservists are covered by TRICARE, the military health-care system, when mobilized but otherwise must find their own health-care coverage. This diminishes the readiness of a force that is relied on to support critical missions around the world.
When does TRICARE kick in?
When in inactive or drilling status, reservists are not entitled to the same TRICARE coverage as their active-duty counterparts. They may be eligible to purchase coverage in TRICARE Reserve Select, a premium-based health plan, but most elect to enroll in plans provided through their civilian employers.
When reservists are called or ordered to active duty for more than 30 days in a row, however, they are eligible for the same health-care benefits through TRICARE as any active-duty service member. The type of orders a reservist is activated on determines the start and end date of coverage.
Reservists mobilized in support of a contingency operation are covered under TRICARE for the duration of their orders, and if they serve for more than 30 days, they are covered for an additional 180 days after their orders end through the Transition Assistance Management Program. Coverage could be longer with delayed-effective orders, with reservists eligible for benefits up to 180 days before the first day of their orders.
For activations not in support of a contingency operation, coverage begins and ends on the first and last date listed on the orders.1 When TRICARE coverage ends, members may purchase TRICARE Reserve Select or return to a civilian health-care plan.
Difficult Decisions
In its 2015 report, the Military Compensation and Retirement Modernization Commission found reservists face difficult decisions regarding their health care during mobilization and demobilization.2 An activated service member will always be covered but must decide what is the best course of action for his or her dependents.
TRICARE coverage can offer a financial benefit, since the family can move off a civilian plan and avoid those monthly payments. However, transitioning from civilian, to military, and back to civilian health-care coverage can be frustrating and can lead to gaps in coverage. Depending on the length of activation orders, some families do not bother moving to TRICARE.
Financial considerations aside, dependents comfortable navigating health-care choices under their own insurance plan may find it difficult to adjust to TRICARE and may have to switch providers. Since reservists are geographically dispersed, a spouse may not have easy access to on-base resources or guidance from other spouses. More than a third of reservists surveyed by the Government Accountability Office reported a problem understanding their benefits while transitioning into TRICARE for a deployment.3
For the reservist, medical care is split between military treatment facilities and civilian medical providers. Records are kept in both worlds, and it takes a concerted effort to ensure test results and other medical information is cross-pollinated. Continuity of medical care is difficult to achieve.
Possible Solutions
One solution to ensure continuity of care for reservists is to afford them the same health-care coverage as their active-duty counterparts. Reservists are a military asset and a force multiplier; for commands to realize their full capability, they must always be medically ready. This includes knowing that their families can access medical services while they are away. This would involve a large financial investment by the government, but the benefit could be available only after a reservist’s first contract is completed, so the government knows the service member is open to a long-term commitment.
Another option is to reimburse reservists for premiums and copays for their civilian health-care plan while they are activated. This would allow families to continue receiving the care they are accustomed to. It also would relieve the administrative costs of reservists constantly enrolling and unenrolling in TRICARE.
Health care is both a recruiting and retention tool. Mobilizations can be a stressful time; reservists and their families should not also have to worry about navigating the health-care system.
1. TRICARE, “Activation/Deactivation Coverage Scenarios,” www.tricare.mil/Plans/Eligibility/NGRMandFamilies/CoverageScenarios.
2. Military Compensation and Retirement Modernization Commission, Final Report of the Military Compensation and Retirement Modernization Commission (Washington, DC: 2015).
3. Government Accountability Office, Most Reservists Have Civilian Health Coverage but More Assistance Is Needed When TRICARE Is Used (Washington, DC: September 2002).
