Wednesday, December 9, 2009

Update: Possible Postponement of TRICARE Access for Gray Area Retirees

By CAPT Marshall Hanson, USNR (Ret)
Director of Legislation and Naval Services

Last week ROA met with representatives from the TRICARE Management Activity, where the Association and other organizations were briefed on the implementation of TRICARE Standard for Gray Area retirees. This was in response to a request by ROA, and a follow-up to an article published in Military Times, where ROA was quoted on its disappointment about a proposed DoD time schedule announced by DoD Health Affairs that would have implementation complete in 11 to 18 months.

The briefing shared that the new benefit should not be referred to as TRICARE Reserve Select (TRS) for Gray Area Retirees, as TRS is viewed as a separate program. This new benefit will be given a new name, and is viewed as a major implementation process, because it affects many different aspects of the military health program and military data collection such as Defense Enrollment Eligibility Reporting System (DEERS). Reassurances were made that the timetable is not linked to the new TRICARE contracts that will begin in about a year, and that the implementation team is being proactive. A draft of the interim federal rules have already been completed, and will be reviewed by the leadership of the various offices being affected by this new program.

The legislative language enacting TRICARE Standard for Gray Area retirees said "that the monthly amount of the premium ...shall be the amount equal to the cost of coverage that the Secretary determines on an appropriate actuarial basis." A number of sources, including the briefing, have indicated that the gray area population is a higher health risk, and the premiums will likely be higher than the estimates published by ROA earlier. The current premiums for drilling Reservists are $47.51 for individuals and $180.17 for families. ROA was warned that at a minimum the Gray Area premiums will be at least 4 times that amount. The drilling premiums could also be increased by DoD in January as is allowed by the original law.

ROA continues to voice its concern over the delays in implementation and feels that actuarial adjustments for an older group are not what was intended. This group doesn't have a lot of the health care costs that younger serving members do who are just starting their families. One of the intentions of including the gray area into the TRICARE system was to take advantage of the group risk pool reduction to save premium costs. National Guard and Reserve retirees should not be paying extra to cover DoD health care costs, when the Pentagon has yet to analyze where its health care money is being spent.

ROA has also voiced the concern to members of The Military Coalition and the National Military and Veterans Alliance that if one group is allowed by Congress to be targeted for higher TRICARE premiums, the other active retirees groups will be targeted for TRICARE fee increases as well.


Anonymous said...


Anonymous said...

So, let me get this straight. Congress is working overtime right now to provide universal health care to everyone, but they can't even get a much simpler health care plan like this off the ground for military who served at least 20 years? And, it's going to take a year (or more) to program and cost over $700 a month for a family? What a joke - - why bother?

Anonymous said...

I'm surprised but then again, the average cost of health care insurance for those who dont have employer's footing the bill is very high usually. This is probably meant as a possible alternative for those who dont have other insurance or cant get other insurance. I imagine the vast majority of us have other jobs and other insurance.

Anonymous said...

With more than a year to go before turning 60 and becoming retired with pay, and being unemployed for the first time in 25 years with no unemployment insurance benefits, I need reasonably priced ($50 or less per month) health insurance now, today, without waiting days, weeks or months for bureaucrats to write regulations, guess at how risky our health is as a group (my opinion is that I and many others in our group are relatively healthy and probably lower-risk than the statistically "average" american), and put our names on the list of covered persons as soon as we sign up online or in response to a mailer. Our information is in DEERS, so all they have to do is download our data to the Tricare contractor's computer system, if it is not already on their system. There are thousands of us that are eligible since the passage of the legislation, and we are being denied equal protection and equal treatment under the law. Some may have other coverage available at a reasonable cost, but some may be paying high rates for COBRA plans or individual health plans, and some have no coverage or they can't afford their coverage without undue hardship. The law is on the books, and there are no legitimate excuses. Delay means more financial hardship and mental anquish, more illness that will go untreated, more deaths from illness and suicide that could have been avoided. I pose the question to DOD today: What is your answer? We don't need more excuses and delays. If DOD continues to deny gray area retirees equal protection of the law, law suits may be required to force the issue and the cost of attorney fees, compensation to those whose illnesses were aggravated or lives that were lost will far exceed the normal costs of providing the health insurance benefit.

Anonymous said...

I agree DOD needs to get this done asap. That said, regardless of the price, one advantage will be portability so you are not dependent on an employer. Concerning price, a reasonable price based on group size etc would be $325 single, $470 husband & wife, and $680 family with very low deductbles and reasonable copays. $50 per month is not realistic.

Anonymous said...

I will bet that two years after this program is implemented there will be less than 1500 Retired Reserve Sponsors sign up for this premium based healthcare program. Any takers?

Anonymous said...

TRICARE Program for Gray Area Reservists On Its Way

December 17, 2009
No. 09-76

FALLS CHURCH, Va. - A new program will offer “gray area” reservists the opportunity to purchase TRICARE health care coverage.

While qualified members of the Selected Reserve may purchase premium-based coverage under TRICARE Reserve Select (TRS), retired National Guard and Reserve personnel did not have TRICARE health coverage options until they reached age 60.

Under a provision of the National Defense Authorization Act for 2010, that’s all changed.

The new provision will allow certain members of the Retired Reserve who are not yet age 60 (“gray-area” retirees), to purchase TRICARE Standard (and Extra) coverage. TRICARE Extra simply means beneficiaries have lower out of pocket costs if they use a network provider.

“We’re working hard to coordinate all the details of eligibility, coverage and costs, and expedite implementation of this important program,” said Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity. “This is a major benefit program with implementation on the same magnitude as TRS. It will require detailed design, development and testing, but qualified retired reservists should be able to purchase coverage by late summer or early fall of 2010.”

While the health care benefit provided for gray-area retirees will be TRICARE Standard and Extra – similar to TRS – the new program will differ from TRS in its qualifications, premiums, copayment rates and catastrophic cap requirements. The program is tentatively called TRICARE Retired Reserve.

The new statute requires premium rates to equal the full cost of the coverage. That is the major difference contrasted with TRS, where the statute provides that Selected Reserve members pay only 28 percent of the cost of the coverage. Premiums for the new gray area retiree program will be announced after program rules are published in the Federal Register.

This new program offers an important health coverage option for Reserve and National Guard members who served their country honorably before hanging up their uniforms at retirement, said Hunter. For more information about TRICARE benefits go to

About TRICARE Management Activity and the Military Health System
TRICARE Management Activity, the Defense Department activity that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.5 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics and dental clinics worldwide. For more about the MHS go to


Anonymous said...

maybe the cost could be lowered by the understanding that the retired soldier would have VA coverage at no cost for anything related to the years of combat and selfless service. Most of the families spoken of would have grown children so we covering the wives for $800 a month; as a retired reservist I would like it known that my country owes these women more than that! Anyone hear me?

Anonymous said...

If the cost is around $700 a month for a family, then my guess would be that very few people would take this. I guess the Government and DoD could feel good about "offering" a program, but being aware of the typical family's budget, they would HAVE to know that they basically be offering something that really isn't feasible for the average veteran. So then really, the true end result of rolling something out priced like this is simply just to anger people who dedicated themselves to a Reserve career of service to their country. On many levels, it's VERY insulting to even announce such a program!

Anonymous said...


Anonymous said...

I'm not quite so outraged as y'all because I'm currently paying more than $1,100 a month for a high-deductible BCBS policy on a family of three. With the deductible, we pay up to $18,000 a year for health care - by far the largest item in our budget. This TRICARE option might actually be an improvement.

Anonymous said...

Sadly, this has turned into an insult. Premiums for family coverage for CY 2011 are $1020/month - about $200- $300 more than what was anticipated. There are better and less expensive plans under various insurers. It seems that the government deliberately set this up so that there would be few if any participants. We are considered a burden, and our service to our nation is not appreciated by the program managers who calculated these rates. There is a 60 day period to express your opinions and concerns - do so - especially to your congressional representatives, ROA, MOAA, etc. These rates are an insult.

Anonymous said...

You are kidding us. We would have to pay over $1000.00 for a family. Remember if it was not for putting our lives on the line daily we would be speaking another langauge. Wake up people!!!