Health Care for Reserve Retirees
Members of the Retired Reserves below age 60 – so called "gray area" retirees are not eligible
for TRICARE health care benefits. However, gray area retirees are eligible for the TRICARE
Retiree Dental Program, which is explained later.
Reserve Component (RC) retirees become eligible for TRICARE benefits when they reach age 60
and begin receiving retirement pay. TRICARE eligibility remains in force until age
65. Upon reaching age 65, TRICARE ends, and you become eligible for Medicare. For
information on TRICARE, contact the Beneficiary Service Representative or Health Benefits Advisor
at your nearest military treatment facility. You can learn more about TRICARE at
http://www.tricare.mil/mybenefit/home/overview/Plans/
LearnAboutPlansAndCosts/TRICAREForLife. Go to this website to find out more about
TRICARE benefits for retirees age 65 and older.
Reserve retirees are eligible for Department of Veterans Affairs (VA) medical care on a
space-available basis. However, there are many limitations and eligibility
requirements. As a retired member of the Guard or Reserve, you should not rely solely on VA
services as your only source of health care. If you are a “gray area” retiree you should
consider obtaining individual or family health insurance plan for medical coverage through your new
employer.
Another option is to purchase extended transitional health care coverage (CHCBP) for up to 18
months of coverage. You have 60 days after separation to enroll in CHCBP. Your coverage
will start the day after your separation.
Supplemental Health Insurance for Reserve Retirees
One short stay in the hospital could offset the cost of several years of supplement health
insurance. Even though you are covered by TRICARE, a supplemental insurance policy is a good
idea for retirees. Here's why:
- TRICARE does not cover all costs.
- TRICARE has a yearly deductible to be paid.
- TRICARE has a yearly cap on non-covered expenses; the cap is extremely high, and you are
responsible for the cost of non-covered items up to that amount.
If you are covered by health insurance with your new employer, you may use TRICARE as your
supplemental insurance for that policy. Check with your TRICARE advisor concerning your
particular circumstances and those of your family.
The Supplemental Health Insurance Test
Private supplemental health insurance makes sense in a variety of situations?
-
Unemployed? If you remain unemployed after retirement, you should ask
yourself, "Do I have sufficient health insurance and coverage for me and my family?"
-
Under-insured? After retirement, did you accept a job that does not provide
full medical coverage for you or your family?
-
Not insured? Do you rely on limited VA medical benefits as your only source
of medical care?
If you answered
YES to any of these questions, you should consider obtaining supplemental health
insurance.
Shopping for Supplemental Health Insurance
There are many places to obtain supplemental health insurance. Several fraternal
associations and many commercial insurance companies offer such plans, but you should look
carefully for the one that is best for you and your family. Insurance plans vary greatly with
which medical procedures are covered and the percentage the policy will pay.
When shopping for health insurance, first consider the benefits you may have as a retiree or
veteran. Then purchase supplemental insurance. The trick is to find a supplemental
insurance plan that covers all your anticipated needs without paying for benefits that duplicate
what you already have.
There are five basic types of health insurance coverage:
-
Hospital expense insurance pays for hospital bills either in part or in
full. Watch out for policies that do not pay for the first 8 to 10 days of a hospital stays
(the average hospital stay is fewer than 8 days).
-
Surgical expense insurance covers surgeon fees. Beware -- for major
surgeries, all of the fees may not be covered. Read the policy carefully before you sign
it.
-
Medical expense insurance covers doctor's visits in the hospital, in the doctor's
office or house calls.
-
Major medical insurance pays practically every form of hospital and outpatient
care as long as a licensed physician provides the care. Most people choose major medical
because it is so comprehensive. However, the payments for this type of coverage are high.
-
Disability insurance pays a percentage of your normal income if a disability
prevents you from doing your job.
When looking at your health insurance coverage, take a moment to review your insurance on your
automobile, personal property, real estate, and loan payments. Insurers sometimes offer
discounts to customers who purchase several types of insurance from the same company.
Date Last Reviewed: November 6, 2009
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