MARCH 15, 2019 – National Guardsmen and their families do not have to struggle to afford healthcare and can stay medically insured after retirement. Those who serve 20 years or more in the National Guard are eligible to receive lifelong medical benefits for themselves and their families through various TRICARE health plans.
These plans offer quality care at affordable rates, making it one of the most valuable benefits available to Guardsmen and an important reason to stay in until retirement.
“TRICARE is one of the best reasons to stay in the National Guard for 20 years,” said Col. Jim Hicks, Idaho Army National Guard director of personnel. “With these benefits you have the potential to save hundreds and thousands of dollars when you reach retirement.”
At age 60, retirees and their families can expect to pay as little as $48 a month for TRICARE, whereas others pay a minimum of $1,000 a month for outside insurance, said William Fackler, Idaho National Guard retirement services officer. Then at age 65, retirees can expect to pay close to nothing for TRICARE, he added.
Several healthcare plans are available through TRICARE depending on the retiree’s age. Each plan offers little-to-no out-of-pocket costs, deductibles or premiums; low catastrophic caps and costs per family; and more freedom to choose healthcare with fewer restrictions.
“People don’t want to worry about medical bills after they retire,” said Fackler. “I’ve talked to lots of veterans who got out before 20 years and they all regret it. I tell folks to stick around because those benefits will be well worth it later on.”
Idaho Army National Guard retiree and Family Assistance Center Specialist Tom Obstarczyk knows first-hand the value of being a TRICARE beneficiary after he accidently sawed two of his fingers off in 2003.
“I was lucky,” said Obstarczyk. “My surgeon at St. Luke’s in Meridian was able to reattach my fingers and it cost me nothing through TRICARE. Where else can you receive full-time medical benefits as a part-time employee?”
Once retired, members can purchase TRICARE Retired Reserve from any age until 60. At that time, retirees may either chose TRICARE Prime Retired or TRICARE Select Retired, which recently replaced TRICARE Extra and Standard. At 65, retirees are no longer eligible for the previously mentioned health care plans but may then choose to enroll in TRICARE for Life.
TRICARE Retired Reserve
Upon retirement, members with 20 or more years of service are eligible to purchase TRICARE Retired Reserve for themselves and their family until they reach age 60. The premium-based health plan offers beneficiaries the option to receive care from any TRICARE-authorized provider for $451.51 a month per member or $1,083.40 a month to include unlimited family members, in addition to deductibles and a $3,598 catastrophic cap.
TRICARE Prime and Select, Retired
Retirees ages 60 to 64 are eligible to purchase TRICARE Prime Retired if living in a prime area or TRICARE Select Retired for themselves and their families.
TRICARE Prime Retired is a managed care option that offers affordable and comprehensive coverage with fewer out-of-pocket costs. Eligible members will receive care from a primary care manager and pay $24.75 a month, or $49.50 a month to include their family, with no deductibles and a $3,000 catastrophic cap.
TRICARE Select Retired is a preferred provider network that offers beneficiaries the most freedom to choose any TRICARE-authorized provider. There are no enrollment fees, however, deductibles are $150 for individuals and no more than $300 per family, with a $3,000 catastrophic cap.
TRICARE for Life
Retirees age 65 and older are eligible to enroll in TRICARE for Life, which is a secondary healthcare coverage for individuals with both Medicare Parts A and B. The program offers members and families the ability to receive care from any authorized provider with no enrollment fees, deductibles of $150 per individual and no more than $300 per family, with a $3000 catastrophic cap.
Medicare costs individuals approximately $135.50 a month and may not cover everything. With TRICARE for Life, beneficiaries typically pay nothing out-of-pocket for services TRICARE pays after Medicare, giving retirees the confidence to quite working sooner, said Fackler.
“People are out there working after age 65 because Medicare is only covering so much of their health costs,” said Fackler. “After retirees turn 65, TRICARE for Life gets billed. Nearly 99 percent of the time whatever Medicare doesn’t pay, TRICARE does so that beneficiaries never see a bill.”
Additionally, retired Guardsmen and their families are eligible for TRICARE’s pharmacy program and various dental and vision healthcare plans.
TRICARE Pharmacy Program
All current TRICARE beneficiaries are eligible to use the TRICARE Pharmacy Program to receive affordable prescription drugs either through retail pharmacies or by a home delivery option. Using Express Scripts, individuals can receive a 90-day supply of medication at home for small copayments of $7 for generic or $24 for name brands.
Dental and Vision Coverage
Retired Guardsmen now have comprehensive dental and vision coverage through the Federal Employees Dental and Vision Insurance Program, which replaced the TRICARE Retiree Dental Program in January 2019. With this new program, beneficiaries may choose between 10 dental and four vision carriers, ranging in price between $40 and $120 a month depending on the plan. Coverage for vision includes routine eye exams, vision corrections without referral and eyeglass frames and lenses.
“Before this new program took effect, Guardsmen had no vision care option and only one available dental plan through TRICARE,” said Fackler. “Now beneficiaries have more options, which is important because not every dental provider took TRICARE.”
TRICARE Young Adult
While adult-children of current-serving Guardsmen are eligible for TRICARE health coverage until age 21, or age 23 if they are enrolled in college, those of retired Guardsmen are entitled to coverage until age 25. With TRICARE Young Adult Prime, beneficiaries receive care through a primary care manager and pay $358 a month, with no deductibles.
With TRICARE Young Adult Select, beneficiaries have the option to receive care using any TRICARE-authorized provider for $214 a month, with deductibles ranging between $51 and $154 per individual and between $102 and $308 per family, depending on a retiree’s rank. Both plans have catastrophic caps of $3,598.
Until Retirement
While TRICARE benefits after retirement may provide Guardsmen a reason to stay in the Guard for 20 years, another TRICARE health plan offers members a reason to stay in until 60.
Current members and their families are eligible to receive TRICARE Reserve Select, which offers lower healthcare rates than TRICARE Retired Reserve and comparable rates to TRICARE Retired Select.
“Soldiers are staying in the military for TRICARE Reserve Select,” said Fackler. “They would spend approximately $800 or more a month on other health plans if they got out before age 60.”
The premium-based health plan offers beneficiaries the option to receive care from any TRICARE-authorized provider for $42.83 a month or $218.01 a month to include their family. Deductibles range between $51 and $102 per individual or between $154 and $308 per family, depending on a member’s current rank, with a $1,028 catastrophic cap.
Preparing for Retirement
To receive benefits, retirees must enroll online for each TRICARE health plan prior to their age of eligibility at www.tricare.mil. Enrollment assistance is available through the Idaho National Guard’s Retirement Services Office at (208) 272-3815 and the Family Assistance Center at (208) 272-4330 or (208) 272-4355. Individuals can also find further information on retirement, transitioning and eligibility by visiting the previously mentioned website and services or by contacting the Idaho National Guard Retiree Outreach Program at (208) 258-4910.
Story by Crystal Farris
Idaho Army National Guard