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INSIGHTi
FY2024 NDAA: TRICARE for Reservists
August 4, 2023
Background
Since September 11, 2001, Congress has enacted new or modified benefits tailored to certain Selected
Reserve members and their dependent family members. These benefits include expanded eligibility for
health care benefits offered through the TRICARE program. Most drilling reservists are eligible to enroll
in a premium-based health plan called TRICARE Reserve Select (TRS).
TRS is structured similarly to TRICARE Select (i.e., preferred provider option) and is available
worldwide. The beneficiary cost features of TRS include monthly premiums, annual deductibles, fixed
co-pays when receiving care from a network provider, and paying a percentage of the allowable charges
when receiving care from a TRICARE-authorized, non-network provider. For calendar year 2023, the
TRS premiums are $48.47 per month for servicemember-only enrollment and $239.69 per month for
servicemember and family member enrollment.
In addition to TRS, drilling reservists and their dependent family members may be eligible for dental
insurance through the TRICARE Dental Program (TDP) and/or vision insurance through the Federal
Employees Dental and Vision Insurance Program (FEDVIP).
Reservists (i.e., members of the Reserves Components, including the National Guard) on federal active
duty orders for more than 30 consecutive days receive identical health benefits as active duty
servicemembers. These benefits include a premium-free health plan (i.e., TRICARE Prime) and premium-
free dental and vision care. Once activated reservists complete an active duty period, they may be eligible
for transitional health benefits as they return to a reserve status.
Table 1 lists the proposed reserve component-specific health care provisions included in the House-
passed (H.R. 2670) and Senate-passed (S. 2226) versions of a National Defense Authorization Act
(NDAA) for FY2024.
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Table 1. FY2024 NDAA Legislative Proposals
House-passed H.R. 2670
Senate-passed S. 2226
Section 701 would amend 10 U.S.C. §1076a to create a
No similar provision.
premium-free TRICARE dental plan option for members of
the Selected Reserve. The provision would also prohibit
copayments for those enrol ed in the premium-free
TRICARE dental plan option.
Section 702 would amend 10 U.S.C. §1076d(c) to extend
Section 701 is a similar provision to House Section 702 with
the period of eligibility to enrol in TRICARE Reserve Select
an effective date of October 1, 2025.
(TRS) for surviving “immediate family” members of a
reservist who died while also enrol ed in TRS. The provision
would extend the period of eligibility from six months to
three years after the servicemember’s death.
Source: CRS analysis of legislation on Congress.gov.
Discussion
As of October 2022, the Department of Defense (DOD) reported a total of 763,432 servicemembers in the
Selected Reserves across all military reserve components (i.e., Army Reserve, Army National Guard,
Marine Corps Reserve, Navy Reserve, Air Force Reserve, and Air National Guard). In recent years, some
military service leaders have supported and military service organizations have advocated for more
TRICARE benefits and reduced cost-sharing requirements for reservists, in order to ensure continuity of
care when transitioning between active and reserve status, and to assist with resolving deficient individual
medical readiness. Some observers have noted potential challenges with the Defense Department’s ability
to sustain existing health benefits, and broader personnel costs associated with extending TRICARE
benefits to a larger population.
Both the House-passed and Senate-passed versions of an FY2024 NDAA include provisions that would
eliminate certain TRICARE cost-sharing requirements for drilling reservists, or would extend the period
of TRICARE eligibility for certain dependent family members of reservists.
Health and Dental Benefits for Reservists
In recent testimony to the Senate Appropriations Committee, Subcommittee on Defense, the Chief of the
National Guard Bureau, General Daniel R. Hokanson, stated that premium-free health care and dental
care are “critically important” to “medical and dental readiness for our personnel.” Section 701 of the
House-passed bill would eliminate cost-sharing requirements for reservists enrolled in TDP. The provision
would amend 10 U.S.C. §1076a to create a premium-free TDP option for members of the Selected
Reserve and prohibit copayments for those enrolled in the dental plan option. The Congressional Budget
Office estimated that the House provision would increase TDP enrollment from approximately 120,000
reservists to 450,000 reservists, and would increase DOD discretionary costs “by about $1.1 billion over
the 2024-2028 period.”
The House bill does not include any proposals that would change TRS eligibility or costs. However, in
H.Rept. 118-125, the House Armed Services Committee (HASC) described that “individuals in the
National Guard and Reserves still face numerous financial and administrative barriers to healthcare
coverage through TRICARE” and often “lose access to TRICARE Reserve Select coverage during their
transition [between reserve and active duty status].” The committee directed the Secretary of Defense to
provide a report by December 1, 2024 on the cost and feasibility of:
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• expanding access to TRS for 60 days for reservists transferring between reserve
components (e.g., transferring from the Army National Guard to the Army Reserve, or
vice-versa);
• allowing reservists to maintain TRS coverage while on active duty orders; and
• waiving the required TRS deductible and lowering the initial premium payment
requirement from two months to one month.
The Senate-passed bill has no similar provision or accompanying report language.
Health Benefits for Survivors
In certain instances, survivors of servicemembers may continue to be eligible for TRICARE depending on
the circumstances of the death. If a servicemember died while on active duty orders, surviving dependent
family members remain eligible for TRICARE benefits indefinitely, unless a surviving spouse remarries
or a dependent child reaches the age of 21 (or 23 if enrolled at an institution of higher education).
Survivors of reservists who were not on active duty orders currently remain eligible for TRS for up to six
months after the servicemember’s death. After that period, a survivor may purchase temporary TRICARE
coverage for 18 to 36 months through the Continued Health Care Benefit Program or opt for health
insurance coverage through other avenues.
Section 702 of the House-passed bill would amend 10 U.S.C. §1076d(c) to extend the period of eligibility
to enroll in TRS for surviving “immediate family” members of a reservist who died while also enrolled in
TRS. The provision would extend the period of eligibility from six months to three years after the
servicemember’s death. Section 701 of the Senate-passed bill is a similar provision that includes an
effective date of October 1, 2025.
For more on TRICARE for reservists, see CRS Report R45399, Military Medical Care: Frequently Asked
Questions, by Bryce H. P. Mendez; and CRS Report R45968, Limits on TRICARE for Reservists:
Frequently Asked Questions.
Author Information
Bryce H. P. Mendez
Specialist in Defense Health Care Policy
Disclaimer
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