FY2024 NDAA: TRICARE for Reservists

FY2024 NDAA: TRICARE for Reservists

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INSIGHTi

FY2024 NDAA: TRICARE for Reservists
Updated January 5, 2024
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 2024, the
TRS premiums are $51.95 per month for servicemember-only enrollment and $256.87 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 and enacted reserve component-specific health care provisions included in the
House-passed (H.R. 2670), Senate-passed (S. 2226), and enacted (P.L. 118-31) versions of the 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
Enacted Legislation (P.L. 118-31)
Section 701 would have amended 10
No similar provision.
Not adopted.
U.S.C. §1076a to create a 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 have amended 10
Section 701 is a similar provision to
Section 702 adopts the Senate
U.S.C. §1076d(c) to extend the period
House Section 702 with an effective
provision.
of eligibility to enrol in TRICARE
date of October 1, 2025.
Reserve Select (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 November 2023, the Department of Defense (DOD) reported a total of 764,526 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, Air National Guard, and Coast Guard Reserve).
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.
For the FY2024 NDAA, Congress considered provisions that would have eliminated certain TRICARE
cost-sharing requirements for drilling reservists, or would have extended 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 have eliminated 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 have increased 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 enacted bill did not include this provision. The
conferees stated that they are “eagerly awaiting the findings and recommendations” on a congressionally
directed DOD study on the feasibility and cost effects of expanding eligibility for TRS and TDP to all

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Selected Reserve members, their dependent family members, and nondependent children under 26 years
old.
The House bill did not include any proposals that would have changed 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
• 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.
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 enacted bill adopts S. 2226 §701, which amends 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 extends the period of eligibility from six months to three years
after the servicemember’s death beginning on October 1, 2025. House Section 702, which was not
adopted, was a similar provision that would have taken effect upon enactment.
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

Congressional Research Service
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Disclaimer
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