FY2024 NDAA: TRICARE for Reservists

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 premiumfree 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.

Congressional Research Service

https://crsreports.congress.gov

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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

U.S.C. §1076a to create a premiumfree TRICARE dental plan option for

members of the Selected Reserve. The

provision would also prohibit

copayments for those enrolled in the

premium-free TRICARE dental plan

option.

No similar provision.

Not adopted.

Section 702 would have amended 10

U.S.C. §1076d(c) to extend the period

of eligibility to enroll in TRICARE

Reserve Select (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 is a similar provision to

House Section 702 with an effective

date of October 1, 2025.

Section 702 adopts the Senate

provision.

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

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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.

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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