Beginning October 1, 2007, purchase of TRICARE Reserve Select (TRS) coverage is available to all members of the Selected Reserve,regardless of any active duty served, unless:
You are eligible for the Federal Employees Health Benefits (FEHB) program (as defined in Chapter 89 of Title 5 United States Code); or
You are currently covered under FEHB, either under your own eligibility or through a family member.
TRS monthly premium amounts are determined by the type of coverage you purchase: TRS member-only or TRS member-and-family. TRS premiums are adjusted annually effective January 1 and are not applied to the catastrophic cap. Note: Cost-shares and deductibles are the same
as those listed previously for TRICARE Standard and TRICARE Extra ADFMs.
Prohibition of Waiving Cost-shares and Deductibles
When using TRICARE Standard, TRICARE Extra, and TRS, you are responsible, under law, to pay an annual deductible and cost-shares associated with your care. The law prohibits health care providers from waiving the deductible or cost-shares and requires providers to make
reasonable efforts to collect these amounts. Providers who offer to waive deductibles and cost-shares, or who advertise that they will do so, can be suspended or excluded as TRICARE-authorized providers.
Balance Billing and Violation of Participation Agreements
Nonparticipating providers may charge up to 15 percent above the TRICARE-allowable charge, which you must pay out-of-pocket. Participating providers are prohibited from balance billing—collecting from you any amount in excess of the TRICARE-allowable charge, less any applicable
patient cost-share you pay. Once a participating provider marks “yes” on the claim form for that service, he or she cannot later revoke or cancel that decision. Participating providers who attempt to fraudulently collect higher payments are commonly referred to as being in “violation of the
participation agreement.” Note: Non-network providers may choose to participate on a claim-by-claim basis.
