The Defense Health Agency published 2023 costs for TRICARE premium-based plans last week, including TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), and TRICARE Young Adult (TYA).

The Selected Reserve will see monthly premiums increase 4% for TRS to $48.47 for individual and $239.69 for family coverage. Gray area retirees’ TRR monthly premiums will increase 9% to $549.35 for individual and $1,320.76 for family coverage. Young adult dependents will face monthly premium increases of 11% for TYA Prime (to $570) and 10% for TYA Select (to $291) in 2023.  

While military health system reforms have led to enrollment and co-pay increases for many beneficiaries, it is important to note TRS, TRR, and TYA premium increases are not discretionary – they are codified in law.

[MOAA'S TRICARE TOOLKIT: TRICARE for Guard and Reserve]

When Congress extended TRICARE eligibility with legislation creating TRS, TRR, and TYA, it directed DoD to calculate premiums based on the actual costs incurred for beneficiary care – costs which increase regularly each year because of health care inflation, increased utilization, and/or a change in the beneficiary pool (more heavily weighted to those with significant health care needs.)

The 1994 legislation that created TRICARE did not include eligibility for non-activated National Guard and Reserve servicemembers and their families, or for dependents over age 23.

As the nation relied heavily on reserve component deployments to support military operations in Afghanistan and Iraq, Congress established TRS with the FY 2005 National Defense Authorization Act (NDAA). The 2010 NDAA included legislation creating TRR.

DoD covers 72% of TRS program costs, with enrolled Selected Reserve service members and their families paying 28% through monthly premiums. The cost of TRR coverage for “gray area” Reservists (those who have retired but are too young to receive retired pay) is fully covered by enrollees’ monthly premiums.

[RELATED: Our National Guard Needs More Support to Overcome Ongoing Challenges]

Congress directed DoD to establish the TRICARE Young Adult program with the FY 2011 NDAA after the Patient Protection and Affordable Care Act (ACA) required all commercial plans to cover young adult dependents up to age 26 on their parents’ health plans. TYA provides individual coverage with a separate premium for young adult dependents. There is no DoD contribution for TYA – it is fully funded by enrollee premiums.

Room for Improvement

TRICARE eligibility expansions were significant wins, but it has been more than a decade since Congress created these programs. Based on evolving circumstances and commercial plan benchmarks, MOAA is now advocating for improvements to TRS, TRR, and TYA:

• Continued heavy reliance on the reserve component has led to calls for free health care for National Guard and Reserve servicemembers. MOAA agrees that maintaining comprehensive health is a readiness issue and has supported legislation for expanded medical and dental benefits for the reserve component.
  
  
• A MOAA-backed provision in the FY 2020 NDAA will eliminate the TRS eligibility exclusion for Federal Employees Health Benefits (FEHBP)-eligible federal employees starting in 2030. We are now working toward an accelerated fix to make federal employees eligible for TRS before the planned 2030 start date.
  
  
• Some gray area retirees draw retired pay early due to deployment credits but still aren’t eligible for retiree TRICARE until age 60. MOAA supports legislation addressing this gap and providing full retirement benefits, including TRICARE, to those who earned early retirement.
  
  
• When TYA was created more than a decade ago, it was unclear whether ACA young adult coverage requirements would survive legal challenges. They have, and now it’s time to bring parity to TRICARE’s young adult coverage. Fixing this parity gap remains a top priority for MOAA and will continue with the 118th Congress.