DoD Drops CHAMPUS Deductible for Joint Endeavor Guard, Reservists
By Rudi Williams
American Forces Press Service
WASHINGTON, Jan. 17, 1996 Family members of reserve component personnel called to active duty to support Operation Joint Endeavor can use CHAMPUS health care benefits without paying the deductible, or enroll in TRICARE.
"This demonstration project provides an interim solution for Reserve and National Guard members activated for Operation Joint Endeavor," said Dr. Stephen C. Joseph, assistant secretary of defense for health affairs.
But, he added, DoD needs legislation to authorize the secretary of defense to waive CHAMPUS deductibles for families of reserve component members when activated in support of contingency operations for 31 days or more.
Guardsmen and reservists called to active duty for 179 days or more can enroll their families in TRICARE Prime. They can use TRICARE Prime only as long as they're on active duty.
Since CHAMPUS deductibles are based on coverage for an entire year, reserve component personnel called to active duty for contingency operations of less than a year should be exempt from paying the fee, officials said. In this project, CHAMPUS will immediately begin cost sharing for family members of activated guardsmen and reservists, covering most of the costs of civilian hospital and doctor care when services are not available through the military.
"This pilot program is consistent with DoD's intent to do better in taking care of reserve component personnel families," said Deborah R. Lee, assistant secretary of defense for reserve affairs. "In the last year, we've put in place a first-ever DoD instruction on family readiness that is allowing reserve families to be better prepared for a mobilization. Now this demonstration project will also help to relieve anxiety associated with reserve family health care needs after a reserve member has been called to active duty."
Waiving the annual deductible -- usually ranging fron $50 to $300 -- reduces reserve component members' out-of-pocket health care expenses, officials noted. The pilot program also provides continuity of care when existing health care providers are also TRICARE and CHAMPUS providers.
TRICARE is the new DoD program that incorporates the health care delivery systems of the military services, as well as CHAMPUS.
TRICARE Prime is a voluntary enrollment option offering beneficiaries the advantage of managed health care. It is available in Oregon, Washington, Hawaii, California, Texas, Oklahoma, Arkansas and most of Louisiana.