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DoD Approves Expanded Health Coverage for Reserve Family Members

By Kathleen T. Rhem
American Forces Press Service

WASHINGTON, March 13, 2003 – Two major changes effective immediately will make it easier for reserve component family members to receive health care coverage from the Defense Department when their sponsor is activated, the department's top doc said.

The first change shortens the time reservists and Guardsmen must be activated -- from 179 to 30 days -- for their family members to be eligible for enrollment in TRICARE Prime, the military's most comprehensive health care option.

Dr. William Winkenwerder, assistant secretary of defense for health affairs, said department officials were "pleased and delighted" to make the changes.

"We realize that reserve members and their families have a need for health care when reservists are called up for active duty," he said. "We wanted to make the use of that benefit easier and more comprehensive."

Officials noted that family members are eligible for coverage as soon as their sponsor is activated as long as that activation will exceed 30 days.

The second important change has to do with a program called TRICARE Prime Remote for Active Duty Family Members. Under the program, families of military members stationed in areas far from military medical care still receive the same level of treatment at comparable cost. Typically, recruiters and ROTC cadre and their families use this benefit if they're located at least 50 miles from a military clinic or hospital.

Previous wording in the rules covering this benefit stated family members must live with their sponsor in an area not covered by a military medical treatment facility.

This created a problem for reserve families whose sponsors were activated. If reservists are activated, chances are they've been sent away from their homes. Obviously, family members can't move with activated reservists in most cases, so this led to many being denied enrollment in Prime Remote.

"There was a clause in the law that said that the family must reside with the active duty member. There was some confusion and some difficulty in coming to a clearer definition of that," Winkenwerder explained. "Reading it one way meant it would have been very difficult for those family members to use the benefit, because they would have had to follow the service member."

The new wording clarifies that regardless of where reserve-component members are deployed, their families are eligible for coverage under this program if the military members' regular home is in a covered location.

"What we've made clear is that wherever that service member was living with his or her family, (the family members) are eligible right then and there," Winkenwerder said.

He said the two changes have been "very well received" in the reserve community. "And we're very glad we're able to do this," he added.

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