The Defense Health Agency published 2024 costs for TRICARE premium-based plans last week, including TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), and TRICARE Young Adult (TYA).

MOAA is vigilant in protecting the TRICARE benefit. Premium increases are not benefit cuts, but rather part of the program design for TRICARE plans that serve populations originally ineligible for TRICARE coverage. The 1994 legislation creating TRICARE did not include eligibility for nonactivated National Guard and Reserve servicemembers and their families, nor for dependents over age 23.

[UPDATED MONTHLY: MOAA's TRICARE Toolkit]

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 typically increase 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).

For 2024, the Selected Reserve will see monthly premiums increase 7.2% for TRS to $51.95 for individual and $256.87 for family coverage. Gray area retirees' TRR monthly premiums will increase 6.5% to $585.24 for individual and $1,406.22 for family coverage. Young adult dependents will face monthly premium increases of 11.8% for TYA Prime (to $637) and 6.9% for TYA Select (to $311) in 2024.

History of Premium-Based Plans 

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 servicemembers 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.

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.

[RELATED: MOAA's TRICARE Guide]

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 updated commercial plan benchmarks, MOAA is now advocating for improvements to Reserve and Young Adult TRICARE coverage:

• 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 advocating for 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 that would provide 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.