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2/4/2012
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Home > Insurance Help & Plans Overview > TRICARE Reserve Select Supplement
USBA TRICARE Reserve Select Supplement Insurance Plan Family Photo
 
    USBA TRICARE Reserve Select Supplement Insurance Plan  
 
Plan Details
Features
Benefits Summary
FAQs
Rates

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Upon approval of your Application, you’ll be issued a Certificate of Insurance. If you are not completely satisfied with the provisions of your Certificate, you can return it within 30 days, without claim, for a prompt, full refund. Important Plan Information
  
USBA TRICARE Reserve Select Supplement Insurance Plan
Introduction

A Few Words About This Plan …

Out-of-pocket expenses can mount up quickly when you receive medical care outside the military system. That’s why supplemental health insurance like the TRICARE Reserve Select Supplemental Plan is so important for you and your family. With this economical insurance coverage, you’re better protected against the high cost of medical expenses you might face each calendar year in the event of illness.

Many people like you are concerned about getting good insurance coverage at an affordable cost. It’s not easy to get that kind of information on your own … and it can eat up a lot of your precious time. That’s why we’re proud to offer the TRICARE Reserve Select Supplement Plan for National Guard and Reservists.

So why choose this plan?

  • Low Monthly Premiums
  • Guaranteed Acceptance (subject to pre-existing condition limitation)
  • 30-Day Satisfaction Guarantee
  • No Medical Exam Required
  • Smokers Pay the Same Price as Non-smokers
  • Pays cost shares – after the annual deductible is met
  • Pays 100% of covered excess charges – after the annual deductible is met

Before you begin the application process, be sure to review the USBA TRICARE Reserve Select Supplement Insurance Plan Features, Benefits Summary, FAQs and Rates.

We invite you to visit any or all of these links now. If you have questions, please don't hesitate to call one of our highly-trained TRICARE specialists at (877) 297-9235.

NOTE: Coverage is not available in Nevada.

ASI, the plan administrator of the TRICARE Supplement Plan, is exercising its contractual right to change the plan underwriter effective October 1, 2010. The plan underwriter will be changed from Hartford Life and Accident Insurance Company to Monumental Life Insurance Company and Transamerica Financial Life Insurance Company (NY residents only).

APPLY NOW!
Application Download
Choose the application that’s right for you:
Carat TRICARE Reserve Select Supplement
Carat TRICARE Reserve Select Supplement (NY Residents Only)
Carat NGAUS or EANGUS Members
Carat NGAUS or EANGUS Members (NY Residents Only)
 
Carat Download Claim Form
Carat Download Claim Form (NY Residents Only)
 
Guardsmen & Reservists Announcement

To qualify for this product, you:
  Carat Must be a member of the selected reserve of the ready reserve
  Carat
Can't be eligible for or enrolled in FEHBP
  Carat
Must be enrolled in TRICARE Reserve Select. Click here to enroll now
Plan Details    
Benefits Summary

BENEFITS SUMMARY CHART
Here’s How The TRICARE Reserve Select Supplement Works To Pay What TRICARE Reserve Select Doesn’t Pay.


Care Required TRICARE Reserve Select Pays Your TRICARE Reserve Select Supplement Pays
Benefits in a Government Hospital Nominal charges may apply. Check with your local facility for details. Current Daily Subsistence Charge.
Benefits in a Civilian Hospital or Skilled Nursing Facility All TRICARE Reserve Select allowable amounts except the first $25.00 or current daily subsistence charges (whichever is greater). - Current Daily Subsistence Charge for each day of Confinement; or

- $25.00 for all Confinements which are due to the same or related Sickness or Injury and separated by less than 60 days; until the TRICARE Cap* is met
Outpatient Benefit TRICARE Network Provider
85% of the negotiated rate after the fiscal year deductible is met.

Non-Network Provider
80% of the TRICARE allowable charge after the fiscal year deductible is met. 		TRICARE Network Provider
Your 15% cost share for covered expenses until the TRICARE Cap* is met.

TRICARE Authorized, Non-Network Provider
Your 20% cost share until the TRICARE Cap* is met PLUS 100% of Covered Excess Charges up to the Legal Limit.
Prescription Drug Benefit
Mail Order (up to 90-day supply)
Network Retail (up to 30-day supply)
Non-Network Retail (up to 30-day supply)		 All but the copayment of $3 generic, $9 brand name or $22 non-formulary

All but the copayment of $3 generic, $9 brand name or $22 non-formulary

All but $9 or 20% of the total cost for generic/brand name or $22 of 20% for non-formulary (whichever is greater) after the fiscal year deductible 		Copayments of $3 generic, $9 brand name or $22 non-formulary

Copayments of $3 generic, $9 brand name or $22 non-formulary

$9 or 20% of the total cost for generic/brand name or $22 or 20% for non-formulary (whichever is greater) after the fiscal year deductible

* TRICARE Catastrophic Cap — Maximum out-of-pocket expense = $1,000 per family, per fiscal year. Monthly premium payments do not apply toward meeting the catastrophic cap.

**TRICARE Annual Outpatient Deductible:   Member-Only Plan Family Plan
E-4 and Below - $50.00 $100.00
E-5 and Above - $150.00 $300.00

We will not pay for expenses which are used to satisfy the Outpatient Deductible charged by TRICARE.

Exclusions may vary by state and underwriter. See your Certificate for complete details.

All outpatient Covered Expenses will be deemed incurred on the date the Covered Person received the treatment, service or supply that gave rise to the expense.

Confined or Confinement means being an inpatient in a Hospital (or Skilled Nursing Facility) due to Sickness or Injury.

Skilled Nursing Facility does not mean:
a) a hospital; or
b) a place for rest, custodial care or the aged; or
c) a place for the treatment of mental disease, drug addicts or alcoholics.

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Features | Benefits Summary | FAQs | Rates
  
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APPLY NOW!
Download the Application That’s
Right For You:
Download Claim Form
Carat TRICARE Reserve Select Supplement Claim Form
Carat TRICARE Reserve Select Supplement (NY Residents Only)
Carat NGAUS or EANGUS Members
Carat NGAUS or EANGUS Members (NY Residents Only)
 
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