Additional Coverage to Help Pay
Cost Shares and Copayments
The TRICARE Reserve Select Supplement Insurance Plan provides coverage to help pay your TRICARE
cost share for inpatient and outpatient care, doctor visits, emergency room care, prescription medications,
and much more. TRICARE Reserve Select Supplement Insurance Plan pays 100% of all covered expenses
in excess of the TRICARE allowed amount, not to exceed the Legal Limit. You can purchase the TRICARE
Reserve Select Supplement Insurance Plan at any time throughout the year as long as you are eligible for
and enrolled in TRICARE Reserve Select.
Plan Sponsor: Government Employees Association
The Government Employees Association is a non-profit, tax-exempt organization; incorporated in
1965 in Washington, D.C. GEA was established to provide active and retired federal, state and
local government employees (including members of the military and National Guard services) with
a network of resources.
Important Notice
This coverage is available to Government Employees Association members and their dependents. If
you are not already a member of Government Employees Association, please complete the enclosed
Government Employees Association membership application or contact Government Employees Association
to apply. Your membership dues can be added to your insurance premium depending on the payment option
you select. Continued membership and benefit enjoyment requires renewal of membership upon expiration
of the initial period. For additional inquiries, call Selman & Company, the plan administrator,
toll‐free at: 1.800.638.2610.
Eligibility
Before enrolling in the TRICARE Reserve Select Supplement Insurance Plan, you must qualify for and be
enrolled in TRICARE Reserve Select (TRS). TRICARE Reserve Select is available to all members of the
Select Reserve regardless of any active duty served, with one exception: If you are eligible for the Federal
Employees Health Benefits Program (FEHBP) or currently covered under FEHBP, you are excluded from
purchasing the restructured TRS plan. For more information, please visit the TRICARE website at
www.tricare.mil/trs.
To qualify for the TRS Supplement, you must be a member of the Select Reserve or the Ready
Reserve, and you cannot be eligible for or enrolled in the Federal Employees Health Benefits Program
(FEHBP) or currently covered under FEHBP (either under their own eligibility or through a family member
with FEHBP).
Class
Members: Members who are eligible for TRS.
Spouses: Spouses who are eligible for TRS. Member must also be covered in order to enroll Spouse.
Child: A child who is eligible for TRS, and 1) is under 21; or 2) 21 or over, but under 23 if enrolled as
a full-time student. Member must also be covered in order to enroll Child(ren) 3) coverage is extended
to adult dependent children who are under age 26 and enrolled in TRICARE Young Adult (TYA)
program.
Effective Date
Your coverage and that of your covered dependents becomes effective on the first day of the month following
receipt of your Enrollment Form and first premium payment. If, on that day, you or a covered dependent are
confined in a hospital, the effective date will be the day following discharge from the hospital. Newborn
children not named in your enrollment form are automatically covered from birth for injury or sickness,
including treatment of congenital defects and birth abnormalities, for 31 days. You must notify the Plan
Administrator in writing and pay the additional premium due within 31 days of birth for coverage to continue
beyond this period. Insured children who are incapable of self-sustaining employment because of mental retardation
or physical disability – and who are unmarried and chiefly dependent on the insured member for support and maintenance
– may continue coverage past policy age limits, with requested proof. Otherwise, each dependent child's coverage
terminates on the premium due date following the date he or she is no longer a dependent.
Renewability
The TRICARE Reserve Select Supplement Insurance coverage is renewable to age 65. As long as premiums
are paid on time; you remain a member of the sponsoring organization; you, your spouse and dependents
remain in an eligible status (you are covered by TRICARE Reserve Select, children are under age 21 or age
23 if a full-time student or age 26 if enrolled in TYA); and the Master Policy and your class of insured
persons remains in effect. So, even if you or a covered dependent develops a serious health condition in the
future, their coverage will not terminate, provided these conditions are met. Coverage terminates at age 65.
Pre-Existing Conditions Limitations
If a member enrolls in TRICARE Reserve Select and requests coverage under the TRICARE Reserve Select
Supplement within 30 days of the date his or her TRICARE Reserve Select coverage begins, we will waive
the Pre-Existing Conditions Limitation. A pre-existing condition provision means any injury or sickness
whether diagnosed or undiagnosed, for which a covered person received medical care or treatment within
the 6 month period preceding the effective date of his or her insurance and will not be covered until the
coverage has been in effect for 6 months. However, new conditions will be covered immediately.
Limitations (Nervous, Mental, Emotional Disorder, Alcoholism, and Drug Addiction Limits)
The coverage provided under the Inpatient Benefit of the TRICARE Supplement Plan for nervous, mental and
emotional disorders, including alcoholism and drug addiction, is limited to: 1) 30 Inpatient treatment days
for a Covered Person age 19 or older; or 2) 45 Inpatient treatment days for a Covered Person under age 19
per Fiscal Year. This Inpatient limit is based on the number of days TRICARE normally provides each Fiscal
Year for such confinements. In rare instances, TRICARE extends these daily limits. If this occurs, we will
limit the number of days that we provide for such confinement to the lesser of: 1) the number of days TRICARE
pays for such Inpatient treatment during the Fiscal Year; or 2) 90 Inpatient days per Fiscal Year. The coverage
provided under the Outpatient Benefit of the TRICARE Supplement plan for: 1) nervous, mental, and emotional
disorders; and 2) alcoholism and drug addiction; is limited to $500 during any Fiscal Year for all such disorders.
Non-Duplication of Coverage under Employer Health Program
If a claim payable under the Policy is also payable under an Employer Health Program with TRICARE as the secondary
payor, we will limit our payment to an amount which, when added to the amounts paid by the Employer Health Program
and TRICARE, will not exceed 100% of TRICARE Covered Expenses.
