Monthly Rates*

MilicarePLUS TRICARE Select Supplement Inpatient and Outpatient Plans
Age	Retired Basic Plan		Retired Choice Plan		Retired Select Plan
	Member	Spouse	Member	Spouse	Member	Spouse
Under 40	$25.52	$35.84	$33.62	$52.42	For All Ages
40–49	$32.19	$45.19	$41.07	$66.12	$209.40	$222.12
50–54	$37.34	$46.06	$52.50	$69.52
55–59	$47.20	$53.18	$66.94	$79.28
60–64	$60.41	$57.01	$84.33	$85.54
	Each child $17.14		Each child $23.97		Each child $105.35
	Active Duty Basic Plan		Active Duty Choice Plan		Active Duty Select Plan
	Spouse $14.24		Spouse $17.14		Spouse $62.59
	Each Child $11.03		Each Child $13.21		Each Child $34.06

 

MilicarePLUS TRICARE Prime Supplement Plan

Retired Member
Age	Rates
Under 40	$14.33
40–44	$15.53
45-49	$19.11
50-54	$23.31
55-59	$25.70
60-64	$27.47
65 & over	$28.66
Each Child	$10.75

 

MilicarePLUS TRICARE Reserve Select Supplement Plan

Member	Spouse	Each Child
$17.14	$17.14	$13.21

 

MilicarePLUS TRICARE Retired Reserve Supplement Inpatient and Outpatient Plans

	Basic Plan		Choice Plan
Age	Member	Spouse	Member	Spouse
Under 40	$25.52	$35.84	$33.62	$52.42
40–49	$32.19	$45.19	$41.07	$66.12
50–54	$37.34	$46.06	$52.50	$69.52
55–59	$47.20	$53.18	$66.94	$79.28
60–64**	$60.41	$57.01	$84.33	$85.54
Each Child	$17.14		$23.97

 

Rates and/or benefits may be changed on a class basis.

 

*You'll be billed four times a year. If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

**Renewal rates only.

You are eligible for coverage if you are a member or auxiliary member of Fleet Reserve Association. If you are over age 65, you must be ineligible for Medicare benefits and not be on active duty. Your MilicarePLUS rates will not increase unless rates increase for all in your classification. Rates are based on attained age and increase as you enter a new age bracket.

 

Basic Plan deductible for Retired and Active Duty is $300/person or $600/family.

 

Choice Plan deductible for Retired and Active Duty is $250/person or $500/family.

 

The Select Plan for Retired has NO deductible.

Skilled Nursing Facility

Hospital means an institution which TRICARE recognizes as a hospital. Skilled Nursing Facility means an institution that operates pursuant to law; in addition to room and board accommodations, is primarily engaged in providing skilled nursing care under the supervision of a Physician; provides continuous 24 hour a day nursing service by or under the supervision of a registered graduate nurse (R.N.); and maintains a daily medical record of each patient. Skilled Nursing Facility does not mean a Hospital that does not include a place for the aged, or for rest, custodial or educational care; alcoholism and drug addiction; the treatment of Mental Illness.

 

Pre-Existing Condition Limitation

During the first 12 months of coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-existing Conditions means any Injury or Sickness for which medical care is received by the Covered Person within the 12 consecutive months prior to the date the Covered Person’s insurance starts or within the 12 consecutive months prior to the effective date of the Covered Person’s increase in coverage. During that time, benefits for all other accidents or illnesses will be paid under the policy provisions. You are urged to consider this limitation before dropping any coverage you may have until the waiting period is over. If your dependents are currently insured under the Active Duty Supplement with FRA and you join the MilicarePLUS Retired Plan within 60 days of your discharge from active duty, we will credit you with continuity of coverage from your dependents’ prior effective date.
 

Exclusions and Limitations

The Policy does not cover: injury or sickness resulting from war or act of war, whether war is declared or undeclared; intentionally self-inflicted injury; suicide or attempted suicide, whether sane or insane. The Policy limits coverage for: routine physical exams and immunizations, except when: rendered to a child up to 6 years from the child’s birth; or ordered by a Uniformed Service: routine physical exams and immunizations, except when: rendered to a child up to 6 years from the child’s birth; or ordered by a Uniformed Service: for a Covered Dependent of an Active Duty Member; for such Dependent’s travel out of the United States due to your assignment; or required for school enrollment (but not sports physicals) by a Covered Child aged 5 through 11 domiciliary or custodial care; care received in a retirement home, rest home or halfway house eye refractions and routine eye exams except when rendered to a child up to 6 years from the child’s birth; eyeglasses and contact lenses; prosthetic devices, except those covered by TRICARE; cosmetic procedures, except those resulting from Sickness or Injury, while a Covered Person; hearing aids; orthopedic footwear; care for the mentally or physically incapacitated if: the care is required because of the mental or physical incapacitation; or the care is received by an Active Duty Member’s child who is covered by the TRICARE Extended Care Health Option (ECHO); drugs which do not require a prescription, except insulin; dental care unless such care is covered by TRICARE, and then only to the extent that TRICARE covers such care; any confinement, service, or supply that is not covered under TRICARE; Hospital nursery charges for a well newborn, except as specifically provided under TRICARE; any routine newborn care except Well Baby Care; any expense or portion thereof which is in excess of the Legal Limit; expenses in excess of the TRICARE Catastrophic Cap; that part of any Covered Expense which is in excess of the TRICARE Allowed Amount, except as otherwise stated in the plan benefits; expenses which are paid in full by TRICARE; any expense or portion thereof applied to the TRICARE Outpatient Deductible, except as otherwise stated in the plan benefits; treatment for the prevention or cure of alcoholism or drug addiction, except as specifically provided under TRICARE and The Policy; treatment by a Physician or confinement not necessary for medical care; nursing services, unless it is for the nurse’s full-time service while the Covered Person is an Inpatient in a Hospital; purchase of a wheel chair, hospital type bed, or other durable equipment, unless TRICARE determines that purchasing the equipment costs less than renting it; care received as part of a grant, study or a research program; care consider experimental or investigational; any part of a Covered Expense which the Covered Person is not legally obligated to pay because of payment by a TRICARE alternative program; any claim under more than one of the TRICARE Supplement Plans. If a claim is payable under more than one plan or benefit, payment will only be made under the provision that provides the highest coverage.

 

Effective Date

Your MilicarePLUS protection begins on the first day of the month after your enrollment form and first premium are received, as long as you're a member in good standing. If on that date you are confined in a Hospital or Skilled Nursing Facility your coverage will be deferred until the first day after you are discharged.

 

Termination

Your coverage will end on the earliest of the following: the date The Policy terminates; the date You are no longer in a class eligible for coverage, or The Policy no longer covers Your class; the date the required premium is due but not paid, subject to the Individual Grace Period; the date You Request We terminate Your coverage; the date You cease to be covered under TRICARE; the date You return to Active Duty; the date You cease to be a Member of the Policyholder; the date You attain Age 65 unless You are not eligible for Medicare and can provide documentation of such from the Social Security Administration; the date You become eligible for Medicare (unless You reside in an area where Medicare is not available. Coverage will not terminate until You reside in an area where Medicare is available); unless continued under the Continuation Provisions. In addition to the events listed, if Your coverage was continued in accordance with the Widow or Widower’s Continuation provision, Your coverage will end on the Premium Due Date on or next following the date You remarry or enter or enter into a legal relationship recognized as a spouse.

 

Rates and/or benefits may be changed on a class basis.

 

*You'll be billed four times a year. If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

You are eligible for coverage if you are a member or auxiliary member of Fleet Reserve Association. If you are over age 65, you must be ineligible for Medicare benefits and not be on active duty. Your MilicarePLUS rates will not increase unless rates increase for all in your classification. Rates are based on attained age and increase as you enter a new age bracket.

Basic Plan deductible for Retired and Active Duty is $300/person or $600/family.

Choice Plan deductible for Retired and Active Duty is $250/person or $500/family.

The Select Plan for Retired has NO deductible.

No, you pay the TRICARE Select deductible.

You qualify for MilicarePLUS with no waiting period for current health conditions if you sign up within 30 days after your employer-sponsored plan ends because you are no longer an eligible participant (for example, if you change jobs, move, or retire). 

If you voluntarily end your employer plan while you are still an eligible participant, you are not eligible to have the Pre-Existing Conditions waived.

As an FRA member under age 65, you and your family are guaranteed acceptance. However, insurance benefits payable are subject to the policy's Pre-Existing Conditions Limitation.

When you retire, if you enroll within 60 days of the date your Active Duty coverage ends, and your family is currently covered under the MilicarePLUS Active Duty TRICARE Supplement, you may qualify to waive the waiting period for current health conditions under your MilicarePLUS Select, Choice or Basic plan.

Yes. You can enroll all or part of your family. Your spouse qualifies for coverage if he/she is not legally separated or divorced from you, unless you are required to provide coverage for such spouse by court decree. Your unmarried children can qualify for coverage up to age 21 (23 if a full-time student or 26 if covered under TRICARE Young Adult).