civilian health-insurance provider. Members of the selected reserve3 components who are not activated may choose to enroll themselves or their families in TRICARE Reserve Select, a premium-based option (Andrews et al., 2008).


Service members leaving the military and their dependents are usually eligible for transitional TRICARE coverage. Active-duty members leaving the military under other than adverse conditions and their dependent family members can receive 18 months of coverage through the Continued Health Care Benefit Program (CHCBP). Children and spouses who were enrolled in TRICARE and lose eligibility can receive CHCBP coverage for up to 36 months. Deactivated National Guard and reserve members who were called to active duty for at least 30 days and separating active-duty members who do not qualify for the CHCBP are usually eligible to receive health-care coverage for 180 days through the Transitional Assistance Management Program (TMA, 2009d).

BOX 5.1

Family in the Military Context

Multiple definitions of family operate in the Department of Defense (DOD), each tied to specific regulatory requirements. The most common definition defines eligibility for military identification cards, which are necessary for access to health care, military exchanges, and a variety of supportive services for families. Military identification cards are currently issued to spouses and unmarried children of service members, with exceptions and additional categories defined by children’s ages, student status, or special needs and by whether the marriage ends in divorce or in death of the service member while on active duty. Spouses and unmarried children of reserve-component members are covered while the service member is on active duty for more than 30 consecutive days (TMA, 2006). Stepchildren may or may not qualify for military identification cards, depending on such factors as age, student status, and the circumstances of the biologic parents.


Other military programs have adopted more inclusive definitions of family. For example, the Yellow Ribbon Reintegration program permits participation by service members’ spouses, children, parents, grandparents, siblings, and significant others (USD(P&R), 2008). In light of the fact that only about half of military members are married, new rules recently issued for the Family and Medical Leave Act expand previous definitions of family caregivers to include adult children’s parents and other kin (US Department of Labor, 2009a).


In practice, some family members do not receive supportive services even when policy permits it. For example, the DOD Task Force on Mental Health (2007) recognized that military family members have difficulty in obtaining treatment for some psychologic health problems because of gaps in provider networks. In addition, families that do not conform to military definitions may have difficulty in obtaining needed services. For example, grandparents who move to military installations to care for children during parents’ deployment may have difficulty in obtaining access to military services, and this can be especially challenging in overseas locations.

3

The selected reserve includes those members of the ready reserve who train throughout the year and participate in annual active-duty training exercises. The individual ready reserve and the inactive National Guard form the other two components of the ready reserve.



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