Medical Entitlements

Medical Treatment

The type of medical treatment IRs are eligible for depends on their status.

Active Duty Status
When on active duty tours greater than 30 days, IRs have the same medical care authorized as members of the AC for the period of duty specified in the orders. Dependents are only authorized care when IRs are on tours 31 days or greater. Medical care is not authorized at government expense beyond the training period for an injury or disease incurred not in the line of duty (see Line of Duty Determination below). Optical and dental care exclusive of Preventative Health Assessment (PHA) is limited to emergencies on a space available basis. The medical facility commander is the final approval authority for this type of care.

Annual Tour or IDT Status
IRs who incur or aggravate an injury or illness while performing Annual Tour or IDTs may seek medical care. Dependents are not authorized care through a MTF during these periods of duty. IRs may be given a required PHA examination through the MTF while on AT or IDT status. Ancillary lab and medical test results from a private health care provider can be added to the PHA if accomplished within the last 11 months of prior PHA.

TRICARE Reserve Select (TRS) and SGLI

TRICARE

TRICARE Reserve Select (TRS) is a premium-based health plan available worldwide to Selected Reserve members of the Ready Reserve and their families who are not eligible for or enrolled in the Federal Employee Health Benefits (FEHB) program or currently covered under FEHB, either under their own eligibility or through a family member.

NOTE: Those members in the Individual Ready Reserve (IRR) do not qualify to purchase TRS.

You may visit any TRICARE-authorized provider, in network or out of network. Care at military treatment facilities is on a space-available basis only. You do not need a referral for any type of care but some services may require prior authorization. The type of provider you see determines how much you'll pay out-of-pocket. If you're visiting a network provider, you'll pay less out of pocket and the provider will file claims for you. For more information on Tricare Reserve Select, visit their website.

SGLI

IMAs often do not drill every month like TRs.  If an IR elects SGLI coverage, the monthly amount will still get charged whether they are performing duty or not.  For example, if an IMA does all of his or her 24 IDTs and Annual Training in one month out of the year and the other 11 months they were not performing duty, they would incur a SGLI debt.  However, once duty is performed, the SGLI debt will be deducted from the next paycheck, regardless of how many days of duty are performed.  If SGLI coverage is elected and duty is never performed,  (for instance, a move to the IRR) the SGLI coverage remains.  If something were to happen, next of kin would still receive their monies. 

When you become an IMA and/or change statuses, it's important to make a point to decline coverage or accept SGLI coverage, knowing that if you accept it, the monthly premiums may accrue as a debt that will automatically be paid the next time you work.  
 

Line of Duty (LOD) Determination

When a member incurs or aggravates an injury, illness or disease while serving in a duty status, a line of duty determination is required. IRs who are injured or become ill while performing military duty must have the MTF physician complete an AF Form 348 Line of Duty Determination promptly, preferably within 30 days of occurrence. NOTE: The injury or illness should have occurred while the member was performing duty on the most recent set of orders or AF IMT 40A.

The Line of Duty is a member driven process and it is the responsibility of the member to provide all supporting documentation. The LOD package is submitted to the HQ RIO/IRM office. Requirements include: all medical documentation pertaining to the injury or illness; a copy of the certified orders or AF Form 40A to show the member’s status during the period of the injury or illness; the AF Form 348 completed through signature of the AD Commander (Part III, line 23. a .b. & c.); Medical Provider Form; Member LOD Initiation Form; Briefings. Once received, all documentation will be routed for official adjudication of In Line of Duty or Not In Line of Duty. Documentation is submitted via a myPers incident 

Medical care is not authorized at the expense of the Air Force beyond the training period for injuries or disease incurred NOT In Line of Duty. Surgical correction for conditions existing prior to military service may be performed only where it is immediately necessary to save life, limb, or sight, to prevent undue suffering, or loss of body tissue. Entitlement, as in line of duty determination, must be established prior to any surgery.
 
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Medical Continuation

Members on active duty under RPA or MPA orders for a specified period of 31 days or more who incur a line of duty medical condition may be placed on medical-specific active duty orders to ensure they receive the medical care and treatment they are entitled until they are returned to duty, processed through the Disability Evaluation System, or the medical condition has been determined not to be in the line of duty. The condition must not only be service connected, but also render member “unable to perform military duties”. NOTE: An approved LOD for any medical condition does not automatically entitle members to medical continuation orders. The service-connected condition must be severe enough that a level of incapacitation occurs that renders the member physically unable to perform any military duties. Members should contact their URC, Detachment or HQ RIO/IRM for more information or to complete a medical continuation orders package.

Incapacitation (INCAP) Pay

Members with an approved LOD who are physically disabled may be entitled to incapacitation pay (INCAP). Members receiving INCAP do not accrue points. Members should contact their servicing Detachment or ARPC/DPAAB for more information concerning INCAP Pay. Members can submit documents and requests for INCAP pay via myFSS HERE.

Pregnancy of USAFR Personnel

IRs on long term AD orders and determined to be pregnant after the start of the tour may be allowed to continue after the 34th week possibly thru delivery date with approval of their AC unit Commander.

IRs determined pregnant prior to duty may be scheduled for and performed duty up to 34 weeks. Beyond 34 weeks IR will require the approval of physician, MTF and AC unit Commander to perform IDT and AT. Additionally, member must reside within 50 miles of the duty location to be considered for approval.

IRs may not take part in transoceanic or deployment training while pregnant. A letter or certificate from the physician, attesting to the duration of pregnancy, is needed before scheduling any training.

Obtain an AF Form 469 Duty Limiting Condition Report from the base of assignment or attachment Medical Treatment Facility. Enlisted personnel, IMAs only, must process an AF Form 656 with ARPC/FM for a maternity uniform. Only one set is allowed. Officers must purchase maternity uniforms at their own expense. AFI 44-102 Community Health Management and AFI 36-2905 Fitness Program, provides further guidance.

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