When does it make sense to go Guard/Reserve?

[upontherocks]

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I am a GMO separating from the military for residency. As I'm doing this, I'm being approached to go over Guard/Reserve opportunities. As much as I enjoyed my time and got to do some cool things, I've gotten a pretty rotten deal and experience all considered, especially for my background and compared to my civilian peers. That said, if things aren't as bad/worth it on the Guard side of things, would it be worth trying out? Are the benefits worth it? Is Tricare on the reserves really that good? I've somehow managed to come out in one piece so far. My future goals are to have my own practice, or something more on the business side of medicine, or the VA, depends on how things work out in the future.

 

[armytrainingsir]

It makes the most sense for a former HPSP doc with 8-10 years AD in a specialty that is at lower risk for deployment and yet in a critical wartime specialty. In that case, with HPSP credited as good years, over halfway there.

Tricare lets you be mobile and not tied to getting care in your own system as most hospital employee insurance plans require you seek care in their system first.

When I went back into the reserves, I was solo practice, paying $1500/mo for BCBS and a $7500 deductible. Tricare was $210/mo at the time. $1000 deductible. That kept more money in my pocket than my 05 drill pay put in it!

Reserve retirement pay, Tricare from 60-65 yo, and TFL is worth somewhere between 700k and one million IMO. If your spouse is younger and not working, you’re on the hook for about 25k per year for their health insurance and related costs if you retire at 65 and go on Medicare.

When you say ‘crappy deal’, I’m guessing you had the typical doc in a box type GMO job in a less desirable location with some crappy leadership and time in the field. In exchange, you have zero medical school debt and can buy a house with no money down. Lots of BC/BE primary care physicians have a crappy job in a miserable place AND $200k of debt. 😉

And you still get to board first at the airport, lol.

 

[pawprint]

Tricare is not good health insurance. It used to be probably 5-10 years ago, but over the last several years people have dropped taking it altogether as it has horrible reimbursement.

If you are in an area that’s military heavy, you might be lucky to have enough providers that take it. Otherwise, you’re going to be stuck with the very long wait times and very slim pickings of practices that take it.

I needed to see a urologist towards the end of my active duty time. Had a 7 month wait at the only local urology practice that took Tricare (nothing active duty where I was). Ultimately didn’t end up being able to be seen because I got out before they could schedule me. I got basic catastrophic insurance and was able to call a different local urology office and got scheduled within 3 weeks.

I could go on about a similar story for my wife. Needed to see a gyn specialist, only 1 provider in the area took Tricare. This person had horrible patient reviews, but was the only option. We opted to wait until I got out and got different insurance. Same story, was able to get in with whatever provider we wanted within about a month.

Now I’m back in civilian residency, and have my hospital’s insurance. I do not need to be seen at my hospital first if I want care…I can pick whatever doctor I want because everyone takes my insurance. I get a discount if I stay within the hospital network…but it’s only a few hundred dollars per year that it could save me so I’m not limited by that if I find another doctor I really like. The military gets you used to seeing “whatever doctor is available”…in the civilian world, you can actually pick the doctor you want to see. Shocking concept…but it’s actually really great.

I would not advise joining the military for Tricare anymore. It’s no longer good insurance except for select market areas.

 

[armytrainingsir]

With so many employed physicians in ‘health systems’ these days, I haven't had an issue with Tricare.

Are there any big name systems that don’t take Tricare?

And at the end of the day, I’ll pay the doc cash with my savings. Hospitals and pharmacies are what’s so unaffordable.

 

[comp1]

I'm not in a particularly military heavy area and everyone who accepts private insurance, accepts Tricare. There are cash only exceptions for like psychotherapy and plastic surgery, but that's it. Reserves can be a good match with VA employment as the system is designed to accommodate it and it puts less stress (read resentment) on the employer.

 

[flightdoc09]

For the OP, if you hated your time active duty, you will probably hate your time in the reserves. Depending on what kind of billet they have you in, you will likely just be an admin monkey doing no real medicine and pretty much just doing PHAs. At least that's what I'm told.


But I am also wondering about going reserves. I'm EM, will be at the 10 year mark where I can separate in a year and a half. Will see what orders are available. But if nothing good, I could get out and make a ton more money. Could also do reserves and get a pretty good retention bonus as reserve EM, or even do reserve flight. Could also switch services and go national guard.

I think the value of Tricare for life, plus a military pension is pretty good if you want to take it easy go semi-retired as you hit your 50's and 60's. Tricare obviously isn't the best, and it's a secondary insurance, but it is pretty good. And with the direction healthcare costs are going in this country, I think it's a good thing to have.

If anyone here has gone Navy to national guard, or navy reserves as flight or EM, would be interested in your thoughts. Also, curious about maximizing points by doing more AD time, or a deployment, instead of just drill.

I needed to see a urologist towards the end of my active duty time. Had a 7 month wait at the only local urology practice that took Tricare (nothing active duty where I was). Ultimately didn’t end up being able to be seen because I got out before they could schedule me. I got basic catastrophic insurance and was able to call a different local urology office and got scheduled within 3 weeks.

Just in case you didn't know, and in case others don't know, you get 6 months of Tricare after separation. I suspect you moved after separation, so wasn't worth seeing a new referral at your new location. But I know a lot of junior enlisted get out and need medical care until they can get a job, and no one tells them this.

 

[pawprint]

Just in case you didn't know, and in case others don't know, you get 6 months of Tricare after separation. I suspect you moved after separation, so wasn't worth seeing a new referral at your new location. But I know a lot of junior enlisted get out and need medical care until they can get a job, and no one tells them this.

This is not true, you only get an extension of your Tricare under a select set of circumstances. Being honorably discharged because you made it to the end of your obligation is not one of those circumstances. The particular program is called TAMP.

Source: https://www.tricare.mil/tamp

You can pay to extend your Tricare through a seperate program called CHCBP, but it’s very expensive (was about $4500 for 90 days, plus a several thousand dollar deductible), you only get it in 90 day allotments before you have to reapply, and you can only apply by paper application. I got better coverage on the marketplace during my job transition for $300/month.

Again, Tricare is not what is chalked up to be anymore. My large academic medical center subspecialty groups do not accept Tricare (the subspecialty groups are run as private practice effectively). You can be seen in the ER and admitted for general inpatient services with Tricare, but if you need any kind of outpatient subspecialty care you are SOL because they bill separately. And don’t take it.

 

[pgg]

Tricare is not good health insurance. It used to be probably 5-10 years ago, but over the last several years people have dropped taking it altogether as it has horrible reimbursement.

I think it really depends a lot on location.

I'm retired Navy.

In 2025 we had both Tricare and a higher quality family plan from United Healthcare (premium was ~$3K/month). United declined our claim for a surgery and has been nothing but a pain in the ass and money flushed away. Tricare paid the claim.

It looks like everyone accepts Tricare here. We are not near a military base, and I don't see a whole lot of Tricare come through our practice. I suspect in areas with a high military population, where civilian physicians are inundated with Tricare referrals, that many will refuse or limit Tricare patients in their practices. That doesn't seem to be the case here.

Also - practically every surgical specialty is hospital-employed here, and I don't think they care one bit about patients' insurance (or lack thereof).

We are dropping United entirely for 2026+ and just going with Tricare. I won't recover the full $36K in annual premiums, because of the way my practice pays for the group policy, but I'll save around $8K, give or take.

Even if we run into problems with some random specialist declining Tricare ... $8K pays for a lot of clinic appointments and concierge / cash-pay services.

 

[pawprint]

I think it really depends a lot on location.

I'm retired Navy.

In 2025 we had both Tricare and a higher quality family plan from United Healthcare (premium was ~$3K/month). United declined our claim for a surgery and has been nothing but a pain in the ass and money flushed away. Tricare paid the claim.

It looks like everyone accepts Tricare here. We are not near a military base, and I don't see a whole lot of Tricare come through our practice. I suspect in areas with a high military population, where civilian physicians are inundated with Tricare referrals, that many will refuse or limit Tricare patients in their practices. That doesn't seem to be the case here.

Also - practically every surgical specialty is hospital-employed here, and I don't think they care one bit about patients' insurance (or lack thereof).

We are dropping United entirely for 2026+ and just going with Tricare. I won't recover the full $36K in annual premiums, because of the way my practice pays for the group policy, but I'll save around $8K, give or take.

Even if we run into problems with some random specialist declining Tricare ... $8K pays for a lot of clinic appointments and concierge / cash-pay services.

I totally agree, I think it’s area-dependent and situation dependent. 3k/month premium is a lot of money…my United plan for my family from my employer is $400/month. That’s for a $600 deductible, $2k max out of pocket/year for my family. It’s great insurance, but not everywhere is that good.

But that’s why I would never advise someone to join the military for the tricare benefit. I think it’s hit or miss, like any insurance company. It shouldn’t be a factor in the decision making process because it may or may not be good, especially years down the road.

If you happen to find that Tricare works great for where you live, then that’s awesome and more power to you. But there’s also the chance it leaves you hanging high and dry. My point is to not add it in the equation of decision making because it’s too unpredictable of whether or not it’s better than a civilian plan.

 

[flightdoc09]

But that’s why I would never advise someone to join the military for the tricare benefit.

But what if instead of joining, I'm a stripper that's marrying into the military for the tricare benefit?

 

[pawprint]

But what if instead of joining, I'm a stripper that's marrying into the military for the tricare benefit?

I mean, tricare is better than nothing, so sounds like a win-win-win to me

 

[DeadCactus]

I am a GMO separating from the military for residency. As I'm doing this, I'm being approached to go over Guard/Reserve opportunities. As much as I enjoyed my time and got to do some cool things, I've gotten a pretty rotten deal and experience all considered, especially for my background and compared to my civilian peers. That said, if things aren't as bad/worth it on the Guard side of things, would it be worth trying out? Are the benefits worth it? Is Tricare on the reserves really that good? I've somehow managed to come out in one piece so far. My future goals are to have my own practice, or something more on the business side of medicine, or the VA, depends on how things work out in the future.

The Guard and Reserve is no different than the rest of the military: the benefits are just good enough to justify joining if you want to join for the sake of being in the military. The bolded part makes me say no, don't do it. Go enjoy civilian life and pursue whatever it is you feel you're owed without the shackles of a military commitment. The Guard and Reserve will always be there later if you start to miss aspects of it.

 

[upontherocks]

Thanks for the responses everyone. I mentioned Tricare as one of the benefits that I'm aware of but curious about any other benefits that makes it worth it. I'm feeling blessed not having to see the doctor any more than necessary but will need insurance still. I don't hate being an admin monkey, but my experience working with others at my location, leadership mainly, has been particularly toxic and unique, I'm not sure what I did to end up here and no one believes what I'm going through (going on leave is one thing I have to fight for, but even TDY my leadership treats like I'm weaseling out of work) so if the Guard/Reserve is anything like that, I can deal without that.

 

[MTGas2B]

Other benefit, if you have kids, and you haven't completed your post-9/11 GI Bill transfer to dependents, you can complete the required time as a drilling reservist, at least for the Navy. I assume same for Army and Air Force.