Reserve after HPSP Active Duty Commitment (Air Force)

[DLorNoBalls]

OK I know what some of you are thinking. Dr. DLoNB, why in the world would you willingly stay in the military after being handed the golden key to your HPSP active duty chastity belt? The allure of cheap health insurance, being able to transfer my GI bill, and salving my HPSP time towards a retirement pension is enticing me. From what I can tell, it's just a weekend per month and maybe 2 weeks a year of active duty time. The retirement pay is not insignificant and could be a huge part of my retirement allowing me to scale back on work even earlier for some kind of coastFIRE plan. Seems like a pretty good deal even before we consider any kind of pay involved. At the same time, this is also how I felt about HPSP as a premed and we all know how that story goes, which is why I'm so cautious about this.

I did 4 years HPSP, 4 years active duty residency, and am currently in my payback period. My current plan was just to separate at 4 years and go full-time civilian and live my rich life, leaving behind my nontransferable GI bill and HPSP time. However, I talked to someone who said they were separating this year and going reserves, and I learned about some of the advantages of going reserves. I'm not looking to get deployed (main reason I will separate when eligible is to get rid of the threat of deployment/PCS). Here are my questions:

• Does anyone have any advice on how to make this decision?
• Has anyone done this who can share their experience? Is it truly as good as it sounds, as in for the minimal amount of work of 1 weekend a month, 2 weeks a year, we get all the above benefits?
• If you're deployed as a reservist, how does the pay structure work?

My main fear if I go down this pathway is being deployed anyway as a reservist and taking a huge pay cut similar to deployments during active duty time. Currently, I view deployments as de facto pay cuts because of the complete lack of ODE for 6 months, not to mention missing important things like the birth of your child, milestones, etc. In the case where I'm a reservist, it would actually be a real pay cut since it wouldn't be "off-duty employment" anymore, it would be my main job that I'm missing out on. I kinda hate being in the military, but I also hate paying out my ass for health insurance and college tuition. I'm an anesthesiologist FWIW.

Thanks for coming to my TED talk, I appreciate any advice/wisdom you folks have.

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[armytrainingsir]

I did it.

Actually came back in from a long break in service.

Retired with 22 good years as an 06 at my MRD, so going from BA check to retirement check. No gray for me, except my hair.

I had a great time.

After coming back in.....

Did ILE, met great friends that I keep up with still

Deployed once,108 days, again great experience, lifelong friends, I was employed by a big non profit at the time who cut me a check to make up the difference in my pay, so that was a wash. Very thankful for that. Missed some birthdays and a couple of funerals and lots of holidays with family. While that sucked, it gave me a deeper appreciation of what my uncles and cousins did in WWII and Vietnam. That appreciation and respect for what they did made those misses a bit more palatable and gave, in a weird sense, more meaning, to me at least, to my deployment.

Pay while deployed is identical to AD pay and allowances. So you already know how that sucks, lol. In the USAR, reservists are still protected by the 90 day BOG policy.

Pay (eat) while a drilling reservist.
25k CWSL bonus
30k or so in drill pay
15k 'pay', actually savings, by having Tricare instead of commercial insurance.

Transferred GI bill benefits to my youngest. which was worth about 20k

If you can make it to 15 good years, if your health fails, you are eligible for a 15 year retirement.

TSP is available, but no matching, for me at least, as I was under the old plan.

My retirement check will be somewhere between 36-40k before taxes etc. Wife will get 55% for life after I, statistically, die first.

Tricare at 60 is 345/yr for me and my wife.

My wife is younger, so Tricare for her will be about $200/yr when I hit Medicare age. Compare to a good friend who still pays about 25k per year for his younger wife's insurance until she turns 65.

I estimate my benefits for getting back into the reserves are worth somewhere between 700-800k over my and my wife's lifetime. Add it my pay and bonuses and the .mil was, in total, likely a million+ side gig for me.


Does that come with a price?
Absolutely.
And that is different for everyone.
For me, it really wasn't that big of a deal and worked out well.


I am thankful for my military service.
One the best decisions I ever made.
And, as one person put it, getting your 20 year letter is like getting a winning lottery ticket. There is a bit of truth to that.

But I'll be the first to admit, I had a 'Forrest Gump' career. Everything just worked out. Great AD experience, specialty of choice, always in MEDCENs, practicing the to the limits of my specialty, good bosses, promoted on time, cool merit badge for my uniform (fit surgeon), made 06 as a doc only, not a commander. One great deployment that was supported by my employer at the time, a fun overseas reserve mission after that for a few weeks, and lifelong friends. I admittedly hit a home run that is not the typical experience, and certainly not predictable.


YMMV. There is no doubt the .mil in the next 10 years will look completely different than the past 10 years.

The biggest piece of advice I have is consider it only if you can live below your means and are ready for the legion of unknown changes coming in the next decade.

Good luck.

 

[pawprint]

Tricare isn’t as great of insurance as you think anymore. It’s completely dependent on who is willing to take it, and if you’re not in an area that’s high military, you’re going to have a hard time finding someone who takes it as it isn’t great for civilian provider reimbursement. The Tricare list that they have online isn’t accurate either. You also will probably be stuck with extra fees and things that Tricare isn’t willing to cover when you need anything outside of normal doctor visits.

I experienced this with my wife who had to have surgery. Couldn’t find anyone who took Tricare, and when I finally did, Tricare didn’t cover a significant aspect of her care during the operation and we were slapped with a pretty hefty bill afterwards.

I’ve had multiple different insurance companies in my life, and Tricare has, by far, been the absolute worst in terms of actual coverage. The annual premium may seem nice, but in practicality, it’s crappy insurance, particularly for dependents. Maybe that’s why the premium is so low.

Active duty folks don’t see this side of it, but once you’re off the active duty side, it rears its ugly head. This may have been different even 10 years ago, but in the last several years the coverage has dropped in quality substantially. As a doctor, if I had a civilian come in and tell me Tricare was suddenly available to them as an insurance option, I’d tell them to find another insurance company without skipping a beat.

Please don’t stay in for Tricare. It’s not what it used to be.

 

[armytrainingsir]

Tricare isn’t as great of insurance as you think anymore. It’s completely dependent on who is willing to take it, and if you’re not in an area that’s high military, you’re going to have a hard time finding someone who takes it as it isn’t great for civilian provider reimbursement. The Tricare list that they have online isn’t accurate either. You also will probably be stuck with extra fees and things that Tricare isn’t willing to cover when you need anything outside of normal doctor visits.

I experienced this with my wife who had to have surgery. Couldn’t find anyone who took Tricare, and when I finally did, Tricare didn’t cover a significant aspect of her care during the operation and we were slapped with a pretty hefty bill afterwards.

I’ve had multiple different insurance companies in my life, and Tricare has, by far, been the absolute worst in terms of actual coverage. The annual premium may seem nice, but in practicality, it’s crappy insurance, particularly for dependents. Maybe that’s why the premium is so low.

Active duty folks don’t see this side of it, but once you’re off the active duty side, it rears its ugly head. This may have been different even 10 years ago, but in the last several years the coverage has dropped in quality substantially. As a doctor, if I had a civilian come in and tell me Tricare was suddenly available to them as an insurance option, I’d tell them to find another insurance company without skipping a beat.

Please don’t stay in for Tricare. It’s not what it used to be.

True.

I am in a mil heavy area and that certainly skews my perspective.

And my wife and I are in good health with minimal visits other than preventative care.

My experience as a patient with Tricare Select has been overall very good for the past decade.

As a solo physician that takes Tricare, you're right. The reimbursement sucks. Thankfully, the patient population mostly makes up for that as they tend to be compliant and reasonable. Certain TFL exceptions to that, lol.

But I have yet to see a healthcare system not take Tricare. And with the move toward employed physicians in health 'systems', hopefully access will be less of an issue in larger areas. Ironically,I have few independent physical options, only employed ones. And since Tricare doesn't require enrollment and any physician can see a Tricare patient one off, calling in a favor is in the cards.

As always, YMMV.