Health Insurance and the Army

My oldest son, Fang, just got the Army to pay for his last two years of college. Of course in exchange, he owes them four years of active duty. Not a problem, this has been his career asperation since he was little. He has been filling out pay forms for his monthly stipend. I asked him about health insurance, since he is still on ours. He had no idea how it will work. I assume once he’s on active duty, the military has a health insurance provider, and that it would work like private insurance - probably like an HMO, as I’m sure they’d rather you see that Army Doctor first.

How off base am I? Would anyone with real world experience chime in?

The military health system is 100% responsible for the care of active duty military members.

Your son should no longer be a covered dependent on your coverage.

Miltary care is centered on a Primary Care provider team, which IMHO is almost universally military medical personnel operating out of a military health facility (clinic or hospital). Sick call, routine examinations, health and wellness management should be there. If care requires experts or capabilities not available at the local facility, the member might be referred to a larger military medical facility or to a civilian provider under referral.

Overall information website (maybe too broad to be of immediate help): About the Military Health System | Health.mil

The military operates its own clinics and hospitals, staffed with DoD-employed doctors. He’d be treated there, with no insurance provider involved.

It’s not clear whether the OP is asking about any military coverage between now when he signed a commitment, and 2-ish years from now when he starts active duty, or is asking about after son is on active duty.

If we’re talking about something like ROTC, there’s also a certain amount of in-between twilight zone time where son would be at various training events short of full-bore active duty.

Big differences between all these situations. I’m not current enough on military health care to offer any useful comments. Beyond suggesting we all want to be precise about which question(s) we’re answering.

Well, I did specify “active duty”. If a member is not yet on active duty, my specific information wouldn’t apply.

This is what I figured would be the case once he graduates and get his commision. It is very reminiscent of my wife’s experience with Kaiser Permanente in the '90s. Most everything was in-house.

He did mention that Army would take care of any injuries that occur during his FTX or drills.

Be careful here. “Gets commission” is not synonymous with “is on active duty and on the payroll”. I got my ROTC commission upon graduation in June, and was not called to active duty until the following March 9 months later.

During that time my status was some flavor of “inactive reserve”. No wages, no military ID card, no health coverage. But also not a full-time student anymore, so no longer eligible for my parents’ employer-based health coverage under the rules then in effect. I was health-uninsured the whole time.

The DoD is a giant bureaucracy and every possible permutation of things that could be different are treated as different. So be very careful in general with assuming that Event X implies status Y. Your son also needs to get conditioned to thinking that way. Don’t assume “it sounds logical that these two things would go together.” Instead ask; it’s the only way to be be sure.

Maybe I’m misremembering, but I thought my fraternity brothers in ROTC were all on active duty by September. Of course that was thirty (mumbly-mumbly) years ago, and I’ve slept since then.

Oh yeah, since he transferred from Air Force, every time he says, “I assume…” his mother and I reply, “But have you asked someone?”

How soon you went on active duty depended on “the needs of the service”. Specifically, the first thing a new O-1 does is attend a school to learn how to do their new job.

All the academy grads are not reservists; they’re already active duty de facto enlisted before graduation and on graduation day they become officers also on active duty payroll. So all the school slots from that day for the next few months are reserved for them, since they’re getting paid. Then once all those folks have started school, the next class dates for [whatever] school go to the ROTC grads who’ve been idling for free since graduation. OTS/OCS folks get blended in there too.

In eras (like mine) where the academy was producing the bulk of new officers, it took a long time to process all their school dates. In eras where the service is expanding rapidly and ROTC and OCS/OTS is running full tilt, the academy folks represent a smaller percentage of the annual intake and so will consume a smaller fraction of the annual class dates. But still starting from graduation day and running as long as necessary to use up the supply of fresh academy O-1s.

It also depends greatly on what specialty the officer is going to. I was a USAF pilot, and a hefty fraction of all USAF Academy grads become pilots. A rather smaller percentage of academy grads become, e.g. personnel officers. So although the academy pilots usually took the first 9 months of the annual supply of pilot school slots, they probably took only 1 month of the annual supply of personnel officer school slots.

Bottom line:
My personal story was common for my era and for my role. But depending on what branch and specialty your son is doing, etc., etc., plus of course the state of the Army in 2026, his active duty start date might be shortly after graduation or might not.

Looping back to the question of the OP, the former quick start to active duty is simple and needs little planning. The latter slow start is the one with risks. As to medical insurance, a place to live, ability to get and keep a worthwhile civilian job or need to mooch off Dad, etc. So my purpose was mostly to warn of yet another potential pitfall you both may not have known was out there.

I see what you did there?

FWIW, under a provision of the Affordable Care Act, you can continue to carry your son on your health insurance coverage, if need be, until his 26th birthday.

I’m aware of that, so I’m not worried about a lack of coverage. I’m more worried about double coverage, and the myriad headaches that occur with that.