Bread Crumbs

TRICARE and the Affordable Care Act

The Affordable Care Act requires you to maintain basic health care coverage—called minimum essential coverage. If you don't have minimum essential coverage, you may have to pay a fee for each month you aren’t covered.

Plans that are Minimum Essential Coverage

If you’re using any of the following health plans, you have the minimum essential coverage required by the health care reform law. Unless you’re considering other health coverage, you don’t need to take any action at this time.

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Standard and Extra
  • TRICARE Standard Overseas
  • TRICARE For Life
  • TRICARE Reserve Select (if purchased)
  • TRICARE Retired Reserve (if purchased)
  • TRICARE Young Adult (if purchased)
  • US Family Health Plan
  • Transitional Assistance Management Program (transitional)
  • Continued Health Care Benefit Program (transitional)

Minimum Essential Coverage for 2014

Typically, you don’t have minimum essential coverage from TRICARE if you’re only eligible for care at military hospitals and clinics (also known as “direct care”) and not covered by another TRICARE plan as listed above.

Examples of beneficiaries eligible only for direct care include:

  • Dependent-parents and parents-in-law
  • Guard/Reserve members getting Line of Duty care
  • Service Secretarial Designees

For the 2014 tax year only, you have a special exemption from the tax penalty.  You can check “yes” in the box on your tax forms for minimum essential coverage.   

But for the 2015 tax year, this rule will be in effect. 

Qualifying for Premium Assistance

In some cases, it may be cheaper to purchase coverage through the Health Insurance Marketplace. You may qualify for assistance to lower your monthly premium in the Marketplace.  You may do so to complement your TRICARE plan or replace it, depending on what fits your budget and meets your needs.

Yes, You May Qualify for Assistance No, You Don't Qualify

If you are eligible to purchase one of the plans below and you choose not to purchase one, you may qualify for assistance to lower your monthly premium for plans purchased through the Health Insurance Marketplace:

  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult (Prime and Standard)
  • Continued Health Care Benefit Program

You should compare these plans with Health Insurance Marketplace plans to see what fits your budget and meets your needs.

If you’re using the following plans, you don’t qualify for assistance to lower your premiums on plans purchased through the Health Insurance Marketplace:

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Standard and Extra
  • TRICARE Standard Overseas
  • TRICARE For Life
  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult
  • Continued Health Care Benefit Program
  • Transitional Assistance Management Program
  • US Family Health Plan

Other Minimum Essential Coverage Options

  • You should consider all available health care options that meet your minimum essential coverage requirement.  
  • Minimum essential coverage may be available through your employer, your spouse’s coverage at work, school health plans, etc. 

Last Updated 1/23/2015

contact Your Contacts
Health Insurance Marketplace

1-800-318-2596

Search Online


View More Contacts