TRICARE and the Affordable Care Act
The Affordable Care Act requires you to maintain basic health care coverage—called minimum essential coverageBasic health care coverage that meets the Affordable Care Act requirement.. If you don't have minimum essential coverage, you may have to pay a fee for each month you aren’t covered.
TRICARE Plans that Provide Minimum Essential Coverage
You have minimum essential coverage if you're using any of the following health plans:
- TRICARE Prime
- TRICARE Prime Remote
- TRICARE Prime Overseas
- TRICARE Prime Remote Overseas
- TRICARE Select
- TRICARE Select Overseas
- TRICARE For Life
- TRICARE Reserve Select (if purchased, see below)
- TRICARE Retired Reserve (if purchased, see below)
- TRICARE Young Adult (if purchased, see below)
- US Family Health Plan
- Transitional Assistance Management Program (transitional)
- Continued Health Care Benefit Program (if purchased, see below)
Qualifying for a Purchased Plan
Do you qualify for one of TRICARE's premium-based plans? These are:
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- Continued Health Care Benefit Program
If you do qualify, you may purchase a premium-based plan to fulfill your minimum essential coverage requirement. Or, you can use:
- Employer health insurance,
- Qualifying school or university health plans
- Medicaid, or
- Plans offered through the Health Insurance Marketplace.*
*Open enrollment for the Health Insurance Marketplace is November 1 - January 31 each year.
When You Don't Have Minimum Essential Coverage
Typically, you don't have minimum essential coverage from DoD/TRICARE if:
- You're only eligible for care at military hospitals and clinics (also known as "direct care"). Examples of beneficiaries only eligible for direct care include:
- Dependent-parents and parents-in-law
- Service Secretarial Designees
- You're a Guard/Reserve member not on active duty but are receiving Line of Duty care for an injury, illness or disease incurred or aggravated in the line of duty.
- You're a member of a foreign military or their dependent who is in the United States and may be entitled to inpatient and/or outpatient care in military hospitals and clinics and/or civilian health care through DoD, based on an agreement between the U.S. and your foreign government.
- You aren't covered by another TRICARE plan listed above.
An Important Note About TRICARE Program Information
At the time of publication, this information is current. It is important to remember that TRICARE policies and benefits are governed by public law and federal regulations. Changes to TRICARE programs are continually made as public law and/or federal regulations are amended. Military hospital and clinic guidelines and policies may be different than those outlined in this publication. For the most recent information, contact your TRICARE regional contractor or local military hospital or clinic.