9-06-13

TRICARE and the Affordable Care Act

A number of shipmates have inquired about the impact, if any, the Patient Protection and Affordable Care Act (PPACA), also known as “Obamacare,” will have on their TRICARE benefits.  Effective January 1, 2014, all Americans must have Minimum Essential Coverage (MEC) to fulfill the individual-coverage mandate of the legislation.  Unless exempted, those without MEC may be required to pay a penalty (“shared responsibility payment”) for each month they go without healthcare coverage.

The TRICARE Management Activity (TMA) confirms that TRICARE Prime, Prime Remote and Standard; the US Family Health Plan, TRICARE Overseas plans; Transitional Assistance Management Plan; and TRICARE for Life (TFL) qualify as an MEC. Purchased programs such as TRICARE Young Adult (TYA), TRICARE Retired Reserve (TRR), TRICARE Reserve Select (TRS), and the Continued Health Care Benefit Program also qualify. Those eligible for direct care only (MTF care only) or for Line of Duty conditions only do not have MEC.*

FRA worked to ensure TRICARE and VA healthcare programs are separate from the PPACA and, as a result, the new healthcare law will not impact TRICARE or VA beneficiaries. FRA’s Legislative Team continues to monitor implementation of the PPACA to ensure those programs are not adversely impacted by unanticipated consequences.

* “If your parents or parents-in-law are dependent on you for support, your local MTF may be able to help with the cost of their health care.  Although dependent parents are not eligible for most TRICARE benefits, they may be eligible to receive health care at the MTF.

Health care for eligible dependent parents or parents-in-law is available on a space-available basis at certain MTFs.  Access to care is subject to change based on the MTF's capacity and capabilities.”

(Excerpted from the TRICARE Prime Handbook)