Active and retired members of the military have many options when it comes to health insurance coverage, but many elect to use the TRICARE program offered by the U.S. Department of Defense (DoD) as an affordable way to gain coverage for themselves and their family members. Formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), this program now covers over nine million beneficiaries across the globe, including active duty military members, veterans, National Guard and Reserve members, their families, and more.
In other words, TRICARE provides a vast network of healthcare services designed for use by military members and their families. So it’s only natural to have questions about how the implementation of the Affordable Care Act (ACA), more commonly known as Obamacare, might affect your benefits under the TRICARE program.
ACA Mandatory Minimum Essential Coverage
There are two sides to the ACA coin. On the one hand, the law calls for insurance providers to meet standards for coverage, ensuring that all Americans have access to affordable health insurance and certain, specified services. The other side is that all American are now responsible for maintaining minimum essential coverage, with failure to comply resulting in penalties (fees).
The good news is that TRICARE programs provide minimum essential coverage (with very few exceptions), which means that most participants enrolled in TRICARE will not be required to obtain additional insurance coverage and will not be subject to penalties. This is not to say that you are unable to participate in other health insurance plans for additional or supplemental coverage should you so choose.
TRICARE is compatible with a variety of other health insurance options, such as Medicare, Medicaid, and employer-sponsored plans, among other options. It is even compatible with some VA healthcare programs. It is not, however, compatible with CHAMPVA – you must choose one or the other if you are eligible for both programs.
The only thing you need to understand when using TRICARE with other health insurance coverage options is that there is a hierarchy when it comes to processing payments. It will differ depending on the type of coverage, so you need to speak with a TRICARE representative or representatives from your other health insurance providers to determine who will process payments first, after which other providers will process remaining money owed for services.
Changes to TRICARE
Following the enactment of Obamacare (and subsequent Supreme Court rulings upholding the law), many TRICARE members were concerned about how healthcare reform would affect their benefits. In truth, Obamacare has had very little effect on TRICARE participants.
This is because TRICARE already met the majority of standards set forth for minimum essential coverage. While many private insurance companies were deeply affected by Obamacare’s standards for preventive services, providing non-discriminatory coverage even to those with preexisting conditions, and other changes, TRICARE plans already satisfied the lion’s share of mandates.
The biggest change to TRICARE was the addition of TRICARE Young Adult (TYA), providing insurance benefits for dependent children under the age of 26. In essence, Obamacare changed almost nothing in terms of TRICARE benefits, and where it did, it only improved member benefits.