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What TRICARE coverage counts as
minimum essential coverage under the
Use the "TRICARE Plans" and "Premium-Based TRICARE Plans" tables below to find out.
TRICARE Plans
Is it
minimum
You have essential What you need to know
coverage?
essential
2. Q.
* Certain unremarried former spouses may qualify for an unlimited duration of coverage.
Affordable Care Act?
What TRICARE coverage counts as minimum essential coverage under the Affordable Care Act?
Buy Continued Health Care Benefit Program coverage
qualify TRICARE Prime but No
a premium tax credit that lowers your premium) or Buy any other plan that qualifies
a health plan and Yes that qualifies as bought
minimum TRICARE coverage essential Retired
TRICARE Prime Yes haven’t Overseas bought
TRICARE Prime
Remote Yes
TRICARE Prime If you have coverage under one of these Remote Overseas plans and choose to buy coverage from the
Health Insurance Marketplace, you may TRICARE Prime not qualify for a premium tax credit that
lowers your premium.
Remote for Active Duty If you lose TRICARE eligibility (e.g.,
Family Members separate from the service, age out, or your TRICARE Prime Yes marital status changes), you can buy:
If you have You
coverage under
this plan and qualify No choose to buy but
coverage from the haven’t
Health Insurance bought Marketplace, you
may not qualify coverage
for a premium tax
credit that lowers
your premium.
You must pay
your premiums
on time to keep
your coverage in
good standing.
Coverage ends
when you reach
age 26.
After your
coverage ends,
you can buy:
For tax year 2016:
Remote for Active Duty
Family Members Overseas
TRICARE Standard TRICARE Standard Yes
Overseas
Keep TRICARE Young Adult coverage
Buy coverage from the Health
Insurance Marketplace or Buy any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
TRICARE For Life
TRICARE For Life Yes Overseas
Note: In some cases, you may qualify for
coverage through the Transitional
US Family Health Plan Yes Assistance Management Program (TAMP).
TRICARE Plus with Yes TRICARE Standard
TAMP Standard Yes
Only TRICARE Plus*
(Not TRICARE-
eligible)
* Coverage is only for No primary care at the
TRICARE Plus with TRICARE For Life
Yes
TAMP Prime Yes If you have coverage under one of these
Continued Health
coverage
Continued Health Care Benefit You
Program; or TRICARE Young TRICARE qualify
Adult coverage if you qualify Young and Yes Coverage from the Health Adult bought
Insurance Marketplace (you may be coverage
able to get a premium tax credit) or
Any other plan that qualifies
as minimum essential coverage
(e.g., coverage through an
employer, Medicare).
as minimum essential coverage (e.g., coverage through an employer, Medicare).
coverage, you Reserve may have to pay
a fee that goes up
every year.
plans and choose to buy coverage from the Health Insurance Marketplace, you may not qualify for a premium tax credit that lowers your premium.
Coverage is for only 180 days. After the 180 days, you can buy:
Continued Health Care Benefit Program or TRICARE Young Adult coverage if you qualify
Coverage from the Health Insurance Marketplace (you may be able to get a premium tax credit) or
Any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
Care Benefit Program coverage
You
qualifies as minimum essential coverage, coverage Only Direct Care you may have to pay a fee that goes up
(Not TRICARE- No every year. To avoid paying a fee, you can eligible) buy:
Coverage from the Health Insurance Marketplace (you may be able to get a premium tax credit) or
Buy TRICARE Young Adult coverage;
Buy coverage from the Health Insurance Marketplace (y ou may be able to get
If you don't have a health plan that qualifies as minimum essential coverage, you may have to pay
military hospital or
clinic where enrolled. If you don't have a health plan that haven’t
Only Line of Duty Care
(Not TRICARE- No
eligible) Any other plan that qualifies
a premium tax credit that lowers your premium) or Buy any other plan that qualifies
Only Transitional Care
for Service-Related Conditions*
(Not TRICARE-
eligible) No * Coverage is only for
180 days and only for the approved condition.
as minimum essential coverage (e.g., coverage through an employer, Medicare).
as minimum
e s s e n t i a l coverage
(e.g., coverage through an employer, Medicare).
Premium-based TRICARE Plans
Keep TRICARE
Only Transitional Care (e.g., coverage through an for Service-Related employer, Medicare). Conditions*
(Not TRICARE- No
qualifies
Health and Wellness
March 31, 2017 15 (e.g., coverage
eligible)
coverage
* Coverage is only for 180 days and only for the approved condition.
Factherobugohoakn .com/NellisBullseye employer,
Premium-based TRICARE Plans
Medicare).
Keep TRICARE Reserve Select coverage
Buy coverage from the Health Insurance Marketplace or Buy any other plan that qualifies
as minimum essential coverage
(e.g., coverage through an employer, Medicare).
Buy TRICARE Reserve Select coverage
Buy coverage from the Health Insurance Marketplace (you may be able to get
a premium tax credit that lowers your premium) or Buy any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
Keep TRICARE Retired Reserve coverage
Buy coverage from the
Health Insurance Marketplace or Buy any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
Buy TRICARE Retired Reserve coverage;
Buy coverage from the Health Insurance Marketplace (y ou may be able to get
a premium tax credit that lowers your premium) or Buy any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
Is it Premium minimu
What you need to know
If you have You qualif coverage under y
this plan and and Yes choose to buy bought
coverage from the TRICARE coverage
Health Insurance Reserve
Marketplace, you Select
may not qualify
for a premium tax
credit that lowers
your premium.
You must pay
your premiums
on time to keep
your coverage in
good standing. You
Coverage is only qualify
for 18-36 No months.* but
After your haven’ t
coverage ends, bought
you can buy:
If you have coverage under this plan and choose to buy coverage from the Health Insurance Marketplace, you may not qualify for a premium tax credit that lowers your premium. You must pay your premiums on time to keep your coverage in good standing.
If you don't have a health plan that qualifies as minimum essential coverage, you may have to pay a fee that goes up every year.
-based Situatio m TRICAR n essential E plans coverage
What you can do
Continued You
Keep Continued Health Care Benefit Program coverage
Buy coverage from the Health Insurance Marketplace or Buy any other plan that qualifies
as minimum essential coverage (e.g., coverage through an employer, Medicare).
Health Care qualify
Benefit and Yes
Program bought coverage
You
Buy coverage from the Health Insurance Marketplace (y ou may be able to get
You only have 60
days from your
loss of TRICARE
eligibility to buy
Continued Health
Care Benefit
Program You coverage. qualify If you don't have
If you have coverage under this plan and choose to buy coverage from the Health Insurance Marketplace, you may not qualify for a premium tax credit that lowers your premium. You must pay your premiums on time to keep your coverage in good standing.
If you don't have a health plan that qualifies as minimum essential coverage, you may have to pay a fee that goes
up every year.
qualify
but No
bought
?
Coverage coverage from the
Health
Insurance
Marketpla ce (you may be able to get a premium tax
credit) or Any other plan that qualifies as minimum essential coverage.
Coverage from the
a fee that goes up every year.
Health Insurance Marketpla ce (you may be able to get a premium tax credit) or
The Defense Finance and Accounting Service (DFAS), the U.S. Coast Guard Pay and Personnel Center, or the Public Health Service Pay Center will report your health care coverage to the IRS.
You'll get your IRS Form 1095 by January 31, 2017. The IRS Form 1095 shows the months of the tax year you and your family members had minimum essential coverage.
Go to the Proof of Minimum Essential Coverage page for contact information for DFAS and the Uniformed Services Pay Centers.
To check your TRICARE eligibility, call the DMDC Support Office at 1-800-538-9552. Your Social Security number (SSN) and the SSNs of your covered family members must be in Defense Enrollment Eligibility Reporting System (DEERS) for your TRICARE coverage to show correctly.
For information on:
The Health Insurance Marketplace, visit www.healthcare.gov or call 1-800-318-
2596.
The fee you may have to pay if you don't have minimum essential coverage, visit http://www.irs.gov/uac/Individual-Shared-Responsibility-Provision and http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families.
The Premium Tax credit, visit http://www.irs.gov/uac/Newsroom/Questions-and- Answers-on-the-Premium-Tax-Credit.
TRICARE and the Affordable Care Act, visit our ACA webpage or call your TRICARE contractor.
Any other plan that
qualifies as minimum essential coverage.
as minimum
