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News | Sept. 29, 2010

Tricare meets or exceeds most new health provisions

Tricare already meets or exceeds most of the new health care provisions in accordance with the Patient Protection and Affordable Care Act that took effect Sept. 23.

The PPACA provides new or expanded options and consumer protections for those with private health insurance coverage.

Most provisions under PPACA, such as restrictions on annual limits, lifetime maximums, "high user" cancellations and denial of coverage for pre-existing conditions, have not been a concern for the more than 9.6 million active-duty military and retiree families under Tricare.

Because Tricare is an entitlement provided for by law, Tricare's coverage has no lifetime cap. Under the basic entitlement, Tricare costs are determined by legislation, and in general, active-duty families and military retirees pay low, or no, annual or monthly fees, unlike coverage under most commercial health insurance plans. There is no cost for medical care for active-duty servicemembers.

One provision under PPACA that is not already addressed in the Tricare entitlement is coverage for dependents up to the age of 26. Tricare's current age limit for dependent children is 21 or age 23, if the dependent child is a full-time college student or has been determined to be incapable of self support.

The recent PPACA requires civilian health plans that provide medical coverage to children to make that coverage available until the child turns 26 years of age.

While the act does not give the Department of Defense the authority to offer this benefit through Tricare, bills pending in the Senate and House of Representatives would extend dependent medical coverage up to age 26.

It is not known yet whether there will be a charge or premium until the law is enacted. If enacted into law, DOD officials will make every effort to implement this provision as soon as possible.

To find out more, Tricare program updates are posted at You can also sign-up to receive Tricare benefit updates via e-mail at