How Does Obamacare Affect Military Families?

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As of October 1, it’s now the law that every American have health insurance coverage or secure a waiver permitting them to forgo coverage in order to avoid a hefty fine.

But, what about the military? How does the Affordable Care Act (ACA), known colloquially as Obamacare, affect military members and their families who have Tricare, the military’s health insurance program?

In short, the vast majority of active duty military families will see no change to their coverage as a result of Obamacare. However, there are nuances and exceptions to everything.

“Simply speaking, the Affordable Care Act will have very little impact on Tricare beneficiaries,” says a news release from the new Defense Health Agency. “The biggest change they will notice may be an extra letter in their mailbox every January, and an extra box to check on their tax forms every April.”

However there are some plans from Tricare that fail to meet the “minimum requirement” set forth in the language of the ACA.

According to the press release:

“There are two groups of TRICARE beneficiaries who do not meet the minimum essential coverage requirement: those getting care for line of duty only related conditions, and those only eligible to receive care in military hospitals or clinics.”

Other programs, such as the Tricare for Young Adults plan, or TYA, may need to be altered to be brought in line with the requirements of the ACA, especially in the area of mental health care.

What has changed are costs and fees, though it is debatable whether this is more of the same budget issues we’ve been seeing, or an unfortunate consequence of Obamacare’s tampering with the insurance market.

Tricare Prime retirees who are under 65 will see an increase in the enrollment fee that they pay yearly that will be based on the amount they receive in their retirement pay from the military.

Tricare for life, the program for retirees over 65 would see increases in enrollment fees as well as changes to the catastrophic cap — the maximum out-of-pocket amount beneficiaries will pay each fiscal year.

Those who opt for the standard version of Tricare will begin seeing fees for the first time. Previously, there was no enrollment fee for standard, and there was a yearly deductible of $150 for single people and $300 for families.

Under the new plan, there will be a $70 fee for singles and $140 for families that will steadily increase through 2018. Deductibles will rise as well until they reach $290 for singles and $580 for families in 2018.

In addition, everyone will see increases in the cost of prescriptions, in some cases doubling the cost to have prescriptions filled.

These increases would make health care unaffordable to most of the junior enlisted troops, forcing them to either opt for Tricare Prime and give up the choice they have in providers or opt out of Tricare for the ACA.

and aren’t required to do anything. Veterans not enrolled with the VA for health care would still need to purchase coverage through the exchanges.

And while the insurance marketplace opened on October 1, so too did a new agency to handle medical care within the defense department.

The Defense Health Agency is hailed as a ” major streamlining effort of military medicine.” The agency will oversee purchasing of supplies and equipment as well as standardize treatments across all services. It also oversees Tricare and its 9.6 million beneficiaries as well as its 800 employees.

“This day has been a long time in coming, and represents a major milestone in the history of the department and in military medicine,” Dr. Jonathan Woodson, the assistant secretary of defense for health affairs, wrote in a message to staff.

Acting deputy director of the Defense Health Agency, Allen Middleton, said that he hopes that the integrated approach will help to reduce the growing cost of health care in the military while maintaining the health of the force.

“Everything we do is designed to enhance the readiness of the force — the medical force, as well as the fighting force,” he said.

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  1. ladylothian I currently have an Active Duty son-in-law who is suffering from liver failure and the base hospital (and doctors) are doing nothing for him. Not even a biopsy to see what is causing it. The usual causes have been ruled out (hepatitis, cyrrhosis, etc. He cannot eat anything without vomiting it back up plus a LOT of bile. This has been going on for two months now and his bilirubin levels are off the charts. Does he have ANY alternative choices. He was told he could get a secondary opinion, but he would have to pay out of pocket to repeat all the tests the military has already done. He cannot afford it. Is there ANY way he can sign up for ObamaCare?
  2. hurting in ohio MY HUSBAND WORKS FOR THE AIR BASE,  SINCE THE OBAMA CARE,  WE ARE SUFFERING A GREAT DEAL.  MY MEDICAL COST AND CO-PAYS HAVE SKY ROCKED!  EVEN AFTER PAYING A GREAT AMOUNT JUST TO HAVE INSURANCE!  I AM GIVING UP MEDICINES THAT I NEED BECAUSE THEY ARE TO EXSPENSIVE OR THEY DON'T HAVE A GENERIC BRAND.  "THANKS FOR NOTHING"  I DON'T KNOW WHO THEY THINK THEY WERE HELPING,  IT WASN'T FOR  THE WORKING PEOPLE OF THE US.  I REGRET VOTING THIS YEAR.  DON'T FEEL I NEED TO VOTE ANYMORE.  IT DOESN'T MAKE A DIFFERENCE.  THE GOVERNMENT EVEN TOOK MY DISABILITY PAYMENT BECAUSE I MARRIED AND IT WAS SSI.   I STILL CAN'T WORK AND THEY ARE STILL TAKING ORGANS OUT.
  3. WendyInnes @Les Sorry it wasn't clear. Active duty troops are indeed automatically enrolled in Prime, but their family members are not. Active duty family members automatically get standard and must enroll in Prime in order to save the costs associated with standard.
  4. WendyInnes JerryBjornstad Jerry, I've not heard anything about this. If you have any evidence of this, I'd love to see it. You can send me a private message here if you'd like.
  5. JerryBjornstad One of my relatives, who is an E-4 in the Army, was told in a meeting last week that he attended with his unit, that they needed to sign a paper that showed they voluntarily were dropping the military health care and wanted to sign up for AHC. He and others refused and were told there would be consequences for their refusal. Anybody know anything about this?
  6. Les Your information is somewhat flawed. You stated changes would force junior enlisted personnel to enroll in tricare prime or go to ACA. Active duty personnel are automatically enrolled in prime at no cost. Also, there are no fees for Tricare For Life. As long as you are enrolled in Medicare Part B, you get TFL at no cost which acts as a Medicare supplement.
  7. SMSgt John Shaw Retired Seems to me that as a retiree on fixed income that opted for Tricare standard (NO premiums) was a really good deal. Now that Obummercare comes along I now have to pay for my plan. Doesn't make any good sense.  Yes Wendy good piece with good info. Shawn I really think you need to re-appraise your position.
  8. WendyInnes Shawn M Griffiths True, the vast majority of us will notice no change at all to coverage, although I'm still waiting to see if premiums will go up. The cost of prescriptions is problematic if, like our family, there are multiple prescriptions filled each month. That can add up over time.
  9. Shawn M Griffiths This is a great piece, Wendy. Thank you for posting it. It seems like there was a lot of talk about how ACA was going to hurt most military families and the truth is it won't, but there are still issues with veteran care and insurance for low-rank service personnel that need to be addressed.
9 comments
ladylothian
ladylothian

I currently have an Active Duty son-in-law who is suffering from liver failure and the base hospital (and doctors) are doing nothing for him. Not even a biopsy to see what is causing it. The usual causes have been ruled out (hepatitis, cyrrhosis, etc. He cannot eat anything without vomiting it back up plus a LOT of bile. This has been going on for two months now and his bilirubin levels are off the charts. Does he have ANY alternative choices. He was told he could get a secondary opinion, but he would have to pay out of pocket to repeat all the tests the military has already done. He cannot afford it. Is there ANY way he can sign up for ObamaCare?

hurting in ohio
hurting in ohio

MY HUSBAND WORKS FOR THE AIR BASE,  SINCE THE OBAMA CARE,  WE ARE SUFFERING A GREAT DEAL.  MY MEDICAL COST AND CO-PAYS HAVE SKY ROCKED!  EVEN AFTER PAYING A GREAT AMOUNT JUST TO HAVE INSURANCE!  I AM GIVING UP MEDICINES THAT I NEED BECAUSE THEY ARE TO EXSPENSIVE OR THEY DON'T HAVE A GENERIC BRAND.  "THANKS FOR NOTHING"  I DON'T KNOW WHO THEY THINK THEY WERE HELPING,  IT WASN'T FOR  THE WORKING PEOPLE OF THE US.  I REGRET VOTING THIS YEAR.  DON'T FEEL I NEED TO VOTE ANYMORE.  IT DOESN'T MAKE A DIFFERENCE.  THE GOVERNMENT EVEN TOOK MY DISABILITY PAYMENT BECAUSE I MARRIED AND IT WAS SSI.   I STILL CAN'T WORK AND THEY ARE STILL TAKING ORGANS OUT.

JerryBjornstad
JerryBjornstad

One of my relatives, who is an E-4 in the Army, was told in a meeting last week that he attended with his unit, that they needed to sign a paper that showed they voluntarily were dropping the military health care and wanted to sign up for AHC. He and others refused and were told there would be consequences for their refusal. Anybody know anything about this? 

Les
Les

Your information is somewhat flawed. You stated changes would force junior enlisted personnel to enroll in tricare prime or go to ACA. Active duty personnel are automatically enrolled in prime at no cost. Also, there are no fees for Tricare For Life. As long as you are enrolled in Medicare Part B, you get TFL at no cost which acts as a Medicare supplement.

SMSgt John Shaw  Retired
SMSgt John Shaw Retired

Seems to me that as a retiree on fixed income that opted for Tricare standard (NO premiums) was a really good deal. Now that Obummercare comes along I now have to pay for my plan. Doesn't make any good sense.

 Yes Wendy good piece with good info. Shawn I really think you need to re-appraise your position.

Shawn M Griffiths
Shawn M Griffiths

This is a great piece, Wendy. Thank you for posting it. It seems like there was a lot of talk about how ACA was going to hurt most military families and the truth is it won't, but there are still issues with veteran care and insurance for low-rank service personnel which need to be addressed.

WendyInnes
WendyInnes

@JerryBjornstad Jerry, I've not heard anything about this. If you have any evidence of this, I'd love to see it. You can send me a private message here if you'd like.

WendyInnes
WendyInnes

@Les Sorry it wasn't clear. Active duty troops are indeed automatically enrolled in Prime, but their family members are not. Active duty family members automatically get standard and must enroll in Prime in order to save the costs associated with standard. 

WendyInnes
WendyInnes

@Shawn M Griffiths True, the vast majority of us will notice no change at all to coverage, although I'm still waiting to see if premiums will go up. The cost of prescriptions is problematic if, like our family, there are multiple prescriptions filled each month. That can add up over time.