TRICARE and the ACA Marketplace: Do You Need Both? | TRICARE.com

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## Quick answer In almost all cases, you do not need an ACA Marketplace (Obamacare) plan if you have TRICARE, as nearly all TRICARE plans meet the "minimum essential coverage" requirement. While you can technically hold both, TRICARE is usually significantly cheaper, and you generally cannot receive government subsidies for a Marketplace plan if you are eligible for TRICARE.

Details

### Minimum Essential Coverage (MEC) Under the Affordable Care Act (ACA), most TRICARE plans qualify as minimum essential coverage. This includes TRICARE Prime, Select, For Life, Reserve Select (TRS), and Retired Reserve (TRR). If you are enrolled in any of these, you already meet the legal requirements for health coverage and do not need to shop on the Marketplace.

### The Problem with Subsidies The biggest conflict between TRICARE and the ACA Marketplace involves **Premium Tax Credits**. * **Eligibility Rule:** If you are eligible for "government-sponsored minimum essential coverage" (like TRICARE), you are generally **not eligible** for subsidies or tax credits to lower the cost of a Marketplace plan. * **Cost Impact:** Without subsidies, a Marketplace plan will likely cost several hundred dollars more per month than a TRICARE plan like TRS or Select.

### When would someone consider a Marketplace plan? There are very few specific scenarios where a Marketplace plan might be relevant to the military community: 1. **Loss of Eligibility:** if you are separating from the military and do not qualify for retiree benefits or TAMP (Transitional Assistance Management Program), a "Qualifying Life Event" allows you to buy a Marketplace plan. 2. **Young Adult Children:** TRICARE Young Adult (TYA) can be expensive (2026 rates vary by plan). Some families find that a Marketplace plan for a 23-year-old child is more cost-effective if that child qualifies for their own subsidies based on a low individual income. 3. **Specialty Providers:** If a specific life-saving specialist is strictly out-of-network for TRICARE but in-network for a local Marketplace PPO, a beneficiary might choose to pay for both, though TRICARE would remain the primary or secondary payer depending on coordination of benefits.

### Coordination of Benefits If you choose to have both TRICARE and a Marketplace (Commercial) insurance plan, TRICARE is always the **secondary payer**. You must notify your regional contractor (Humana Military in the East or TriWest in the West) to ensure proper coordination of benefits.

## Who this affects * **Active Duty Family Members:** Usually better off with TRICARE Prime or Select; rarely benefit from the Marketplace. * **National Guard and Reserve:** TRICARE Reserve Select is significantly cheaper than most unsubsidized Marketplace plans. * **Retirees:** Typically use TRICARE Select or Prime; Marketplace plans are rarely cost-competitive. * **Young Adults (Ages 21–26):** This group most frequently compares TYA against Marketplace options for better pricing. * **Separating Service Members:** Those leaving the military without retirement status often use the Marketplace as their primary bridge to civilian coverage.

## Sources * **TRICARE.mil:** ACA Information - https://www.tricare.mil/aca * **Defense Health Agency (DHA):** TRICARE and the ACA - https://health.mil * **Healthcare.gov:** Military Coverage and the Marketplace - https://www.healthcare.gov/military/