Bread Crumbs

Certificates of Creditable Coverage No Longer Needed for Beneficiaries Losing TRICARE Coverage

1/12/2015

TRICARE will no longer send beneficiaries certificates of creditable coverage when they lose TRICARE eligibility. These certificates are no longer needed when beneficiaries transition off TRICARE. Beneficiaries will instead receive notice that their TRICARE coverage is ending.

The Patient Protection and Affordable Care Act (ACA) passed by Congress in 2011 changes the law so that insurers cannot deny you coverage based on preexisting conditions. Before this law went into effect, when you switched health plans, you had to prove to your new plan that you had coverage before joining them; otherwise they might not cover you for prior illnesses or injuries you had. With this change in the law, you don’t need a certificate to prove you had coverage.

TRICARE beneficiaries can lose their coverage for several reasons. Some of the most common include separating from active duty, aging out or choosing to stop paying for a premium based TRICARE plan. When beneficiaries receive notice that their coverage is ending, it will include relevant information about other TRICARE options like the Transitional Assistance Management Program (TAMP) and ways for beneficiaries to explore their options on the state ACA health exchanges.

All TRICARE health plans exceed the ACA requirement that health coverage must offer a level of minimal essential coverage.  If you are looking for other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance.", you're encouraged to explore your options through the Market Place at www.healthcare.gov. The current open season runs from November 15 through February 15, 2015.

Beneficiaries eligible to purchase TRICARE premium based plans (TRICARE Retired Reserve, TRICARE Reserve Select, TRICARE Young Adult, and the Continuing Health Care Plan Benefit) who choose not to purchase this coverage, may qualify for premium assistance or state Medicaid based on income, family size, and state of residence.  They should go to www.healthcare.gov or contact their state marketplace for assistance.

Last Updated 6/7/2016