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USC › Title 10 › Subtitle A › Part II › Chapter 55 › § 1097a

10 USC § 1097a - TRICARE Prime: automatic enrollments; payment options

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Current through Pub. L. 113-9. (See Public Laws for the current Congress.)

(a) Automatic Enrollment of Certain Dependents.—
(1) In the case of a dependent of a member of the uniformed services who is entitled to medical and dental care under section 1076 (a)(2)(A) of this title and resides in a catchment area in which TRICARE Prime is offered, the Secretary—
(A) shall automatically enroll the dependent in TRICARE Prime if the member is in pay grade E–4 or below; and
(B) may automatically enroll the dependent in TRICARE Prime if the member is in pay grade E–5 or higher.
(2) Whenever a dependent of a member is enrolled in TRICARE Prime under paragraph (1), the Secretary concerned shall provide written notice of the enrollment to the member.
(3) The enrollment of a dependent of the member may be terminated by the member or the dependent at any time.
(b) Automatic Renewal of Enrollments of Covered Beneficiaries.—
(1) An enrollment of a covered beneficiary in TRICARE Prime shall be automatically renewed upon the expiration of the enrollment unless the renewal is declined.
(2) Not later than 15 days before the expiration date for an enrollment of a covered beneficiary in TRICARE Prime, the Secretary concerned shall—
(A) transmit a written notification of the pending expiration and renewal of enrollment to the covered beneficiary or, in the case of a dependent of a member of the uniformed services, to the member; and
(B) afford the beneficiary or member, as the case may be, an opportunity to decline the renewal of enrollment.
(c) Payment Options for Retirees.— A member or former member of the uniformed services eligible for medical care and dental care under section 1074 (b) of this title may elect to have any fee payable by the member or former member for an enrollment in TRICARE Prime withheld from the member’s retired pay, retainer pay, or equivalent pay, as the case may be, or to be paid from a financial institution through electronic transfers of funds. The fee shall be paid in accordance with the election. A member may elect under this section to pay the fee in full at the beginning of the enrollment period or to make payments on a monthly or quarterly basis.
(d) Regulations and Exceptions.— The Secretary of Defense shall prescribe regulations, including procedures, to carry out this section. Regulations prescribed to carry out the automatic enrollment requirements under this section may include such exceptions to the automatic enrollment procedures as the Secretary determines appropriate for the effective operation of TRICARE Prime.
(e) No Copayment for Immediate Family.— No copayment shall be charged a member for care provided under TRICARE Prime to a dependent of a member of the uniformed services described in subparagraph (A), (D), or (I) of section 1072 (2) of this title.
(f) Definitions.— In this section:
(1) The term “TRICARE Prime” means the managed care option of the TRICARE program.
(2) The term “catchment area”, with respect to a facility of a uniformed service, means the service area of the facility, as designated under regulations prescribed by the administering Secretaries.

(a) Automatic Enrollment of Certain Dependents.— Each dependent of a member of the uniformed services in grade E4 or below who is entitled to medical and dental care under section 1076 (a)(2)(A) of this title and resides in the catchment area of a facility of a uniformed service offering TRICARE Prime shall be automatically enrolled in TRICARE Prime at the facility. The Secretary concerned shall provide written notice of the enrollment to the member. The enrollment of a dependent of the member may be terminated by the member or the dependent at any time.
(b) Automatic Renewal of Enrollments of Covered Beneficiaries.—
(1) An enrollment of a covered beneficiary in TRICARE Prime shall be automatically renewed upon the expiration of the enrollment unless the renewal is declined.
(2) Not later than 15 days before the expiration date for an enrollment of a covered beneficiary in TRICARE Prime, the Secretary concerned shall—
(A) transmit a written notification of the pending expiration and renewal of enrollment to the covered beneficiary or, in the case of a dependent of a member of the uniformed services, to the member; and
(B) afford the beneficiary or member, as the case may be, an opportunity to decline the renewal of enrollment.
(c) Payment Options for Retirees.— A member or former member of the uniformed services eligible for medical care and dental care under section 1074 (b) of this title may elect to have any fee payable by the member or former member for an enrollment in TRICARE Prime withheld from the member’s retired pay, retainer pay, or equivalent pay, as the case may be, or to be paid from a financial institution through electronic transfers of funds. The fee shall be paid in accordance with the election. A member may elect under this section to pay the fee in full at the beginning of the enrollment period or to make payments on a monthly or quarterly basis.
(d) Regulations and Exceptions.— The Secretary of Defense shall prescribe regulations, including procedures, to carry out this section. Regulations prescribed to carry out the automatic enrollment requirements under this section may include such exceptions to the automatic enrollment procedures as the Secretary determines appropriate for the effective operation of TRICARE Prime.
(e) No Copayment for Immediate Family.— No copayment shall be charged a member for care provided under TRICARE Prime to a dependent of a member of the uniformed services described in subparagraph (A), (D), or (I) of section 1072 (2) of this title.
(f) Definitions.— In this section:
(1) The term “TRICARE Prime” means the managed care option of the TRICARE program.
(2) The term “catchment area”, with respect to a facility of a uniformed service, means the service area of the facility, as designated under regulations prescribed by the administering Secretaries.

Source

(Added Pub. L. 105–261, div. A, title VII, § 712(a)(1),Oct. 17, 1998, 112 Stat. 2058; amended Pub. L. 106–398, § 1 [[div. A], title VII, § 752(a)], Oct. 30, 2000, 114 Stat. 1654, 1654A–195; Pub. L. 107–107, div. A, title X, § 1048(a)(11),Dec. 28, 2001, 115 Stat. 1223.)
Amendments

2001—Subsec. (e). Pub. L. 107–107substituted “section 1072 (2)” for “section 1072”.
2000—Subsecs. (e), (f). Pub. L. 106–398added subsec. (e) and redesignated former subsec. (e) as (f).
Effective Date of 2000 Amendment

Pub. L. 106–398, § 1 [[div. A], title VII, § 752(b)], Oct. 30, 2000, 114 Stat. 1654, 1654A–195, provided that: “The amendments made by subsection (a) [amending this section] shall take effect 180 days after the date of the enactment of this Act [Oct. 30, 2000], and shall apply with respect to care provided on or after that date.”
Effective Date

Pub. L. 105–261, div. A, title VII, § 712(b),Oct. 17, 1998, 112 Stat. 2059, provided that: “The regulations required under subsection (d) ofsection 1097a of title 10, United States Code (as added by subsection (a)), shall be prescribed to take effect not later than September 30, 1999. The section shall be applied under TRICARE Prime on and after the date on which the regulations take effect.”

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10 USCDescription of ChangeSession YearPublic LawStatutes at Large
§ 1097a2012112-239 [Sec.] 711126 Stat. 1801

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32 CFR - Title 32—National Defense

32 CFR Part 199 - CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS)

32 CFR 799

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