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10 U.S.C. § 1099 — Health care enrollment system and payment options
Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment of System.—** The Secretary of Defense, after consultation with the other administering Secretaries, shall establish a system of health care enrollment for covered beneficiaries who reside in the United States.
**(b) Description of System.—** Such system shall—
(1) allow covered beneficiaries to elect to enroll in a health care plan, or modify a previous election, from eligible health care plans designated by the Secretary of Defense during—
(A) an annual open enrollment period; and
(B) any period based on a qualifying event experienced by the beneficiary, as determined appropriate by the Secretary; or
(2) if necessary in order to ensure full use of facilities of the uniformed services in a geographical area, assign covered beneficiaries who reside in such area to such facilities.
**(c) Health Care Plans Available Under System.—** A health care plan designated by the Secretary of Defense under the system described in subsection (a) shall provide all health care to which a covered beneficiary is entitled under this chapter. Such a plan may consist of any of the following:
(1) Use of facilities of the uniformed services.
(2) A plan under the TRICARE program.
(3) Any other health care plan contracted for by the Secretary of Defense.
(4) Any combination of the plans described in paragraphs (1), (2), and (3).
**(d) Payment Options.—**
(1) A member or former member of the uniformed services, or a dependent thereof, eligible for medical care and dental care under section 1074(b) or 1076 of this title shall pay a premium for coverage under this chapter.
(2) To the maximum extent practicable, a premium owed by a member, former member, or dependent under paragraph (1) shall be withheld from the retired, retainer, or equivalent pay of the membe
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Source location: Title 10, Chapter 55, § 1099; chapter-055-medical-and-dental-care.md
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**(a) Establishment of System.—** The Secretary of Defense, after consultation with the other administering Secretaries, shall establish a system of health care enrollment for covered beneficiaries who reside in the United States.
**(b) Description of System.—** Such system shall—
(1) allow covered beneficiaries to elect to enroll in a health care plan, or modify a previous election, from eligible health care plans designated by the Secretary of Defense during—
(A) an annual open enrollment period; and
(B) any period based on a qualifying event experienced by the beneficiary, as determined appropriate by the Secretary; or
(2) if necessary in order to ensure full use of facilities of the uniformed services in a geographical area, assign covered beneficiaries who reside in such area to such facilities.
**(c) Health Care Plans Available Under System.—** A health care plan designated by the Secretary of Defense under the system described in subsection (a) shall provide all health care to which a covered beneficiary is entitled under this chapter. Such a plan may consist of any of the following:
(1) Use of facilities of the uniformed services.
(2) A plan under the TRICARE program.
(3) Any other health care plan contracted for by the Secretary of Defense.
(4) Any combination of the plans described in paragraphs (1), (2), and (3).
**(d) Payment Options.—**
(1) A member or former member of the uniformed services, or a dependent thereof, eligible for medical care and dental care under section 1074(b) or 1076 of this title shall pay a premium for coverage under this chapter.
(2) To the maximum extent practicable, a premium owed by a member, former member, or dependent under paragraph (1) shall be withheld from the retired, retainer, or equivalent pay of the member, former member, or dependent. In all other cases, a premium shall be paid in a frequency and method determined by the Secretary.
**(e) Regulations.—** The Secretary of Defense, after consultation with the other administering Secretaries, shall prescribe regulations to carry out this section.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Responsible Officials.—**
(1) Except as otherwise provided in this chapter, the Secretary of Defense shall administer this chapter for the armed forces under his jurisdiction, the Secretary of Homeland Security shall administer this chapter for the Coast Guard when the Coast Guard is not operating as a service in the Navy, and the Secretary of Health and Human Services shall administer this chapter for the National Oceanic and Atmospheric Administration and the Public Health Service. This chapter shall be administered consistent with the Assisted Suicide Funding Restriction Act of 1997 ([42 U.S.C. 14401](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section14401&num=0&edition=prelim) et seq.).
(2) Except as otherwise provided in this chapter, the Secretary of Defense shall have responsibility for administering the TRICARE program and making any decision affecting such program.
**(b) Stability in Program of Benefits.—** The Secretary of Defense shall, to the maximum extent practicable, provide a stable program of benefits under this chapter throughout each fiscal year. To achieve the stability in the case of managed care support contracts entered into under this chapter, the contracts shall be administered so as to implement all changes in benefits and administration on a quarterly basis. However, the Secretary of Defense may implement any such change prior to the next fiscal quarter if the Secretary determines that the change would significantly improve the provision of care to eligible beneficiaries under this chapter.
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1073
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Federal law — U.S. Code and appendices · legal_authorities
In this chapter:
(1) The term “uniformed services” means the armed forces and the Commissioned Corps of the National Oceanic and Atmospheric Administration and of the Public Health Service.
(2) The term “dependent”, with respect to a member or former member of a uniformed service, means—
(A) the spouse;
(B) the unremarried widow;
(C) the unremarried widower;
(D) a child who—
(i) has not attained the age of 21;
(ii) has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary and is, or was at the time of the member’s or former member’s death, in fact dependent on the member or former member for over one-half of the child’s support; or
(iii) is incapable of self-support because of a mental or physical incapacity that occurs while a dependent of a member or former member under clause (i) or (ii) and is, or was at the time of the member’s or former member’s death, in fact dependent on the member or former member for over one-half of the child’s support;
(E) a parent or parent-in-law who is, or was at the time of the member’s or former member’s death, in fact dependent on him for over one-half of his support and residing in his household;
(F) the unremarried former spouse of a member or former member who (i) on the date of the final decree of divorce, dissolution, or annulment, had been married to the member or former member for a period of at least 20 years during which period the member or former member performed at least 20 years of service which is creditable in determining that member’s or former member’s eligibility for retired or retainer pay, or equivalent pay, and (ii) does not have medical coverage under an employer-sponsored health plan;
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1072
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Federal law — U.S. Code and appendices · legal_authorities
**(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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1076/a/2/A&num=0&edition=prelim) 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.—** An enrollment of a covered beneficiary in TRICARE Prime shall be automatically renewed upon the expiration of the enrollment unless the renewal is declined.
**(c) 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.
**(d) 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](https://uscode.house.gov/vi
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1097a
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment.—**
(1) Not later than January 1, 2018, the Secretary of Defense shall establish a self-managed, preferred-provider network option under the TRICARE program. Such option shall be known as “TRICARE Select”.
(2) The Secretary shall establish TRICARE Select in all areas. Under TRICARE Select, eligible beneficiaries will not have restrictions on the freedom of choice of the beneficiary with respect to health care providers.
**(b) Enrollment Eligibility.—**
(1) The beneficiary categories for purposes of eligibility to enroll in TRICARE Select and cost-sharing requirements applicable to such category are as follows:
(A) An “active-duty family member” category that consists of beneficiaries who are covered by [section 1079 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1079&num=0&edition=prelim) (as dependents of active duty members).
(B) A “retired” category that consists of beneficiaries covered by subsection (c) of [section 1086 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1086&num=0&edition=prelim), other than Medicare-eligible beneficiaries described in subsection (d)(2) of such section.
(C) A “reserve and young adult” category that consists of beneficiaries who are covered by—
(i) [section 1076d of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1076d&num=0&edition=prelim);
(ii) section 1076e; or
(iii) section 1110b.
(2) A covered beneficiary who elects to participate in TRICARE Select shall enroll in such option under [section 1099 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1099&num=0&edition=prelim).
**(c) Cost-sharing Requirements.—** The cost-
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1075
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In General.—** The Secretary of Defense, after consulting with the other administering Secretaries, may contract for the delivery of health care to which covered beneficiaries are entitled under this chapter. The Secretary may enter into a contract under this section with any of the following:
(1) Health maintenance organizations.
(2) Preferred provider organizations.
(3) Individual providers, individual medical facilities, or insurers.
(4) Consortiums of such providers, facilities, or insurers.
**(b) Scope of Coverage Under Health Care Plans.—** A contract entered into under this section may provide for the delivery of—
(1) selected health care services;
(2) total health care services for selected covered beneficiaries; or
(3) total health care services for all covered beneficiaries who reside in a geographical area designated by the Secretary.
**(c) Coordination With Facilities of the Uniformed Services.—** The Secretary of Defense may provide for the coordination of health care services provided pursuant to any contract or agreement under this section with those services provided in medical treatment facilities of the uniformed services. Subject to the availability of space and facilities and the capabilities of the medical or dental staff, the Secretary may not deny access to facilities of the uniformed services to a covered beneficiary on the basis of whether the beneficiary enrolled or declined enrollment in any program established under, or operating in connection with, any contract under this section. Notwithstanding the preferences established by sections 1074(b) and 1076 of this title, the Secretary shall, as an incentive for enrollment, establish reasonable preferences for services in facilities of the uniformed services for covered beneficiari
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1097
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Federal law — U.S. Code and appendices · legal_authorities
Page 1156
TITLE 10—ARMED FORCES
§ 1097d
Editorial Notes
REFERENCES IN TEXT
Section 1079(j) of this title, referred to in subsec.
(a)(1), was redesignated section 1079(i) of this title by
Pub. L. 113–291, div. A, title VII, § 703(a)(3), Dec. 19, 2014,
128 Stat. 3411.
The Social Security Act, referred to in subsec. (a)(1),
is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of
the Act is classified generally to subchapter XVIII
(§ 1395 et seq.) of chapter 7 of Title 42, The Public
Health and Welfare. Section 1862 of the Act is classified
to section 1395y of Title 42. For complete classification
of this Act to the Code, see section 1305 of Title 42 and
Tables.
Section 5000 of the Internal Revenue Code of 1986, re-
ferred to in subsec. (f)(2), is classified to section 5000 of
Title 26, Internal Revenue Code.
§ 1097d. TRICARE program: notice of change to
benefits
(a) PROVISION OF NOTICE.—(1) If the Secretary
makes a significant change to any benefits pro-
vided by the TRICARE program to covered bene-
ficiaries, the Secretary shall provide individuals
described in paragraph (2) with notice explaining
such changes.
(2) The individuals described by this paragraph
are covered beneficiaries participating in the
TRICARE program who may be affected by a
significant change covered by a notification
under paragraph (1).
(3) The Secretary shall provide notice under
paragraph (1) through electronic means.
(b) TIMING
OF NOTICE.—The Secretary shall
provide notice under paragraph (1) of subsection
(a) by the earlier of the following dates:
(1) The date that the Secretary determines
would afford individuals described in para-
graph (2) of such subsection adequate time to
understand the change covered by the notifi-
cation.
(2) The date that is 90 da
Source: Supplied 2024 U.S. Code historical extraction · 10 U.S.C. § 1099
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