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10 U.S.C. § 1097a — TRICARE Prime: automatic enrollments
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
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Source location: Title 10, Chapter 55, § 1097a; chapter-055-medical-and-dental-care.md
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**(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/view.xhtml?req=granuleid:USC-prelim-title10-section1072/2&num=0&edition=prelim).
**(e) Authority for Multiple Networks in the Same Geographic Area.—**
(1) The Secretary may establish a system of multiple networks of providers under TRICARE Prime in the same geographic area or areas.
(2) Under a system established under paragraph (1), the Secretary may require a covered beneficiary enrolling in TRICARE Prime to enroll in a specific provider network established pursuant to such system, in which case any provider not in that specific provider network shall be deemed an out-of-network provider with respect to the covered beneficiary (regardless of whether the provider is in a different TRICARE Prime provider network) for purposes of this section or any other provision of law limiting the coverage or provision of health care services to those provided by network providers under the TRICARE program.
**(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.
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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
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1099
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Federal law — U.S. Code and appendices · legal_authorities
Page 1152
TITLE 10—ARMED FORCES
§ 1097a
retired pay is increased under section 1401a of
this title.
(Added Pub. L. 99–661, div. A, title VII, § 701(a)(1),
Nov. 14, 1986, 100 Stat. 3895; amended Pub. L.
103–337, div. A, title VII, §§ 713, 714(a), Oct. 5, 1994,
108 Stat. 2802; Pub. L. 104–106, div. A, title VII,
§§ 712, 713, Feb. 10, 1996, 110 Stat. 374; Pub. L.
109–364, div. A, title VII, § 704(a), Oct. 17, 2006, 120
Stat. 2280; Pub. L. 110–181, div. A, title VII,
§ 701(a), Jan. 28, 2008, 122 Stat. 187; Pub. L.
110–417, [div. A], title VII, § 701(a), Oct. 14, 2008,
122 Stat. 4498; Pub. L. 111–383, div. A, title VII,
§ 701(a), Jan. 7, 2011, 124 Stat. 4244; Pub. L. 112–81,
div. A, title VII, § 701(a), Dec. 31, 2011, 125 Stat.
1469.)
Editorial Notes
AMENDMENTS
2011—Subsec. (e). Pub. L. 112–81 designated existing
provisions as par. (1), substituted ‘‘Except as provided
by paragraph (2), a premium,’’ for ‘‘A premium,’’, and
added par. (2).
Subsec. (e). Pub. L. 111–383 substituted ‘‘September
30, 2011’’ for ‘‘September 30, 2009’’.
2008—Subsec. (e). Pub. L. 110–417 substituted ‘‘Sep-
tember 30, 2009’’ for ‘‘September 30, 2008’’.
Pub. L. 110–181 substituted ‘‘September 30, 2008’’ for
‘‘September 30, 2007’’.
2006—Subsec. (e). Pub. L. 109–364 inserted at end ‘‘A
premium, deductible, copayment, or other charge pre-
scribed by the Secretary under this subsection may not
be increased during the period beginning on April 1,
2006, and ending on September 30, 2007.’’
1996—Subsec. (c). Pub. L. 104–106, § 712, substituted
‘‘Notwithstanding the preferences established by sec-
tions 1074(b) and 1076 of this title, the Secretary shall’’
for ‘‘However, the Secretary may’’.
Subsec. (e). Pub. L. 104–106, § 713, inserted at end
‘‘Without imposing additional costs
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