10 U.S.C. § 1076f — TRICARE program: extension of coverage

Page 1090 TITLE 10—ARMED FORCES § 1076f (b) TERMINATION OF ELIGIBILITY UPON OBTAIN- ING OTHER TRICARE COVERAGE.—Eligibility for TRICARE Retired Reserve coverage of a member under this section shall terminate upon the member becoming eligible for TRICARE cov- erage at age 60 under section 1086 of this title. (c) FAMILY MEMBERS.—While a member of a re- serve component is covered by TRICARE Re- tired Reserve under this section, the members of the immediate family of such member are eligi- ble for TRICARE Retired Reserve coverage as dependents of the member. If a member of a re- serve component dies while in a period of cov- erage under this section, the eligibility of the members of the immediate family of such mem- ber for TRICARE Retired Reserve coverage under this section shall continue for the same period of time that would be provided under sec- tion 1086 of this title if the member had been eli- gible at the time of death for TRICARE cov- erage under such section (instead of under this section). (d) PREMIUMS.—(1) A member of a reserve com- ponent covered by TRICARE Retired Reserve under this section shall pay a premium for that coverage. Such premium shall apply instead of any enrollment fees required under section 1075 of this title. (2) The Secretary of Defense shall prescribe for the purposes of this section one premium for TRICARE Retired Reserve coverage of members without dependents and one premium for TRICARE Retired Reserve coverage of members with dependents referred to in subsection (f)(1). The premium prescribed for a coverage shall apply uniformly to all members of the reserve components covered under this section. (3) The monthly amount of the premium in ef- fect for a month for TRICARE Retired Reserve coverage under this section shall be the amount equal to the cost of coverage that the Secretary determines on an appropriate actuarial basis. (4) The Secretary shall prescribe the require- ments and procedures applicable to the payment of premiums under this subsection. (5) Amounts collected as premiums under this subsection shall be credited to the appropriation available for the Defense Health Program Ac- count under section 1100 of this title, shall be merged with sums in such Account that are available for the fiscal year in which collected, and shall be available under subsection (b) of such section for such fiscal year. (e) REGULATIONS.—The Secretary of Defense, in consultation with the other administering Secretaries, shall prescribe regulations for the administration of this section. (f) DEFINITIONS.—In this section: (1) The term ‘‘immediate family’’, with re- spect to a member of a reserve component, means all of the member’s dependents de- scribed in subparagraphs (A), (D), and (I) of section 1072(2) of this title. (2) The term ‘‘TRICARE Retired Reserve’’ means— (A) medical care at facilities of the uni- formed services to which a dependent de- scribed in section 1076(a)(2) of this title is entitled; and (B) health benefits under the TRICARE Se- lect self-managed, preferred provider net- work option under section 1075 of this title made available to beneficiaries by reason of this section and subject to the cost-sharing requirements set forth in such section 1075. (Added Pub. L. 111–84, div. A, title VII, § 705(a), Oct. 28, 2009, 123 Stat. 2374; Pub. L. 114–328, div. A, title VII, § 701(j)(1)(C), Dec. 23, 2016, 130 Stat. 2192; Pub. L. 115–91, div. A, title VII, § 701(b), Dec. 12, 2017, 131 Stat. 1432; Pub. L. 116–92, div. A, title XVII, § 1731(a)(25), Dec. 20, 2019, 133 Stat. 1813.) Editorial Notes AMENDMENTS 2019—Subsec. (d)(1). Pub. L. 116–92 substituted ‘‘sec- tion 1075 of this title’’ for ‘‘section 1075 of this section’’. 2017—Subsec. (b). Pub. L. 115–91, § 701(b)(1), struck out ‘‘Retired Reserve’’ after ‘‘TRICARE’’ in heading. See first 2016 Amendment note for subsec. (b) below. Subsec. (c). Pub. L. 115–91, § 701(b)(2), struck out ‘‘Re- tired Reserve’’ before ‘‘coverage under such section’’ in last sentence. Subsec. (f)(2). Pub. L. 115–91, § 701(b)(3), added par. (2) and struck out former par. (2) which read as follows: ‘‘The term ‘TRICARE Retired Reserve’ means the TRICARE Select self-managed, preferred-provider net- work option under section 1075 made available to bene- ficiaries by reason of this section and in accordance with subsection (d)(1).’’ 2016—Pub. L. 114–328, § 701(j)(1)(C)(iv), substituted ‘‘TRICARE Retired Reserve’’ for ‘‘TRICARE Standard’’ in section catchline and wherever appearing in text. Subsec. (b). Pub. L. 114–328, § 701(j)(1)(C)(iv), which di- rected substitution of ‘‘TRICARE Retired Reserve’’ for ‘‘TRICARE Standard’’ wherever appearing in text, was also executed to heading of subsec. (b) to reflect the probable intent of Congress and the subsequent amend- ment by Pub. L. 115–91, § 701(b)(1), which could be exe- cuted only if the substitution had taken place. Pub. L. 114–328, § 701(j)(1)(C)(iii), substituted ‘‘TRICARE coverage at’’ for ‘‘TRICARE Standard cov- erage at’’. Subsec. (d)(1). Pub. L. 114–328, § 701(j)(1)(C)(i), inserted at end ‘‘Such premium shall apply instead of any en- rollment fees required under section 1075 of this sec- tion.’’ Subsec. (f)(2). Pub. L. 114–328, § 701(j)(1)(C)(ii), added par. (2) and struck out former par. (2) which defined the term ‘‘TRICARE Standard’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2016 AMENDMENT Amendment by Pub. L. 114–328 applicable with re- spect to the provision of health care under the TRICARE program beginning on Jan. 1, 2018, see sec- tion 701(k) of Pub. L. 114–328, set out as a note under section 1072 of this title. EFFECTIVE DATE Pub. L. 111–84, div. A, title VII, § 705(c), Oct. 28, 2009, 123 Stat. 2375, provided that: ‘‘Section 1076e of title 10, United States Code, as inserted by subsection (a), shall apply to coverage for months beginning on or after Oc- tober 1, 2009, or such earlier date as the Secretary of Defense may specify.’’ § 1076f. TRICARE program: extension of coverage for certain members of the National Guard and dependents during certain disaster re- sponse duty (a) EXTENDED COVERAGE.—During a period in which a member of the National Guard is per- forming disaster response duty, the member may be treated as being on active duty for a pe- Page 1091 TITLE 10—ARMED FORCES § 1077 riod of more than 30 days for purposes of the eli- gibility of the member and dependents of the member for health care benefits under the TRICARE program if such period immediately follows a period in which the member served on full-time National Guard duty under section 502(f) of title 32, including pursuant to chapter 9 of such title, unless the Governor of the State (or, with respect to the District of Columbia, the mayor of the District of Columbia) determines that such extended eligibility is not in the best interest of the member or the State. (b) CONTRIBUTION BY STATE.—(1) The Secretary shall charge a State for the costs of providing coverage under the TRICARE program to mem- bers of the National Guard of the State and the dependents of the members pursuant to sub- section (a). Such charges shall be paid from the funds of the State or from any other non-Fed- eral funds. (2) Any amounts received by the Secretary under paragraph (1) shall be credited to the ap- propriation available for the Defense Health Program Account under section 1100 of this title, shall be merged with sums in such Ac- count that are available for the fiscal year in which collected, and shall be available under subsection (b) of such section, including to carry out subsection (a) of this section. (c) DEFINITIONS.—In this section: (1) The term ‘‘disaster response duty’’ means duty performed by a member of the National Guard in State status pursuant to an emer- gency declaration by the Governor of the State (or, with respect to the District of Co- lumbia, the mayor of the District of Columbia) in response to a disaster or in preparation for an imminent disaster. (2) The term ‘‘State’’ means each of the sev- eral States, the District of Columbia, the Commonwealth of Puerto Rico, and any terri- tory or possession of the United States. (Added Pub. L. 114–328, div. A, title VII, § 711(a), Dec. 23, 2016, 130 Stat. 2213.) § 1077. Medical care for dependents: authorized care in facilities of uniformed services (a) Only the following types of health care may be provided under section 1076 of this title: (1) Hospitalization. (2) Outpatient care. (3) Drugs, including, in accordance with sub- section (h), medically necessary vitamins. (4) Treatment of medical and surgical condi- tions. (5) Treatment of nervous, mental, and chron- ic conditions. (6) Treatment of contagious diseases. (7) Physical examinations, including eye ex- aminations, and immunizations. (8) Maternity and infant care, including well-baby care that includes one screening of an infant for the level of lead in the blood of the infant. (9) Diagnostic tests and services, including laboratory and X-ray examinations. (10) Dental care. (11) Ambulance service and home calls when medically necessary. (12) Durable equipment, which may be pro- vided on a loan basis. (13) Primary and preventive health care services for women (as defined in section 1074d(b) of this title). (14) Preventive health care screening for colon or prostate cancer, at the intervals and using the screening methods prescribed under section 1074d(a)(2) of this title. (15) Prosthetic devices, as determined by the Secretary of Defense to be necessary because of significant conditions resulting from trau- ma, congenital anomalies, or disease. (16) Except as provided by subsection (g), a hearing aid, but only if the dependent has a profound hearing loss, as determined under standards prescribed in regulations by the Secretary of Defense in consultation with the administering Secretaries, and only for the following dependents: (A) A dependent of a member of the uni- formed services on active duty. (B) A dependent under subparagraph (D) or (I) of section 1072(2) of this title of a former member of the uniformed services who— (i) is entitled to retired or retainer pay, or equivalent pay; and (ii) is enrolled in family coverage under TRICARE Prime. (17) Any rehabilitative therapy to improve, restore, or maintain function, or to minimize or prevent deterioration of function, of a pa- tient when prescribed by a physician. (18) In accordance with subsection (h), medi- cally necessary food and the medical equip- ment and supplies necessary to administer such food (other than durable medical equip- ment and supplies). (b) The following types of health care may not be provided under section 1076 of this title: (1) Domiciliary or custodial care. (2) Orthopedic footwear and spectacles, ex- cept that, outside of the United States and at stations inside the United States where ade- quate civilian facilities are unavailable, such items may be sold to dependents at cost to the United States. (3) The elective correction of minor der- matological blemishes and marks or minor an- atomical anomalies. (c)(1) Except as specified in paragraphs (2) and (3), a dependent participating under a dental plan established under section 1076a of this title may not be provided dental care under section 1076(a) of this title except for emergency dental care, dental care provided outside the United States, and dental care that is not covered by such plan. (2)(A) Dependents who are 12 years of age or younger and are covered by a dental plan estab- lished under section 1076a of this title may be treated by postgraduate dental residents in a dental treatment facility of the uniformed serv- ices under a graduate dental education program accredited by the American Dental Association if— (i) treatment of pediatric dental patients is necessary in order to satisfy an accreditation standard of the American Dental Association that is applicable to such program, or training in pediatric dental care is necessary for the residents to be professionally qualified to pro-