2013 US Code
Title 10 - Armed Forces
Subtitle A - General Military Law (§§ 101 - 2925)
Part II - PERSONNEL (§§ 501 - 1805)
Chapter 55 - MEDICAL AND DENTAL CARE (§§ 1071 - 1110b)
Section 1097a - TRICARE Prime: automatic enrollments; payment options
Publication Title | United States Code, 2012 Edition, Supplement 1, Title 10 - ARMED FORCES |
Category | Bills and Statutes |
Collection | United States Code |
SuDoc Class Number | Y 1.2/5: |
Contained Within | Title 10 - ARMED FORCES Subtitle A - General Military Law PART II - PERSONNEL CHAPTER 55 - MEDICAL AND DENTAL CARE Sec. 1097a - TRICARE Prime: automatic enrollments; payment options |
Contains | section 1097a |
Date | 2013 |
Laws in Effect as of Date | January 16, 2014 |
Positive Law | Yes |
Disposition | standard |
Source Credit | 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; Pub. L. 112-239, div. A, title VII, §711, Jan. 2, 2013, 126 Stat. 1801. |
Statutes at Large References | 112 Stat. 2058, 2059 114 Stat. 1654 115 Stat. 1223 126 Stat. 1801, 1816 127 Stat. 789 |
Public Law References | Public Law 105-261, Public Law 106-398, Public Law 107-107, Public Law 112-239, Public Law 113-66 |
Download PDF
(a)
(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)
(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)
(d)
(e)
(f)
(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.
(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; Pub. L. 112–239, div. A, title VII, §711, Jan. 2, 2013, 126 Stat. 1801.)
AMENDMENTS2013—Subsec. (a). Pub. L. 112–239 amended subsec. (a) generally. Prior to amendment, text read as follows: "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."
2001—Subsec. (e). Pub. L. 107–107 substituted "section 1072(2)" for "section 1072".
2000—Subsecs. (e), (f). Pub. L. 106–398 added subsec. (e) and redesignated former subsec. (e) as (f).
EFFECTIVE DATE OF 2000 AMENDMENTPub. 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 DATEPub. L. 105–261, div. A, title VII, §712(b), Oct. 17, 1998, 112 Stat. 2059, provided that: "The regulations required under subsection (d) of section 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."
FUTURE AVAILABILITY OF TRICARE PRIME THROUGHOUT THE UNITED STATESPub. L. 112–239, div. A, title VII, §732, Jan. 2, 2013, 126 Stat. 1816, as amended by Pub. L. 113–66, div. A, title VII, §701, Dec. 26, 2013, 127 Stat. 789, provided that:
"(a)
"(1)
"(2)
"(A) A description, by region, of the difference in availability of TRICARE Prime for eligible beneficiaries (other than eligible beneficiaries on active duty in the Armed Forces) under newly awarded TRICARE managed care contracts, including, in particular, an identification of the regions or areas in which TRICARE Prime will no longer be available for such beneficiaries under such contracts.
"(B) An estimate of the increased costs to be incurred by an affected eligible beneficiary for health care under the TRICARE program.
"(C) An estimate of the savings to be achieved by the Department as a result of the contracts described in subparagraph (A).
"(D) A description of the plans of the Department to continue to assess the impact on access to health care for affected eligible beneficiaries.
"(E) A description of the plan of the Department to provide assistance to affected eligible beneficiaries who are transitioning from TRICARE Prime to TRICARE Standard, including assistance with respect to identifying health care providers.
"(F) Any other matter the Secretary considers appropriate.
"(b)
"(1)
"(2)
"(3)
"(A) in a ZIP code that is in a region described in subsection (c)(1)(B); and
"(B) within 100 miles of a military medical treatment facility.
"(4)
"(c)
"(1) The term 'affected eligible beneficiary' means an eligible beneficiary under the TRICARE Program (other than eligible beneficiaries on active duty in the Armed Forces) who, as of the date of the enactment of this Act [Jan. 2, 2013]—
"(A) is enrolled in TRICARE Prime; and
"(B) resides in a region of the United States in which TRICARE Prime enrollment will no longer be available for such beneficiary under a contract described in subsection (a)(2)(A) that does not allow for such enrollment because of the location in which such beneficiary resides.
"(2) The term 'TRICARE Prime' means the managed care option of the TRICARE program.
"(3) The term 'TRICARE program' has the meaning given that term in section 1072(7) of title 10, United States Code.
"(4) The term 'TRICARE Standard' means the fee-for-service option of the TRICARE Program."
Disclaimer: These codes may not be the most recent version. The United States Government Printing Office may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the US site. Please check official sources.