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10 U.S.C. § 1086aCertain former spouses: extension of period of eligibility for health benefits

submitted 37 years ago by Pub. L. 101-189 to r/title-10-ARMED-FORCES · 538 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Secretary of Defense must tell certain former dependents about conversion health policies. Buying one can extend medical and dental eligibility for 24 months, subject to the section’s conditions.

(a) The Secretary of Defense must tell each person who has been a dependent for at least one year under section 1072(2)(H) that the person may buy a conversion health policy. The policy must provide coverage for at least 24 months. (b) (1) Subject to paragraph (2), a person who was a dependent for one year and buys the policy during that year, or within a reasonable time set by the Secretary, remains eligible for medical and dental care under section 1076 and health benefits under section 1086 until the end of the 24-month period beginning on the later of the date dependency ends or the purchase date. (2) The extension applies only to a condition that existed when policy coverage began and for which the policy provides no care solely because it is preexisting. (c) (1) If the Secretary cannot reasonably soon contract with a private insurer for a policy costing no more than the comparable-coverage payment under section 8905a(d)(1)(A) of title 5, the Secretary must provide the coverage through the Civilian Health and Medical Program of the Uniformed Services. The person must pay into the Military Health Care Account or another appropriate account the individual and Government contributions required for a section 1079 plan participant, plus administrative costs of no more than 2 percent of those contributions. (2) The person’s payment may not exceed the cited comparable-coverage payment. (3) To lower premiums, the Secretary may offer less mental-health coverage and greater purchaser cost-sharing. (d) “Conversion health policy” means a private-insurer health policy negotiated by the Secretary and the insurer for purchase by or use of a person who was a dependent for one year under section 1072(2)(H).
the actual law source: uscode.house.gov ↗public domain
(a)Availability of Conversion Health Policies.—

The Secretary of Defense shall inform each person who has been a dependent for a period of one year or more under section 1072(2)(H) of this title of the availability of a conversion health policy for purchase by the person. A conversion health policy offered under this subsection shall provide coverage for not less than a 24-month period.

(b)Effect of Purchase.—
(1)

Subject to paragraph (2), if a person who is a dependent for a one-year period under section 1072(2)(H) of this title purchases a conversion health policy within that period (or within a reasonable time after that period as prescribed by the Secretary of Defense), the person shall continue to be eligible for medical and dental care in the manner described in section 1076 of this title and health benefits under section 1086 of this title until the end of the 24-month period beginning on the later of—

(A)

the date the person is no longer a dependent under section 1072(2)(H) of this title; and

(B)

the date of the purchase of the policy.

(2)

The extended period of eligibility provided under paragraph (1) shall apply only with regard to a condition of the person that—

(A)

exists on the date on which coverage under the conversion health policy begins; and

(B)

for which care is not provided under the policy solely on the grounds that the condition is a preexisting condition.

(c)Effect of Unavailability of Policies.—
(1)

If the Secretary of Defense is unable, within a reasonable time, to enter into a contract with a private insurer to offer conversion health policies under subsection (a) at a rate not to exceed the payment required under section 8905a(d)(1)(A) of title 5 for comparable coverage, the Secretary shall provide the coverage required under such a policy through the Civilian Health and Medical Program of the Uniformed Services. Subject to paragraph (2), a person receiving coverage under this subsection shall be required to pay into the Military Health Care Account or other appropriate account an amount equal to the sum of—

(A)

the individual and Government contributions which would be required in the case of a person enrolled in a health benefits plan contracted for under section 1079 of this title; and

(B)

an amount necessary for administrative expenses, but not to exceed two percent of the amount under subparagraph (A).

(2)

The amount paid by a person who purchases a conversion health policy from the Secretary of Defense under paragraph (1) may not exceed the payment required under section 8905a(d)(1)(A) of title 5 for comparable coverage.

(3)

In order to reduce premiums required under paragraph (1), the Secretary of Defense may offer a program of coverage that, with respect to mental health services, offers reduced coverage and increased cost-sharing by the purchaser.

(d)Conversion Health Policy Defined.—

In this section, the term “conversion health policy” means a health insurance policy with a private insurer, developed through negotiations between the Secretary of Defense and the private insurer, that is available for purchase by or for the use of a person who is a dependent for a one-year period under section 1072(2)(H) of this title.

Source credit: (Added Pub. L. 101–189, div. A, title VII, § 731(b)(1), Nov. 29, 1989, 103 Stat. 1482; amended Pub. L. 102–484, div. D, title XLIV, § 4407(b), Oct. 23, 1992, 106 Stat. 2707; Pub. L. 103–35, title II, § 202(a)(16), May 31, 1993, 107 Stat. 102.)

history & why it existsrecord from the source credit
  • 1989Enacted · Pub. L. 101-189 · 103 Stat. 1482
  • 1992Amended · Pub. L. 102-484 · 106 Stat. 2707
  • 1993Amended · Pub. L. 103-35 · 107 Stat. 102

A history note hasn’t been published yet. The record shows enactment by Pub. L. 101-189 on 1989-11-29.

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