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

10 USC 1086a - Certain former spouses: extension of period of eligibility for health benefits

(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.

Advertisement