Pub. L. 89–614, § 2(7)80 Stat. 865Pub. L. 95–485, title VIII, § 806(a)(2)92 Stat. 1622Pub. L. 96–173, § 193 Stat. 1287Pub. L. 96–513, title V94 Stat. 2908Pub. L. 97–86, title IX, § 906(a)(2)95 Stat. 1117Pub. L. 97–252, title X, § 1004(c)96 Stat. 737Pub. L. 98–94, title IX, § 931(b)97 Stat. 649Pub. L. 98–525, title VI, § 632(a)(2)98 Stat. 2543Pub. L. 98–557, § 19(13)98 Stat. 2870Pub. L. 99–145, title VI, § 652(b)99 Stat. 657Pub. L. 99–661, div. A, title VI, § 604(f)(1)(C)100 Stat. 3877Pub. L. 100–180, div. A, title VII, § 721(b)101 Stat. 1115Pub. L. 100–456, div. A, title VI, § 646(b)102 Stat. 1989Pub. L. 101–189, div. A, title VII, § 731(c)(2)103 Stat. 1482Pub. L. 101–510, div. A, title VII, § 712(b)104 Stat. 1583Pub. L. 102–190, div. A, title VII, § 704(a)105 Stat. 1401Pub. L. 102–484, div. A, title VII106 Stat. 2432Pub. L. 103–35, title II, § 203(b)(2)107 Stat. 102Pub. L. 103–160, div. A, title VII, § 716(b)(2)107 Stat. 1693Pub. L. 103–337, div. A, title VII, § 711108 Stat. 2801Pub. L. 104–106, div. A, title VII, § 732110 Stat. 381Pub. L. 104–201, div. A, title VII, § 734(a)(2)110 Stat. 2598Pub. L. 106–398, § 1 [[div. A]114 Stat. 1654Pub. L. 108–173, title IX, § 900(e)(4)(A)117 Stat. 2373Pub. L. 109–364, div. A, title VII, § 704(b)120 Stat. 2280Pub. L. 110–181, div. A, title VII, § 701(b)122 Stat. 187Pub. L. 110–417122 Stat. 4498Pub. L. 111–84, div. A, title VII123 Stat. 2375Pub. L. 111–383, div. A, title VII, § 701(b)124 Stat. 4244Pub. L. 112–239, div. A, title X, § 1076(f)(11)126 Stat. 1952Pub. L. 113–291, div. A, title VII, § 703(c)(2)128 Stat. 3412Pub. L. 115–91, div. A, title VII, § 739(d)(2)131 Stat. 1447Pub. L. 117–81, div. A, title VII, § 701(b)135 Stat. 1778(Added , , ; amended , , ; , , ; , §§ 501(14), 511(36), (39), , , 2923; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , title XVI, § 1621(a)(3), , , 1603; , , ; , (b)(1), , ; , §§ 703(a), 705(a), , ; , , ; , , ; , , ; , , ; , (b)(2), , ; , title VII, §§ 712(a)(1), 759], , , 1654A–176, 1654A–200; , , ; , , ; , , ; , [div. A], title VII, § 701(b), , ; , §§ 706, 709, , , 2378; , , ; , , ; , , ; , , ; , , .)
Editorial Notes
References in Text
act Aug. 14, 1935, ch. 53149 Stat. 620section 1305 of Title 42The Social Security Act, referred to in subsec. (d), is , . Title XVIII of the Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. Parts A and B of title XVIII of the Act are classified generally to parts A (§ 1395c et seq.) and B (§ 1395j et seq.), respectively, of subchapter XVIII of chapter 7 of Title 42. For complete classification of this Act to the Code, see and Tables.
Prior Provisions
act Aug. 10, 1956, ch. 104170A Stat. 88Pub. L. 85–861, § 36(B)(5)72 Stat. 1570A prior section 1086, , , authorized the mailing of official post cards, ballots, voting instructions, and envelopes, free of postage, prior to repeal by , , , as superseded by the Federal Voting Assistance Act of 1955 which is classified to subchapter I–D (§ 1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare.
Amendments
Pub. L. 117–81, § 701(b)(1)2021—Subsec. (a). , inserted “and (except as provided in subsection (i)) treatments for eating disorders” after “eye examinations”.
Pub. L. 117–81, § 701(b)(2)Subsec. (i). , added subsec. (i).
Pub. L. 115–912017—Subsec. (b). substituted “calendar year” for “fiscal year” wherever appearing.
Pub. L. 113–291, § 703(c)(2)(A)2014—Subsec. (d)(4)(A)(ii). , substituted “section 1079(i)(1)” for “section 1079(j)(1)”.
Pub. L. 113–291, § 703(c)(2)(B)Subsec. (g). , substituted “Section 1079(i)” for “Section 1079(j)”.
Pub. L. 112–2392013—Subsec. (b)(1). substituted “paragraph (2)” for “clause (2)”.
Pub. L. 111–3832011—Subsec. (b)(3). substituted “” for “”.
Pub. L. 111–84, § 7092009—Subsec. (b)(3). , substituted “” for “”.
Pub. L. 111–84, § 706Subsec. (d)(4), (5). , added par. (4) and redesignated former par. (4) as (5).
Pub. L. 110–4172008—Subsec. (b)(3). substituted “” for “”.
Pub. L. 110–181 substituted “” for “.”
Pub. L. 109–3642006—Subsec. (b)(3). inserted “, except that in no case may the charges for inpatient care for a patient exceed $535 per day during the period beginning on , and ending on .” after “charges for inpatient care”.
Pub. L. 108–1732003—Subsec. (d)(4). substituted “Administrator of the Centers for Medicare & Medicaid Services” for “administrator of the Health Care Financing Administration” in last sentence.
Pub. L. 106–398, § 1 [[div. A]2000—Subsec. (b)(4). , title VII, § 759], substituted “$3,000” for “$7,500”.
Pub. L. 106–398, § 1 [[div. A]Subsec. (d)(2). , title VII, § 712(a)(1)(A)], added par. (2) and struck out former par. (2) which read as follows: “The prohibition contained in paragraph (1) shall not apply in the case of a person referred to in subsection (c) who—
42 U.S.C. 426(b)(2)42 U.S.C. 426–1(a)“(A) is entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act pursuant to subparagraph (A) or (C) of section 226(b)(2) of such Act () or section 226A(a) of such Act ();
“(B) is under 65 years of age; and
42 U.S.C. 1395j“(C) is enrolled in the supplementary medical insurance program under part B of such title ( et seq.).”
Pub. L. 106–398, § 1 [[div. A]Subsec. (d)(4). , title VII, § 712(a)(1)(B)], substituted “subparagraph (B) of paragraph (2) who do not satisfy the condition specified in subparagraph (A) of such paragraph” for “paragraph (1) who satisfy only the criteria specified in subparagraphs (A) and (B) of paragraph (2), but not subparagraph (C) of such paragraph,”.
Pub. L. 104–1061996—Subsec. (d)(4). added par. (4).
Pub. L. 104–201Subsec. (e). substituted “inpatient medical care” for “benefits” in first sentence and “subsections (b) and (c) of section 1080” for “section 1080(b)” in last sentence.
Pub. L. 103–33742 U.S.C. 13951994—Subsec. (d)(3). added par. (3) and struck out former par. (3) which read as follows: “If a person described in paragraph (2) receives medical or dental care for which payment may be made under both title XVIII of the Social Security Act ( et seq.) and a plan contracted for under subsection (a), the amount payable for that care under the plan may not exceed the difference between—
“(A) the sum of any deductibles, coinsurance, and balance billing charges that would be imposed on the person if payment for that care were made solely under that title; and
“(B) the sum of any deductibles, coinsurance, and balance billing charges that would be imposed on the person if payment for that care were made solely under the plan.”
Pub. L. 103–35Pub. L. 102–190, § 704(a)1993—Subsec. (d). made technical amendment to directory language of . See 1991 Amendment note below.
Pub. L. 103–160section 1080(b) of this titleSubsec. (e). inserted at end “In addition, shall apply in making the determination whether to issue a nonavailability of health care statement for a person covered by this section.”
Pub. L. 102–484, § 703(a)1992—Subsec. (b)(4). , substituted “$7,500” for “$10,000”.
Pub. L. 102–484, § 705(a)42 U.S.C. 426–1(a)Subsec. (d)(2)(A). , inserted before semicolon “or section 226A(a) of such Act ()”.
Pub. L. 102–190, § 704(b)(1)(A)42 U.S.C. 1395c1991—Subsec. (c). , substituted “Except as provided in subsection (d), the following” for “The following” in introductory provisions and struck out at end “However, a person who is entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act ( et seq.) is not eligible for health benefits under this section.”
Pub. L. 102–190, § 704(a)Pub. L. 103–35section 1079(j) of this titleSubsec. (d). , as amended by , added subsec. (d) and struck out former subsec. (d) which read as follows: “The provisions of shall apply to a plan covered by this section.”
Pub. L. 102–190, § 704(b)(1)(B)Section 1079(j) of this titleSubsec. (g). , substituted “ shall apply to a plan contracted for under this section, except that” for “Notwithstanding subsection (d) or any other provision of this chapter,”.
Pub. L. 101–5101990—Subsec. (b)(1), (2). substituted “$150” for “$50” in par. (1) and “$300” for “$100” in par. (2).
Pub. L. 101–189, § 731(c)(2)section 1072(2)(F) of this title1989—Subsec. (c)(3). , amended par. (3) generally. Prior to amendment, par. (3) read as follows: “A dependent covered by .”
Pub. L. 101–189, § 1621(a)(3)Subsec. (g). , substituted “facilities of the Department of Veterans Affairs” for “Veterans’ Administration facilities”.
Pub. L. 100–456, § 646(b)(1)1988—Subsec. (b)(3). , inserted provision authorizing Secretary of Defense to exempt a patient from paying such charges if the hospital to which the patient is admitted does not impose a legal obligation on any of its patients to pay for inpatient care.
Pub. L. 100–456, § 646(b)(2)Subsec. (h). , added subsec. (h).
Pub. L. 100–1801987—Subsec. (b)(4). added par. (4).
Pub. L. 99–6611986—Subsec. (c)(2)(B). inserted reference to disease.
Pub. L. 99–145section 1072(2)(E) of this title1985—Subsec. (c)(2). amended par. (2) generally. Prior to amendment, par. (2) read as follows: “A dependent of a member of a uniformed service who died while on active duty for a period of more than thirty days, except a dependent covered by .”
Pub. L. 98–557, § 19(13)(A)1984—Subsec. (a). , substituted reference to other administering Secretaries for reference to Secretary of Health and Human Services.
Pub. L. 98–525 inserted “However, eye examinations may not be provided under such plans for persons covered by subsection (c).”
Pub. L. 98–557, § 19(13)(B)Subsec. (e). , substituted reference to the administering Secretaries for reference to the Secretary of Defense and the Secretary of Health and Human Services.
Pub. L. 98–94section 1079(j) of this title1983—Subsec. (d). substituted “The provisions of shall apply to a plan covered by this section” for “No benefits shall be payable under any plan covered by this section in the case of a person enrolled in any other insurance, medical service, or health plan provided by law or through employment unless that person certifies that the particular benefit he is claiming is not payable under the other plan”.
Pub. L. 97–2521982—Subsec. (c)(3). added par. (3).
Pub. L. 97–861981—Subsec. (f). substituted “services by an individual health-care professional (or other noninstitutional health-care provider)” for “physician services”.
Pub. L. 96–513, § 511(36)1980—Subsec. (a). , substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.
Pub. L. 96–513, § 511(39)(A)Subsec. (b). , substituted “percent” for “per centum” wherever appearing.
Pub. L. 96–51342 U.S.C. 1395c79 Stat. 286Subsec. (c). , §§ 501(14), 511(39)(B), substituted “section 1072(2)(E)” for “section 1072(2)(F)” in pars. (1) and (2) and, in provisions following par. (2), substituted “part A of title XVIII of the Social Security Act ( et seq.)” for “title I of the Social Security Amendments of 1965 ()”.
Pub. L. 96–1731979—Subsec. (g). added subsec. (g).
Pub. L. 95–4851978—Subsec. (f). added subsec. (f).
Statutory Notes and Related Subsidiaries
Effective Date of 2021 Amendment
Pub. L. 117–81section 701(d) of Pub. L. 117–81section 1079 of this titleAmendment by effective , see , set out as a note under .
Effective Date of 2000 Amendment
Pub. L. 106–398, § 1 [[div. A]114 Stat. 1654
Effective Date of 1992 Amendment
Pub. L. 102–484, div. A, title VII, § 703(b)106 Stat. 2432
Effective Date of 1991 Amendment
Pub. L. 102–190, div. A, title VII, § 704(c)105 Stat. 1402Pub. L. 102–484, div. A, title VII, § 705(c)(1)106 Stat. 2433, , , which provided that subsection (d) of this section was to apply with respect to health care benefits or services received by a person described in such subsection on or after , was repealed by , , .
Effective Date of 1990 Amendment
Pub. L. 101–510section 1079 of this titlesection 712(c) of Pub. L. 101–510section 1079 of this titleAmendment by applicable with respect to health care provided under this section and on or after , see , set out as a note under .
Effective Date of 1989 Amendment
section 731(c)(2) of Pub. L. 101–18910 U.S.C. 1072(2)(H)section 731(d) of Pub. L. 101–189section 1072 of this titleAmendment by applicable to a person referred to in whose decree of divorce, dissolution, or annulment becomes final on or after , and to a person so referred to whose decree became final during the period from to , as if the amendment had become effective on , see , set out as a note under .
Effective Date of 1988 Amendment
Pub. L. 100–456section 646(c) of Pub. L. 100–456section 1079 of this titleAmendment by applicable with respect to medical care received after , see , set out as a note under .
Effective Date of 1987 Amendment
Pub. L. 100–180section 721(c) of Pub. L. 100–180section 1079 of this titleAmendment by applicable with respect to fiscal years beginning after , see , set out as a note under .
Effective Date of 1986 Amendment
Pub. L. 99–661section 604(g) of Pub. L. 99–661section 1074a of this titleAmendment by applicable with respect to persons who, after , incur or aggravate an injury, illness, or disease or die, see , set out as a note under .
Effective Date of 1985 Amendment
Pub. L. 99–145section 652(c) of Pub. L. 99–145section 1076 of this titleAmendment by applicable only with respect to dependents of members of the uniformed services whose deaths occur after , see , set out as a note under .
Effective Date of 1984 Amendment
Pub. L. 98–525section 632(a)(3) of Pub. L. 98–525section 1079 of this titleAmendment by applicable only to health care furnished after , see , set out as a note under .
Effective Date of 1983 Amendment
Pub. L. 98–94section 931(c) of Pub. L. 98–94section 1079 of this titleAmendment by effective , see , set out as a note under .
Effective Date of 1982 Amendment; Transition Provisions
Pub. L. 97–252section 1006 of Pub. L. 97–252section 1408 of this titleAmendment by effective , and applicable in the case of any former spouse of a member or former member of the uniformed services whether final decree of divorce, dissolution, or annulment of marriage of former spouse and such member or former member is dated before, on, or after , see , set out as an Effective Date; Transition Provisions note under .
Effective Date of 1981 Amendment
Pub. L. 97–86section 906(b) of Pub. L. 97–86section 1079 of this titleAmendment by to apply with respect to claims submitted for payment for services provided after the end of the 30-day period beginning on , see , set out as a note under .
Effective Date of 1980 Amendment
section 501(14) of Pub. L. 96–513Pub. L. 96–513section 701 of Pub. L. 96–513section 101 of this titleAmendment by effective , and amendment by section 511(36), (39) of effective , see , set out as a note under .
Effective Date of 1979 Amendment
Pub. L. 96–173, § 293 Stat. 1287
Effective Date of 1978 Amendment
Pub. L. 95–485section 806(b) of Pub. L. 95–485section 1079 of this titleAmendment by applicable with respect to claims submitted for payment for services provided on or after the first day of the first calendar year beginning after , see , set out as a note under .
Effective Date
section 3 of Pub. L. 89–614section 1071 of this titleFor effective date of section, see , set out as a note under .
Temporary Authority for Waiver of Collection of Payments Due for CHAMPUS Benefits Received by Certain Persons Unaware of Loss of CHAMPUS Eligibility
Pub. L. 108–375, div. A, title VII, § 716118 Stat. 1986, , , authorized the Secretary of Defense to waive the collection of payments otherwise due for health benefits from certain persons described in subsec. (d) of this section who were unaware of the loss of eligibility to receive health benefits under such subsection and authorized a continuation of benefits for such persons during the period beginning on , and ending on .
Similar provisions were contained in the following prior authorization acts:
Pub. L. 105–261, div. A, title VII, § 704112 Stat. 2057, , .
Minimum Amount Payable for Services Provided Under This Section
Pub. L. 103–335, title VIII, § 8052108 Stat. 2629
Authorization To Apply Section 1079 Payment Rules for Spouse and Children of Member Who Dies While on Active Duty
Pub. L. 103–160, div. A, title VII, § 704107 Stat. 1687section 1079(b) of this titlesection 1086(b) of this titlePub. L. 103–337, div. A, title VII, § 707(d)108 Stat. 2801, , , provided that in the case of an eligible dependent of a member of a uniformed service who died while on active duty for a period of more than 30 days, the administering Secretary could apply the payment provisions set forth in (in lieu of the payment provisions set forth in ), with respect to health benefits received by the dependent under such section 1086 in connection with an illness or medical condition for which the dependent was receiving treatment under chapter 55 of this title at time of death of the member, prior to repeal by , , .
Pub. L. 103–337, div. A, title VII, § 707(d)108 Stat. 2801
Coverage of Care Provided Since
Pub. L. 102–484, div. A, title VII, § 705(b)106 Stat. 2433