PRIA, Government Policy, Made Personal

Summary

Lets servicemembers who lost health insurance because of military service get their old coverage back when they leave the service. The plan must have been active the day before their service began and must have ended while they were serving. Dependents covered because of the servicemember are included. Insurers cannot add a waiting period or exclude care for a condition that began before or during the service if that condition would not have been excluded while coverage was continuous, unless the Department of Veterans Affairs has found the condition to be a service-connected disability. The rule does not apply to people with employer coverage under chapter 43 of title 38. You must ask for reinstatement within 120 days after leaving service. Premiums cannot be raised above what would have been charged if coverage had not stopped, except for general rate increases that affect everyone similarly.

Title 50, §4024

War and National Defense, Source: USLM XML via OLRC

(a)Reinstatement of health insurance

A servicemember who, by reason of military service as defined in section 4023(a)(1) of this title, is entitled to the rights and protections of this chapter shall also be entitled upon termination or release from such service to reinstatement of any health insurance that—

(1)was in effect on the day before such service commenced; and

(2)was terminated effective on a date during the period of such service.

(b)No exclusion or waiting period

The reinstatement of health care insurance coverage for the health or physical condition of a servicemember described in subsection (a), or any other person who is covered by the insurance by reason of the coverage of the servicemember, shall not be subject to an exclusion or a waiting period, if—

(1)the condition arose before or during the period of such service;

(2)an exclusion or a waiting period would not have been imposed for the condition during the period of coverage; and

(3)in a case in which the condition relates to the servicemember, the condition has not been determined by the Secretary of Veterans Affairs to be a disability incurred or aggravated in the line of duty (within the meaning of section 105 of title 38).

(c)Exceptions

Subsection (a) does not apply to a servicemember entitled to participate in employer-offered insurance benefits pursuant to the provisions of chapter 43 of title 38.

(d)Time for applying for reinstatement

An application under this section must be filed not later than 120 days after the date of the termination of or release from military service.

(e)Limitation on premium increases

(1)Premium protection

The amount of the premium for health insurance coverage that was terminated by a servicemember and required to be reinstated under subsection (a) may not be increased, for the balance of the period for which coverage would have been continued had the coverage not been terminated, to an amount greater than the amount chargeable for such coverage before the termination.

(2)Increases of general applicability not precluded

Paragraph (1) does not prevent an increase in premium to the extent of any general increase in the premiums charged by the carrier of the health care insurance for the same health insurance coverage for persons similarly covered by such insurance during the period between the termination and the reinstatement.

Notes & Related Subsidiaries

Editorial Notes

Codification Section was formerly classified to section 594 of the former Appendix to this title prior to editorial reclassification and renumbering as this section.

Prior Provisions

A prior section 704 of act Oct. 17, 1940, ch. 888, art. VII, as added Pub. L. 107–107, div. A, title XVI, § 1603, Dec. 28, 2001, 115 Stat. 1276, related to guarantee of residency for military personnel, prior to the general amendment of this Act by Pub. L. 108–189. See section 4025 of this title.

Amendments

2006—Subsec. (b)(3). Pub. L. 109–233, § 302(b), substituted “in a case in which the” for “if the”. Subsec. (e). Pub. L. 109–233, § 302(a), added subsec. (e).

Statutory Notes and Related Subsidiaries

Effective Date

Section applicable to any case not final before Dec. 19, 2003, see section 3 of Pub. L. 108–189, set out as a note under section 3901 of this title.

§4024 Health Insurance Reinstatement