#### § 161.22 Benefits for foreign affiliates.

(a) *Sponsored NATO and PFP personnel in the United States.* Active duty officer and enlisted personnel of NATO and PFP countries serving in the United States under the sponsorship or invitation of the DoD or a Military Service and their accompanying dependents living in the sponsor's U.S. household are eligible for benefits as shown in Table 47 to this subpart.

Table 47 to Subpart C of Part 161—Benefits for Sponsored NATO and PFP Personnel and Accompanying Dependents in the United States

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | 1 | 2 | 2 | 2. |
| Spouse | 3 | 1 | 4 | 4 | 4. |
| Children, Unmarried, Under 21 Years: | | | | | |
| Legitimate, adopted, stepchild, Illegitimate child of member, or Illegitimate child of spouse | 3, 4 | 1, 4 | 4 | 4 | 4. |
| Ward | No | No | 5 | 5 | 5. |
| Children, Unmarried, 21 Years and Over | 3, 6 | 1, 6 | 7 | 7 | 7. |
| Parent, Parent-in-Law, Stepparent, or Parent by Adoption | No | No | 4 | 4 | 4. |
| | | | | | |
| --- | --- | --- | --- | --- | --- |
| **Notes:** | | | | | |
| 1. Yes, for outpatient care no charge and for inpatient care at full reimbursable rate. | | | | | |
| 2. Yes, if: | | | | | |
| a. Under orders issued by a U.S. Military Service; or | | | | | |
| b. Assigned military attaché duties in the United States and designated on reciprocal agreements with the Department of State. | | | | | |
| 3. Yes, for outpatient care only. | | | | | |
| 4. Yes, if residing in the household of the authorized sponsor in the United States. | | | | | |
| 5. Yes, if, for determination of dependency made on or after July 1, 1994, placed in the legal custody of the sponsor as a result of a court of competent jurisdiction in the United States (or possession of the United States) for a period of at least 12 consecutive months, and if residing in the authorized sponsor's household. | | | | | |
| 6. Yes, if residing in the household of the authorized sponsor in the United States and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical incapacity that existed before age 21, or occurred before the age of 23 while a full-time student while a dependent of a sponsor, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |
| 7. Yes, if the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |

(b) *Sponsored non-NATO personnel in the United States.* Active duty officer and enlisted personnel of non-NATO countries serving in the United States under DoD or Service sponsorship or invitation and their dependents, living in the non-NATO personnel's U.S. household, are eligible for benefits as shown in Table 48 to this subpart.

Table 48 to Subpart C of Part 161—Benefits for Sponsored Non-NATO Personnel and Accompanying Dependents in the United States

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | 1 | 2 | 2 | 2. |
| Spouse | No | 1 | 3 | 3 | 3. |
| Children, Unmarried, Under 21 Years: | | | | | |
| Legitimate, adopted, stepchild, illegitimate child of member, or illegitimate child of spouse | No | 1, 4 | 3 | 3 | 3. |
| Ward | No | No | 4 | 4 | 4. |
| Children, Unmarried, 21 Years and Over | No | 1, 5 | 6 | 6 | 6. |
| Parent, Parent-in-Law, Stepparent, or Parent by Adoption | No | No | 3 | 3 | 3. |
| | | | | | |
| --- | --- | --- | --- | --- | --- |
| **Notes:** | | | | | |
| 1. Yes, for outpatient care only on a reimbursable basis. | | | | | |
| 2. Yes, if under orders issued by a U.S. Military Service. | | | | | |
| 3. Yes, if residing in the household of the authorized sponsor in the United States. | | | | | |
| 4. Yes, if, for determination of dependency made on or after July 1, 1994, placed in the legal custody of the sponsor as a result of a court of competent jurisdiction in the United States (or possession of the United States) for a period of at least 12 consecutive months, and if residing in the authorized sponsor's household. | | | | | |
| 5. Yes, if residing in the household of the authorized sponsor in the United States and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical incapacity that existed before age 21, or occurred before the age of 23 while a full-time student while a dependent of a sponsor, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |
| 6. Yes, if residing in the household of the authorized sponsor in the United States and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |

(c) *Non-sponsored NATO personnel in the United States.* Active duty officer and enlisted personnel of NATO countries who, in connection with their official NATO duties, are stationed in the United States but are not under DoD or Service sponsorship and their accompanying dependents living in the non-sponsored NATO personnel's U.S. household are eligible for benefits as shown in Table 49 to this subpart.

Table 49 to Subpart C of Part 161—Benefits for Non-Sponsored NATO and PFP Personnel in the United States and Accompanying Dependents

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | 1 | No | No | No. |
| Spouse | 2 | 1 | No | No | No. |
| Children, Unmarried, Under 21 Years: | | | | | |
| Legitimate, adopted, stepchild, illegitimate child of member, or illegitimate child of spouse | 2, 3 | 1, 3 | No | No | No. |
| Ward | No | No | No | No | No. |
| Children, Unmarried, 21 Years and Over | 2, 3, 4 | 1, 3, 4 | No | No | No. |
| Parent, Parent-in-Law, Stepparent, or Parent by Adoption | No | No | No | No | No. |
| | | | | | |
| --- | --- | --- | --- | --- | --- |
| **Notes:** | | | | | |
| 1. Yes, for outpatient care no charge and for inpatient care at full reimbursable rate. | | | | | |
| 2. Yes, for outpatient care only. | | | | | |
| 3. Yes, if residing in the household of the authorized sponsor in the United States. | | | | | |
| 4. Yes, if residing in the household of the authorized sponsor in the United States and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical incapacity that existed before age 21, or occurred before the age of 23 while a full-time student while a dependent of a sponsor, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |

(d) *NATO and non-NATO personnel outside the United States.* Active duty officer and enlisted personnel of NATO and non-NATO countries serving outside the United States and outside their own country under DoD or Service sponsorship or invitation and their accompanying dependents living with the sponsor are eligible for benefits as shown in Table 50 to this subpart. These benefits may be extended to this category of personnel not under DoD or Service sponsorship or invitation when it is determined by the major overseas commander that the granting of such privileges is in the best interests of the United States and such personnel are connected with, or their activities are related to, the performance of functions of the Service establishment.

Table 50 to Subpart C of Part 161—Benefits for NATO, PFP, and Non-NATO Personnel Outside the United States and Accompanying Dependents

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | 1 | Yes | Yes | Yes. |
| Spouse | No | 1 | Yes | Yes | Yes. |
| Children, Unmarried, Under 21 Years: | | | | | |
| Legitimate, adopted, stepchild, illegitimate child of member, or illegitimate child of spouse | No | 1, 2 | 2 | 2 | 2. |
| Ward | No | No | 3 | 3 | 3. |
| Children, Unmarried, 21 Years and Over | No | 1, 4 | 5 | 5 | 5. |
| Parent, Parent-in-Law, Stepparent, or Parent by Adoption | No | No | 2 | 2 | 2. |
| | | | | | |
| --- | --- | --- | --- | --- | --- |
| **Notes:** | | | | | |
| 1. Yes, for outpatient care only on a reimbursable basis. | | | | | |
| 2. Yes, if residing in the household of the authorized sponsor and dependent on over 50 percent support. | | | | | |
| 3. Yes, if, for determination of dependency made on or after July 1, 1994, placed in the legal custody of the sponsor as a result of a court of competent jurisdiction in the United States (or possession of the United States) for a period of at least 12 consecutive months, and if dependent on the sponsor for over 50 percent of the child's support, and residing in the sponsor's household. | | | | | |
| 4. Yes, if residing in the household of the authorized sponsor and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical incapacity that existed before age 21, or occurred before the age of 23 while a full-time student while a dependent of a sponsor, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |
| 5. Yes, if residing in the household of the authorized sponsor in the United States and the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |

(e) *Korean Augmentation to the U.S. Army (KATUSA).* Military service is mandatory for all Republic of Korea (ROK) male citizens. Those male citizens who speak English often become KATUSA serving with the U.S. Army forces in the ROK. This arrangement is provided for in the status of forces agreement between the United States and ROK. The KATUSAs are identified in DEERS for the purpose of issuing CACs for access to the U.S. installations in the ROK. No other benefits are provided as shown in Table 51 to this subpart.

Table 51 to Subpart C of Part 161—Benefits for KATUSA

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | No | No | No | No. |

(f) *Foreign national civilians.* Civilian employees of a foreign government who are assigned a support role with the DoD or Military Services or attending school at one of the DoD or uniformed services advanced schools may be identified in DEERS for the purpose of issuing a CAC. The foreign national civilian must be sponsored by the DoD or a Military Service regardless of whether the foreign national civilian is from a NATO, PFP, or non-NATO country. There are no benefits assigned and no dependent benefits are extended as shown in Table 52 to this subpart.

Table 52 to Subpart C of Part 161—Benefits for Foreign National Civilians

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | No | No | No | No. |

(g) *Foreign national contractors.* Contractor personnel, contracted to a foreign government, who are assigned a support role with the DoD or Military Services or as a representative of a foreign government at one of the DoD or uniformed services advanced schools may be identified in DEERS for the purpose of issuing a CAC for physical and logical access requirements. The foreign national contractor must be sponsored by the DoD or a Military Service regardless of whether the foreign national civilian is from a NATO, PFP, or a non-NATO country. There are no benefits assigned and no dependent benefits are extended as shown in Table 53 to this subpart.

Table 53 to Subpart C of Part 161—Benefits for Foreign National Contractors

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | No | No | No | No. |

(h) *Personnel subject to a Reciprocal Health Care Agreement (RHCA) in the United States.* For countries that have bilateral RHCAs with the DoD, RHCAs provide that a limited number of foreign force members and their dependents in the United States may be provided inpatient medical care at MTFs on a space-available basis without cost (except for a subsistence charge, if it applies). Provision of such care is contingent on comparable care being made available to a comparable number of U.S. military personnel and their dependents in the foreign country. Benefits are provided as shown in Table 54 to this subpart.

Table 54 to Subpart C of Part 161—Benefits for Foreign Force Members and Eligible Dependents Residing in the United States Who Are Covered by an RHCA

| | CHC | DC | C | MWR | E |
| --- | --- | --- | --- | --- | --- |
| Self | No | 1 | No | No | No. |
| Spouse | No | 1 | No | No | No. |
| Children, Unmarried, Under 21 Years: | | | | | |
| Legitimate, adopted, stepchild, illegitimate child of member, or illegitimate child of spouse | No | 1, 2 | No | No | No. |
| Ward | No | No | No | No | No. |
| Children, Unmarried, 21 Years and Over | No | 1, 2, 3 | No | No | No. |
| Parent, Parent-in-Law, Stepparent, or Parent by Adoption | No | No | No | No | No. |
| | | | | | |
| --- | --- | --- | --- | --- | --- |
| **Notes:** | | | | | |
| 1. As determined by the appropriate RHCA. | | | | | |
| 2. Yes, if residing in the household of the authorized sponsor in the United States. | | | | | |
| 3. Yes, if residing in the household of the authorized sponsor in the United States, the child: | | | | | |
| a. Has not attained the age of 23, is enrolled in a full-time course of study at an institution of higher learning approved by the administering Secretary, and is dependent on the sponsor for over 50 percent of the child's support; or | | | | | |
| b. Is incapable of self-support because of a mental or physical incapacity that existed before age 21, or occurred before the age of 23 while a full-time student while a dependent of a sponsor, and is dependent on the sponsor for over 50 percent of the child's support. | | | | | |

[[81 FR 74879](https://www.federalregister.gov/citation/81-FR-74879), Oct. 27, 2016, as amended at [89 FR 11193](https://www.federalregister.gov/citation/89-FR-11193), Feb. 14, 2024]