ber or former member who is a family member for pur-
poses of such chapter. 
‘‘(3) A person eligible for coverage under this sub-
section shall not be required to satisfy any eligibility cri-
teria specified in chapter 89 of title 5 (except as provided 
in paragraph (1)(C) or (1)(D)) as a condition for enroll-
ment in health benefits plans offered through the Federal 
Employees Health Benefits program under this section. 
‘‘(4) For purposes of determining whether an indi-
vidual is a member of family under paragraph (5) of sec-
tion 8901 of title 5 for purposes of paragraph (1)(C) or 
(1)(D), a member or former member described in section 
1076(b) or 1076(a)(2)(B) of this title shall be deemed to 
be an employee under such section. 
‘‘(5) An eligible beneficiary who enrolls in the Federal 
Employees Health Benefits program under this section 
shall not be eligible to receive health care under section 
1086 or section 1097. Such a beneficiary may continue 
to receive health care in a military medical treatment facil-
ity, in which case the treatment facility shall be reim-
bursed by the Federal Employees Health Benefits pro-
gram for health care services or drugs received by the ben-
eficiary. 
‘‘(c) CHANGE OF HEALTH BENEFITS PLAN.—An eli-
gible beneficiary enrolled in a Federal Employees Health
Benefits plan under this section may change health bene-
fits plans and coverage in the same manner as any other 
Federal Employees Health Benefits program beneficiary 
may change such plans. 
‘‘(d) GOVERNMENT CONTRIBUTIONS.—The amount 
of the Government contribution for an eligible beneficiary 
who enrolls in a health benefits plan under chapter 89 of 
title 5 in accordance with this section may not exceed the 
amount of the Government contribution which would be 
payable if the electing beneficiary were an employee (as 
defined for purposes of such chapter) enrolled in the same 
health benefits plan and level of benefits. 
‘‘(e) SEPARATE RISK POOLS.—The Director of the 
Office of Personnel Management shall require health bene-
fits plans under chapter 89 of title 5 to maintain a sepa-
rate risk pool for purposes of establishing premium rates 
for eligible beneficiaries who enroll in such a plan in ac-
cordance with this section. 
‘‘(f) REIMBURSEMENT FOR EXPENSES FOR HEALTH 
CARE SERVICES NORMALLY PROVIDED BY THE DEPART-
MENT OF DEFENSE UNDER TRICARE STANDARD.—The 
Secretary of Defense shall develop and implement a sys-
tem to reimburse an eligible beneficiary who enrolls in a 
health benefits plan under chapter 89 of title 5 in accord-
ance with this section for health care costs incurred by
the beneficiary that are not paid under the health benefits 
plan but would have been paid by the Department of De-
fense under TRICARE Standard.’’. 
(2) The item relating to section 1108 at the begin-
ning of such chapter is amended to read as follows: 
‘‘1108. Health care coverage through Federal Employees Health Benefits pro-
gram.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on October 1, 2005. 
SEC. 4. REIMBURSEMENT FOR TRICARE PHARMACY BENE-
FITS AT TRICARE NETWORK PHARMACY LEV-
ELS TO CERTAIN MILITARY RETIREES AND 
DEPENDENTS IN HARDSHIP CASES. 
(a) IN GENERAL.—In the case of an eligible person 
who has a certification described in subsection (b), the 
Secretary shall reimburse such person for pharmacy bene-
fits received from a pharmacy that is not a TRICARE 
network pharmacy in the same manner and in the same 
amounts as the Secretary would reimburse such person 
for such benefits received from a pharmacy that is a 
TRICARE network pharmacy. 
(b) CERTIFICATION.—The certification referred to in 
subsection (a) is a certification from an eligible person’s 
physician—