Although DEERS and the ID card system are
related, there are instances when the beneficiary is in
possession of a valid ID card and the DEERS system
shows the patient as ineligible or not in the database. In
these instances, eligibility verification using the ID
card shall not override DEERS without some other
type of collateral documentation. (See sections on
DEERS overrides and exceptions later in this chapter.)
It must be stressed that military treatment facilities
(MTFs) are to verify eligibility.
eligibility is under the cognizance of the respective
service personnel offices.
Patients who present for non-emergency treatment
without a valid ID card but who are in the DEERS
database will not be provided medical care without
first signing a statement that they are eligible and
giving the reason why a valid ID card is not in their
possession. If a valid ID card is not provided within 30
calendar days, the patient is referred for billing as a
Civilian Humanitarian Non-indigent, in accordance
with the R e s o u rc e s M a n a g e m e n t H a n d b o o k,
NAVMED P-5020. Such billing may be delayed if the
commanding officer of the facility is convinced proof
is delayed for reasons beyond the control of the patient
or sponsor. In all cases where a patient presents
without an ID card and does not appear in the DEERS
database, non-emergency care will be denied.
REASONS FOR INELIGIBILITY.When a
DEERS check is performed and the patient is found
ineligible for any of the following reasons, routine
non-emergency healthcare will be denied (except as
noted later in this section).
Sponsor not enrolled in DEERS
Dependent not enrolled in DEERS
Ineligible due to passed terminal (end) eligibility
Sponsor has separated from active duty
Spouse is divorced from sponsor and is not
entitled to benefits as a former spouse
Dependent child is married
UNDER NO CIRCUMSTANCES WILL THE
CLERK PERFORMING THE ELIGIBILITY
CHECK DENY THE REQUESTED CARE. Only
command-designated supervisory personnel can
perform this function.
DEERS ELIGIBILITY OVERRIDES.The
nine DEERS eligibility overrides are listed below.
Unless otherwise stated, all overrides must be
supported by a valid ID card.
1. DD 1172The patient presents an original or
copy of the DD 1172 used for DEERS
enrollment. There are specific items required
for verification, and current service directives
must be checked.
2. All Other Dependents Recently Becoming
Eligible for BenefitsPatients who become
eligible for benefits in the previous 120 days
may be treated upon presentation of a valid ID
card. For children under 10 years of age, a valid
ID card of a parent or guardian is acceptable.
Upon application for care beyond 120 days,
follow the procedure in item 1, above.
3. New Identification CardPatients presenting
with a new valid ID card, issued within the
previous 120 days, will not be denied care.
4. Ineligible Due to ID Card ExpirationWhen
the database shows a patient as ineligible
because of ID card expiration, care may be
rendered as long as the patient has a new ID card
issued within the previous 120 days. After 120
days, follow the procedure in item 1, above.
5. Sponsors Entering Active Duty Status for a
Period of Greater than 30 DaysA copy of
orders ordering a reservist or guardsman to an
active duty period of greater than 30 days may be
accepted for the first 120 days of the active duty
period. After that, follow the procedure in step 1.
6. NewbornsNewborns will not be denied care
for a period of 1 year following birth. The
patients birth certificate suffices when
presented with a parents valid ID card.
7. Emergency CareThis is a medical decision
and shall be determined by criteria established
within the command.
8. Sponsors Duty Station is Outside the 50
United States or has an APO/FPO
AddressDependents whose sponsors are
assigned outside the 50 United States or to a
duty station with an APO/FPO address will not
be denied care as long as the sponsor is enrolled
and eligible in DEERS.
9. SurvivorsWhen an eligibility check
indicates that a deceased sponsor is not enrolled