I 

115TH CONGRESS 

1ST SESSION H. R. 4571 

To amend title 10, United States Code, to expand eligibility for the TRICARE 

program to include certain veterans entitled to benefits under the Medicare program due to conditions or injuries incurred during service in 

the Armed Forces and to waive the Medicare part B late enrollment 

penalty for such veterans, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 6, 2017 

Mrs. DAVIS of California (for herself, Mr. WILSON of South Carolina, Ms. 

GABBARD, Mr. MAST, and Ms. ROSEN) introduced the following bill; 

which was referred to the Committee on Armed Services, and in addition 

to the Committees on Energy and Commerce, and Ways and Means, for 

a period to be subsequently determined by the Speaker, in each case for 

consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title 10, United States Code, to expand eligibility 

for the TRICARE program to include certain veterans 

entitled to benefits under the Medicare program due 

to conditions or injuries incurred during service in the 

Armed Forces and to waive the Medicare part B late 

enrollment penalty for such veterans, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Fair Access to Insur3 ance for Retired (FAIR) Heroes Act of 2017’’. 

4 SEC. 2. ELIGIBILITY FOR TRICARE FOR VETERANS ENTI5 TLED TO MEDICARE BENEFITS DUE TO CON6 DITIONS OR INJURIES INCURRED DURING 

7 SERVICE IN THE ARMED FORCES. 

8 (a) TRICARE PROVISIONS.— 

9 (1) IN GENERAL.—Paragraph (2) of section 

10 1086(d) of title 10, United States Code, is amend11 ed— 

12 (A) in subparagraph (A), by striking ‘‘is 

13 enrolled’’ and inserting ‘‘(i) is enrolled’’; 

14 (B) by redesignating subparagraph (B) as 

15 clause (ii); 

16 (C) in clause (ii), as redesignated by para17 graph (2), by striking the period at the end and 

18 inserting ‘‘; or’’; and 

19 (D) by inserting after subparagraph (A) 

20 the following new subparagraph (B): 

21 ‘‘(B) is a person described in subparagraph 

22 (A)(ii) who— 

23 ‘‘(i) is retired for disability under chapter 

24 61 of this title as a result of an injury or condi25 tion suffered during service in the armed forces; 


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1 ‘‘(ii)(I) is entitled to hospital insurance 

2 benefits under part A of title XVIII of the So3 cial Security Act pursuant to subparagraph (A) 

4 or (C) of section 226(b)(2) of such Act (42 

5 U.S.C. 426(b)(2)) and is entitled to a benefit 

6 described in subparagraph (A) of such section; 

7 or 

8 ‘‘(II) is entitled to hospital insurance bene9 fits under part A of title XVIII of the Social 

10 Security Act pursuant to subparagraph (A) or 

11 (C) of such section and whose entitlement to a 

12 benefit described in subparagraph (A) of such 

13 section terminated due to performance of sub14 stantial gainful activity; and 

15 ‘‘(iii) has declined to enroll in the supple16 mentary medical insurance program under part 

17 B of title XVIII of the Social Security Act (42 

18 U.S.C. 1395j et seq.).’’. 

19 (2) ALLOWANCE OF ONE CHANGE OF ENROLL20 MENT.—Such section is further amended by adding 

21 at the end the following new paragraph: 

22 ‘‘(6)(A) Except as provided in subparagraph (B), 

23 after the end of the special enrollment period provided 

24 under section 2(a)(3) of the Fair Access to Insurance for 

25 Retired (FAIR) Heroes Act of 2017, an individual deVerDate Sep 11 2014 02:46 Dec 12, 2017 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4571.IH H4571

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1 scribed in paragraph (2)(B) may switch only once from 

2 enrollment under the Medicare program under title XVIII 

3 of the Social Security Act (42 U.S.C. 1395 et seq.) to en4 rollment in a plan contracted for under subsection (a). 

5 ‘‘(B) The limitation under subparagraph (A) does not 

6 apply to enrollment by an individual in a plan contracted 

7 for under subsection (a) by reason of termination of the 

8 entitlement of the individual to a benefit described in sub9 paragraph (A) of section 226(b)(2) of the Social Security 

10 Act (42 U.S.C. 426(b)(2)) due to the performance of sub11 stantial gainful activity.’’. 

12 (3) SPECIAL ENROLLMENT PERIOD.— 

13 (A) IN GENERAL.—The Secretary of De14 fense shall provide for a special enrollment pe15 riod during which an individual described in 

16 subsection (d)(2)(B) of section 1086 of title 10, 

17 United States Code, may enroll in a health care 

18 plan under such section. Such period shall 

19 begin as soon as possible after the date of the 

20 enactment of this Act and shall end 12 months 

21 later. 

22 (B) COVERAGE PERIOD.—In the case of an 

23 individual who enrolls during the special enroll24 ment period provided under subparagraph (A), 

25 the coverage period under section 1086 of title 


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1 10, United States Code, shall begin on the first 

2 day of the month following the month in which 

3 the individual enrolls. 

4 (4) CONFORMING AMENDMENTS.—Section 

5 1086(d) of title 10, United States Code, is amend6 ed— 

7 (A) in paragraph (4)(A), in the matter 

8 preceding clause (i), by striking ‘‘paragraph 

9 (2)(B)’’ and inserting ‘‘paragraph (2)(A)(ii)’’; 

10 and 

11 (B) in paragraph (5)— 

12 (i) by striking ‘‘subparagraph (B)’’ 

13 and inserting ‘‘subparagraph (A)(ii)’’; and 

14 (ii) by striking ‘‘subparagraph (A)’’ 

15 and inserting ‘‘subparagraph (A)(i)’’. 

16 (b) MEDICARE PROVISIONS.— 

17 (1) WAIVER OF MEDICARE PART B LATE EN18 ROLLMENT PENALTY.— 

19 (A) IN GENERAL.—Section 1839(b) of the 

20 Social Security Act (42 U.S.C. 1395r(b)) is 

21 amended by adding at the end the following 

22 new sentences: ‘‘No increase in the premium 

23 shall be effected for a month in the case of an 

24 individual who demonstrates to the Secretary 

25 that the individual, with respect to such month, 


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1 is an individual described in section 

2 1086(d)(2)(B) of title 10, United States Code. 

3 The Secretary of Health and Human Services 

4 shall consult with the Secretary of Defense in 

5 identifying individuals described in the previous 

6 sentence.’’. 

7 (B) EFFECTIVE DATE.—The amendment 

8 made by subparagraph (A) shall apply to pre9 miums for months beginning after the date of 

10 the enactment of this Act. The Secretary shall 

11 establish a method for providing rebates of pre12 mium penalties paid for months after the date 

13 of the enactment of this Act for which a penalty 

14 does not apply under such amendment but for 

15 which a penalty was previously collected. 

16 (2) MEDICARE PART B SPECIAL ENROLLMENT

17 PERIOD.— 

18 (A) IN GENERAL.—In the case of any indi19 vidual who, as of the date of the enactment of 

20 this Act, is eligible to enroll but is not enrolled 

21 under part B of title XVIII of the Social Secu22 rity Act and is an individual described in sec23 tion 1086(d)(2)(B) of title 10, United States 

24 Code, the Secretary of Health and Human 

25 Services shall provide for a special enrollment 


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1 period during which the individual may enroll 

2 under such part. Such period shall begin as 

3 soon as possible after the date of the enactment 

4 of this Act and shall end 12 months later. 

5 (B) COVERAGE PERIOD.—In the case of an 

6 individual who enrolls during the special enroll7 ment period provided under subparagraph (A), 

8 the coverage period under part B of title XVIII 

9 of the Social Security Act shall begin on the 

10 first day of the month following the month in 

11 which the individual enrolls. 

12 (c) NOTIFICATION AND INFORMATION TO BENE13 FICIARIES.— 

14 (1) NOTIFICATION REGARDING INSURANCE OP15 TIONS.—The Secretary of Defense shall coordinate 

16 with the Secretary of Health and Human Services to 

17 identify individuals described in section 

18 1086(d)(2)(B) of title 10, United States Code, as 

19 added by subsection (a), and notify those individuals 

20 about their health insurance options under the 

21 TRICARE program, as defined in section 1072 of 

22 such title, and the Medicare program under title 

23 XVIII of the Social Security Act (42 U.S.C. 1395 et 

24 seq.). 


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1 (2) PROVISION OF INFORMATION TO BENE2 FICIARIES.— 

3 (A) IN GENERAL.—The Secretary of De4 fense shall provide to individuals described in 

5 paragraph (1) educational materials, informa6 tion, and counseling regarding the effects of not 

7 enrolling in the supplementary medical insur8 ance program under part B of title XVIII of 

9 the Social Security Act (42 U.S.C. 1395j et 

10 seq.), including information comparing pre11 miums, copayments, deductibles, provider net12 works, future enrollment opportunities, and 

13 penalties for the various health insurance plans 

14 available to assist those individuals in making 

15 appropriate health insurance choices. 

16 (B) TIMING.—The Secretary shall provide 

17 the educational materials, information, and 

18 counseling described in subparagraph (A) to an 

19 individual described in paragraph (1) before the 

20 individual elects to change enrollment between 

21 the TRICARE program, as defined in section 

22 1072 of title 10, United States Code, and the 

23 Medicare program under title XVIII of the So24 cial Security Act (42 U.S.C. 1395 et seq.). 

Æ 


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