II 

115TH CONGRESS 

1ST SESSION S. 2117 

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 SENATE OF THE UNITED STATES 

NOVEMBER 9, 2017 

Mr. NELSON (for himself and Mr. BLUMENTHAL) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Fair Access to Insur5 ance for Retired (FAIR) Heroes Act of 2017’’. 


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1 SEC. 2. ELIGIBILITY FOR TRICARE FOR VETERANS ENTI2 TLED TO MEDICARE BENEFITS DUE TO CON3 DITIONS OR INJURIES INCURRED DURING 

4 SERVICE IN THE ARMED FORCES. 

5 (a) TRICARE PROVISIONS.— 

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

7 1086(d) of title 10, United States Code, is amend8 ed— 

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

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

11 (B) by redesignating subparagraph (B) as 

12 clause (ii); 

13 (C) in clause (ii), as redesignated by para14 graph (2), by striking the period at the end and 

15 inserting ‘‘; or’’; and 

16 (D) by inserting after subparagraph (A) 

17 the following new subparagraph (B): 

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

19 (A)(ii) who— 

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

21 61 of this title as a result of an injury or condi22 tion suffered during service in the armed forces; 

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

24 benefits under part A of title XVIII of the So25 cial Security Act pursuant to subparagraph (A) 

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


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

2 described in subparagraph (A) of such section; 

3 or 

4 ‘‘(II) is entitled to hospital insurance bene5 fits under part A of title XVIII of the Social 

6 Security Act pursuant to subparagraph (A) or 

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

8 benefit described in subparagraph (A) of such 

9 section terminated due to performance of sub10 stantial gainful activity; and 

11 ‘‘(iii) has declined to enroll in the supple12 mentary medical insurance program under part 

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

14 U.S.C. 1395j et seq.).’’. 

15 (2) ALLOWANCE OF ONE CHANGE OF ENROLL16 MENT.—Such section is further amended by adding 

17 at the end the following new paragraph: 

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

19 after the end of the special enrollment period provided 

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

21 Retired (FAIR) Heroes Act of 2017, an individual de22 scribed in paragraph (2)(B) may switch only once from 

23 enrollment under the Medicare program under title XVIII 

24 of the Social Security Act (42 U.S.C. 1395 et seq.) to en25 rollment in a plan contracted for under subsection (a). 


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

2 apply to enrollment by an individual in a plan contracted 

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

4 entitlement of the individual to a benefit described in sub5 paragraph (A) of section 226(b)(2) of the Social Security 

6 Act (42 U.S.C. 426(b)(2)) due to the performance of sub7 stantial gainful activity.’’. 

8 (3) SPECIAL ENROLLMENT PERIOD.— 

9 (A) IN GENERAL.—The Secretary of De10 fense shall provide for a special enrollment pe11 riod during which an individual described in 

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

13 United States Code, may enroll in a health care 

14 plan under such section. Such period shall 

15 begin as soon as possible after the date of the 

16 enactment of this Act and shall end 12 months 

17 later. 

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

19 individual who enrolls during the special enroll20 ment period provided under subparagraph (A), 

21 the coverage period under section 1086 of title 

22 10, United States Code, shall begin on the first 

23 day of the month following the month in which 

24 the individual enrolls. 


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1 (4) CONFORMING AMENDMENTS.—Section 

2 1086(d) of title 10, United States Code, is amend3 ed— 

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

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

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

7 and 

8 (B) in paragraph (5)— 

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

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

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

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

13 (b) MEDICARE PROVISIONS.— 

14 (1) WAIVER OF MEDICARE PART B LATE EN15 ROLLMENT PENALTY.— 

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

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

18 amended by adding at the end the following 

19 new sentences: ‘‘No increase in the premium 

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

21 individual who demonstrates to the Secretary 

22 that the individual, with respect to such month, 

23 is an individual described in section 

24 1086(d)(2)(B) of title 10, United States Code. 

25 The Secretary of Health and Human Services 


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1 shall consult with the Secretary of Defense in 

2 identifying individuals described in the previous 

3 sentence.’’. 

4 (B) EFFECTIVE DATE.—The amendment 

5 made by subparagraph (A) shall apply to pre6 miums for months beginning after the date of 

7 the enactment of this Act. The Secretary shall 

8 establish a method for providing rebates of pre9 mium penalties paid for months after the date 

10 of the enactment of this Act for which a penalty 

11 does not apply under such amendment but for 

12 which a penalty was previously collected. 

13 (2) MEDICARE PART B SPECIAL ENROLLMENT

14 PERIOD.— 

15 (A) IN GENERAL.—In the case of any indi16 vidual who, as of the date of the enactment of 

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

18 under part B of title XVIII of the Social Secu19 rity Act and is an individual described in sec20 tion 1086(d)(2)(B) of title 10, United States 

21 Code, the Secretary of Health and Human 

22 Services shall provide for a special enrollment 

23 period during which the individual may enroll 

24 under such part. Such period shall begin as 


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1 soon as possible after the date of the enactment 

2 of this Act and shall end 12 months later. 

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

4 individual who enrolls during the special enroll5 ment period provided under subparagraph (A), 

6 the coverage period under part B of title XVIII 

7 of the Social Security Act shall begin on the 

8 first day of the month following the month in 

9 which the individual enrolls. 

10 (c) NOTIFICATION AND INFORMATION TO BENE11 FICIARIES.— 

12 (1) NOTIFICATION REGARDING INSURANCE OP13 TIONS.—The Secretary of Defense shall coordinate 

14 with the Secretary of Health and Human Services to 

15 identify individuals described in section 

16 1086(d)(2)(B) of title 10, United States Code, as 

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

18 about their health insurance options under the 

19 TRICARE program, as defined in section 1072 of 

20 such title, and the Medicare program under title 

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

22 seq.). 

23 (2) PROVISION OF INFORMATION TO BENE24 FICIARIES.— 


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1 (A) IN GENERAL.—The Secretary of De2 fense shall provide to individuals described in 

3 paragraph (1) educational materials, informa4 tion, and counseling regarding the effects of not 

5 enrolling in the supplementary medical insur6 ance program under part B of title XVIII of 

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

8 seq.), including information comparing pre9 miums, copayments, deductibles, provider net10 works, future enrollment opportunities, and 

11 penalties for the various health insurance plans 

12 available to assist those individuals in making 

13 appropriate health insurance choices. 

14 (B) TIMING.—The Secretary shall provide 

15 the educational materials, information, and 

16 counseling described in subparagraph (A) to an 

17 individual described in paragraph (1) before the 

18 individual elects to change enrollment between 

19 the TRICARE program, as defined in section 

20 1072 of title 10, United States Code, and the 

21 Medicare program under title XVIII of the So22 cial Security Act (42 U.S.C. 1395 et seq.). 

Æ 


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