- Currently, first responders are eligible for Medicare at age 65.
- A bill has been proposed to extend Medicare to first responders ages 50 to 64 who are either retired or no longer able to work due to a service-related disability.
- If you’re younger than age 65 and are in need of healthcare coverage, you have other options.
First responders who retire before age 65 may soon be able to enroll in Medicare.
Right now, first responders qualify for Medicare coverage at age 65, just like everyone else. But a bill is circulating through Congress to change that age to as low as 50 years old.
The term “first responder” can mean different things to different people. For the purposes of Medicare eligibility and the proposed legislation, a first responder includes people with the following jobs:
- police officer
- emergency medical technician or paramedic
If you’re in one of these occupations, you may have specific health concerns, including:
- exposure to asbestos or other dangerous chemicals or substances
- lung disease
- certain cancers
First responders generally receive the same benefits as everyone else while actively employed. But when active employment ends, healthcare coverage ends as well. Plans like COBRA can help for a limited amount of time, but they’re often very expensive.
Social Security Section 218
Under the Social Security Administration (SSA), Section 218 is a provision that allows states to provide retirement and healthcare coverage to local or state employees. This includes either a combination of Social Security and Medicare coverage or just Medicare alone.
So, how do you know if you’re eligible for these benefits? The qualifications are based solely on specific job descriptions. You must be a public employee of either a state or local government, which applies to many first responders.
Currently, all 50 states, Puerto Rico, the Virgin Islands, and approximately 60 interstate instrumentalities have a Section 218 agreement with the SSA to provide Medicare coverage.
Mandatory Medicare coverage rule
The mandatory Medicare coverage rule of 1986 states that any state or local government employee hired on or after March 31, 1986, receives mandatory Medicare coverage.
But exceptions include:
- people hired to be relieved from unemployment
- any services performed in a hospital, home, or institution
- temporary employees providing services temporarily (such as in case of fire, storms, snow, earthquakes, or floods)
- “nonresident aliens,” as defined by the IRS
- students who attend classes at a school, college, or university where they’re working
Medicare is the U.S. healthcare program for adults 65 years old and over. It’s made up of several parts, which are:
- Part A. Part A is your hospital insurance, which covers costs associated with inpatient hospital stays.
- Part B. Part B is the part of Medicare that provides medical insurance. It’s used to cover costs associated with outpatient services.
- Part C (Medicare Advantage). Part C plans cover all the same things are original Medicare (parts A and B). They also often include coverage for prescription drugs, dental care, vision, and other healthcare services.
- Part D. Part D covers prescription drugs and is an add-on plan to original Medicare.
- Medicare supplement insurance. Also known as Medigap, this is optional coverage that can help you pay for out-of-pocket costs like deductibles, coinsurance, or copayments that you’re responsible for.
You must meet at least one of the following criteria to qualify for Medicare coverage:
If you’re a first responder, you may be considering retiring before age 65 – and you’re not alone. Many first responders consider early retirement for a variety of reasons, which may include:
- feelings of isolation
- no longer being able to meet the physical demands of the job
- difficulties working with a younger incoming workforce
- physical and emotional stress
So, many members of Congress are urging the consideration of healthcare coverage for early retirees.
S. 2552: Expanding Healthcare Options for Early Retirees Act
On September 26, 2019, the bill S. 2552 Expanding Healthcare Options for Early Retirees Act was introduced to Congress. If passed, this bill would expand Medicare coverage to include first responders ages 50 to 64 who have left public service due to retirement or disability.
The type of coverage would be identical to the Medicare coverage offered to Americans ages 65 and older, including the deductible, coinsurance, and copayment amounts.
The bill has been introduced to the Senate and has been referred to the Finance Committee for review. As of this writing, no other status changes have happened.
If you’re under age 65 and in need of assistance for your healthcare coverage, you have available options to consider, such as Medicaid. This is a joint federal and state healthcare program that provides coverage to millions of Americans each year.
Each state may have different eligibility criteria, but the basic criteria for everyone includes:
- Financial eligibility. You must make under a certain amount of income annually to qualify. This amount may vary by state.
- Nonfinancial eligibility. You must be a resident of the state in which you’re applying for Medicaid, have lawful citizenship status, and meet other criteria found here.
At this time, the rules for Medicare eligibility are the same for first responders as for everyone else. You can apply when you’re 65 years old or if you have a qualifying condition or disability.
A bill was introduced to Congress in late 2019 that would allow first responders under age 65 to receive Medicare coverage if they retire sooner or have a work-related disability.
Keep your eye on the news or check in on this Congressional website about the bill for any updates.