Medicare is a federally funded program that provides insurance benefits to those aged 65 and older. While there are already some exceptions to the Medicare qualifying age, some Congress members are looking to expand these exceptions to include first responders who retire before age 65.
First responders, in the context of this article, are those in the following occupations:
- emergency medical technicians (EMTs)
- police officers
This article will cover current legislation regarding first responders and early qualifications for Medicare.
First responders attend natural and technological disasters.
The job can be highly stressful, with the workers undertaking a high degree of risk as exposure to hazards are parts of their job description, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
In terms of their health, SAMHSA has also found that first responders experience higher rates of depression, post-traumatic stress disorder (PTSD), suicidal ideation, and substance use disorder compared to the general population.
First responders also have physically demanding jobs that often lead to early retirement. As a result, they experience gaps in insurance coverage until they reach the age at which they qualify for Medicare.
Members of Congress have proposed legislation that would make Medicare available to first responders who have served their community and others.
Currently, first responders can receive Medicare coverage under the same stipulations as all Americans. Specifically, when a United States citizen turns age 65, they are eligible for Medicare benefits.
There are some current exceptions to the age requirement for Medicare, but they are more health-related than occupation-related.
For example, a person under age 65 may qualify for Medicare if:
- they have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
- they have end stage renal disease (ESRD) and therefore require dialysis
- they have a certified disability and are receiving Social Security benefits
Providing Medicare coverage for an occupation such as first responders would be an example of expanded coverage that is not related to a health concern.
Until Congress passes proposed legislation, first responders have Medicare coverage options that are similar to the rest of the American population. However, the lawmakers have proposed legislation that would potentially change this coverage.
On September 26, 2019, a bill was introduced by Senator Sherrod Brown (D-OH) titled the Expanding Health Care Options for Early Retirees Act. Another name for the act is “Medicare Buy-In Option for First Responders 50 to 64 Years of Age Who Are Separated From Service Due to Retirement or Disability.”
Under the bill, a person would be able to obtain Medicare benefits if they:
- were a first responder separated from their job due to retirement or disability
- are a citizen or national of the U.S. or an alien who is lawfully admitted for permanent residence
- are a qualified, retired, or disabled first responder between the ages of 50–65.
Once the bill was introduced, it was referred to the Senate Finance Committee. On December 10, 2019, the first subcommittee hearings were held, which is the last noted movement of the bill, according to Congress.gov.
Since the bill’s introduction, several national organizations have endorsed it. These include:
- Fraternal Order of Police
- International Association of Firefighters
- National Association of Police Organizations
- National Sheriffs Association
- National Troopers Coalition
- National Conference on Public Employee Retirement Systems
Under the bill, qualifying retirees would also be eligible for help paying for monthly Medicare costs from tax credits or other benefits from their former employer or a pension plan, if applicable.
Were the proposal to pass, there are some potential logistics to work out.
For example, when a person chooses original Medicare instead of Medicare Advantage, they are required to pay a monthly premium for Medicare Part B, which is outpatient medical insurance.
Individuals do not pay a premium for Part A, which is inpatient hospital coverage, providing they paid Medicare taxes for at least 40 quarters.
The new legislation states the Secretary of the Department of Health and Human Services (HHS) would be responsible for establishing premiums for first responders.
As a result, the premiums could be the same, or they could be higher. Then, when a first responder turns age 65, they would likely transition to the same premiums as other Medicare beneficiaries who are the same age.
The bill proposes to cover only the retired first responder and would not extend to dependents.
In 2019, Congress introduced legislation for early Medicare qualification for retired first responders.
The bill recognizes that first responders face unique health and disability challenges when it comes to retirement age and may not be able to perform their job duties until age 65 when they could qualify for Medicare.
The bill is currently with the Finance Committee.
Congress.gov will routinely update their site as the bill continues to make its way through the process, and a person can sign up for alerts if they have specific questions regarding the bill’s progress.