S. 3221: Expanding Health Care Options for First Responders Act

This bill, titled the Expanding Health Care Options for First Responders Act, aims to provide an option for certain first responders aged 50 to 64 to buy into Medicare if they are separated from service due to retirement or disability. Here are the key components of the bill:

Eligibility

• Individuals must be residents of the United States.
• They must be U.S. citizens or lawful permanent residents.
• They should not currently be entitled to benefits under Medicare Part A or eligible to enroll in Parts A or B.
• They must be aged 50-64 years old.
• They must be classified as a qualified first responder who has been separated from service due to retirement or disability.

Benefits

• Those enrolled will be entitled to the same benefits as individuals entitled to Medicare benefits under Parts A, B, and D, including options for Medicare Advantage plans that offer qualified prescription drug coverage.

Enrollment and Coverage Periods

• The Secretary of Health and Human Services will establish specific enrollment and coverage periods for eligible individuals.
• Enrollment will coincide with periods for plans under the Affordable Care Act.
• Coverage will start on January 1 of the year following at least one year after the bill's enactment.

Premiums

• The bill provides for a monthly premium based on the estimated annual cost of benefits provided under Medicare Parts A, B, and D.
• There may be additional costs if individuals opt for more expensive Medicare Advantage or prescription drug plans.

Payment of Premiums

• Premium payments will be collected by the Secretary and deposited into the Medicare trust funds.

Medicaid and Other Insurance Considerations

• Those enrolled in this program will not be eligible for cost-sharing assistance from Medicaid.
• Employers may provide or reimburse premium payments for retired employees without impacting individuals' gross income for tax purposes.

Oversight and Implementation

• An advisory committee known as the Medicare Buy In Oversight Board will be established to oversee the program's rollout and effectiveness.

Outreach and Enrollment Support

• The Secretary will provide grants to organizations to assist with outreach, education, and enrollment assistance to raise awareness of this Medicare buy-in option.
• Eligible entities for grant awards include states, nonprofit organizations, and first responder organizations.

Impact on Current Medicare Beneficiaries

• The bill mandates that its provisions should not negatively affect the Medicare benefits for current beneficiaries or impact the Medicare trust funds.

Consultation

During the implementation process, the Secretary will consult with various stakeholders including beneficiaries, healthcare providers, and organizations representing first responders to ensure effective rollout.

Relevant Companies

• None found