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

This section establishes a Medicare buy-in option under new SSA §1899D for qualified first responders aged 50 to 64 who are separated from service due to retirement or disability. Eligible individuals—U.S. residents who are citizens, nationals, or lawful permanent residents and not otherwise entitled to Medicare Parts A or B—receive the same Part A benefits (with enrollment in Parts B and D) as individuals entitled to Part A, including eligibility for Medicare Advantage plans with prescription drug coverage (MA-PD plans); coverage begins January 1 of the first year at least one year after enactment, with enrollment periods coordinated with ACA Exchanges and Medicare Parts C and D. Enrollees pay a monthly premium equal to one-twelfth of the estimated average annual per capita cost for Parts A, B, and D benefits and administration (or Part C if applicable), deposited into the Medicare Trust Funds, with no eligibility for Medicaid cost-sharing assistance under title XIX; such coverage constitutes minimum essential coverage under IRC §5000A and is treated as a qualified health plan enrolled through an Exchange for premium tax credit eligibility under IRC §36B (other than ineligibility for other minimum essential coverage). "Qualified first responder" means a first responder—defined as a qualified law enforcement officer (per 18 USC §926B(c)), certain public safety officers (per IRC §72(t)(10)(B)(i)), or federal firefighter (per 5 USC §§8331(21), 8401(14))—who has separated from service due to retirement or disability.