US SB3221

First responders ages 50-64 who are separated from service due to retirement or disability would be eligible to buy into Medicare coverage, including Parts A, B, D, and Medicare Advantage plans

Eligible first responders include law enforcement officers, firefighters, and emergency medical personnel who are U.S. citizens or permanent residents not otherwise entitled to Medicare

Monthly premiums would equal 1/12 of the estimated annual per capita cost for Medicare benefits; enrollees would be eligible for ACA premium tax credits and cost-sharing reductions based on income

Coverage would begin January 1 of the first year starting at least one year after enactment, with enrollment periods coordinated with ACA Exchange and Medicare enrollment periods

Establishes a Medicare Buy In Oversight Board to monitor implementation and grants program (January 2027-December 2029) for outreach and enrollment assistance to eligible first responders