Medicare denied


Q.  I am a former air traffic controller, age 62, retired on disability in 1979 (before the 1985 Medicare Act). Because I was never eligible to pay into Medicare, Social Security tells me that I am forever ineligible for Medicare benefits. OPM says that is not so, but hasn’t provided a law to challenge Social Security’s decision. OPM suggested that there is a rule just for people like myself, which uses a 10-year combined service (Civil Service & Social Security) rule to determine eligibility. I am unable to find such a rule and I’m not in financial condition to hire an attorney to locate it. Can you suggest a solution ?

A.  I don’t believe there is any such rule. As far as I can tell, to be eligible for Medicare you have to have worked for 10 years in jobs where Social Security (FICA) deductions were taken from your wages or self-employment income.



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Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to


  1. Based on my Mother’s experience…… all active Fed employees were “grandfathered” into the Medicare system in (I think) 1985. She retired in 1986, and is currently participating in Medicare (she had no prior Soc. Security service). A coworker of hers who retired a few years earlier and was not an active employee when the change in status for CSRS employees was put in place has not been able to participate in Medicare.

  2. I work for Social Security, was a Benefit Authorizer and later a Claims Authorizer, and I have to state that the original poster is out of luck to get free Medicare based on his own work at least. Here’s the Social Security procedure references:, and, but I’ll explain what the rule is.

    Basically, he would have had to have been a federal employee in January, 1983, when federal employees began paying into Medicare. The law they passed back then said if you were a fed worker IN THAT MONTH, you not only started paying into Medicare, but also were given “deemed” QCs for Medicare purposes only, for all federal work you did previously. So if, for instance you began working for the federal government in say 1975, you didn’t pay into Medicare but got credit for Medicare purposes anyway, up to 4 qc’s a year, for each year from 1975 thru 1982.

    The mother of the commenter before me was a fed in 01/1983, and that’s why she got Medicare credit for all her fed employment up to that time, as well as QC’s she actually began paying in 1983. That co-worker who retired “a few years earlier” didn’t meet the 01/1983 employment requirement, so they couldn’t get any credit for prior fed service.

    So you don’t have to just work in jobs that took out fica taxes to get Medicare credit. As OPM explained, there IS an exception or special rules to grant fed employees Medicare based on “deemed” coverage(or “combined” ss and fed coverage as you put it), but you HAD to have been a federal employee in January of 1983. Whoever mentioned the rule at OPM may not have realized you left federal service prior to 01/1983.

    Of course, the original poster can still get Medicare based on a spouse’s entitlement, or pay for the (expensive)premium for Medicare Part A if they really need it. It’s not exactly true they are “forever ineligible” for it.

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