SL 50001.540 Voluntary Medicare Coverage
Soc. Sec. Act, Section 218(n)
All States can execute a Section 218 Agreement with SSA to provide Medicare only coverage for employees who are members of a public retirement system and not covered under a Section 218 Agreement.
Employees who were hired prior to April 1, 1986, and who are not currently paying into Medicare, may not make Medicare contributions if the employee’s services are not covered under Medicare.