RS 01901: Coverage and Exceptions
TN 31 (08-05)
Section 210(p) of the Social Security Act;
Regulation No.4, Sec. 404.1018(b)
1. Federal Employment
Effective with remuneration paid after December 31, 1982, services for the Federal government that are not subject to Social Security coverage are subject to hospital insurance (HI)-only coverage unless excluded under
2. State and Local Employment
Effective for most State and local government employees hired after
March 31, 1986 and not subject to Social Security coverage, remuneration for services is subject to HI-only coverage unless otherwise excluded.
Employees who were hired prior to April 1, 1986, who are not covered by Social Security and Medicare under a Section 218 Agreement or mandatory Social Security coverage, are exempt from both Social Security and Medicare coverage and taxation. However, States may extend HI-only coverage to those same State and local government employees who were hired before April 1, 1986 by means of a HI-only coverage referendum.
Medicare Qualified Government Employment
Federal, State or local government employment that is subject only to the hospital insurance portion of the tax imposed by the Federal Insurance Contributions Act (FICA).