Eligible retired public safety officers (police, firefighters) may elect to exclude governmental retirement plan distributions that don't exceed their health or long-term care premiums, if the distributions are paid directly to insurers. However, the direct payment requirement is removed as of the date of enactment of the SECURE 2.0 Act. The retired employee will need to include an attestation in their return that the distribution does not exceed the amount the employee paid for qualified health insurance premiums for the year of the payment. The exclusion is limited to $3,000 per year. Any amount excluded isn't deductible as a medical expense for itemized deductions and isn’t includible as health insurance for the self-employed health insurance deduction (PPA § 845).  See the guide "Medical Deductions" for details.