Medicare During and After Incarceration: What You Need to Know

 If you already had Medicare before your arrest, you will still be eligible for the program while you’re incarcerated. However, your coverage will likely be suspended until your release. You may need to join Medicare while incarcerated and/or pay monthly premiums so you don’t have gaps in coverage once you’re released.

Medicare During and After Incarceration

If you’re preparing to go into incarceration, there are most likely a lot of things on your mind. What happens to Medicare when you’re incarcerated may be at the top of your list, and for good reason — coverage for your medical care is an important consideration.

Here, we cover how being incarcerated can affect your Medicare coverage and what you need to do to ensure your coverage continues.

Defining Incarceration

Medicare considers you incarcerated if you’re:

  • Under arrest
  • In prison or in jail
  • On medical furlough from prison or jail
  • Required by court order to live in a mental health facility, a halfway house, or home detention
  • Confined completely or partially in any way under a penal statute or rule
  • Under supervised release

Do I Qualify for Medicare When Going Into Incarceration?

If you’re about to be incarcerated, you may be wondering if you’ll qualify for Medicare while in jail. The answer will vary based on a few different factors.

If you already enrolled in Medicare before your arrest, you will still be eligible for the program while you’re incarcerated. However, your coverage will likely be suspended until your release.

Anyone who turns 65 and qualifies for Medicare while incarcerated should actively enroll in Medicare Parts A and B during your Initial Enrollment Period (IEP). Medicare Part A covers:

  • Inpatient hospital care
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Medicare Part B covers:

  • Services from doctors
  • Outpatient care
  • Home health care
  • Medical equipment
  • Some preventive services

Your IEP includes the month of your 65th birthday in addition to the three months before and the three months after. Your coverage will start on a different date depending on when you enroll. You won’t be eligible for automatic enrollment if incarcerated — you have to do it yourself.

 

If you don’t enroll in Medicare while incarcerated, you might not have health coverage for several months once you’re released.

 

What Happens to My Medicare While I’m Incarcerated?

In most cases, Medicare won’t pay for any medical care you need while incarcerated. After you’ve been incarcerated for over 30 days and are convicted of a crime, your Social Security retirement benefits or Social Security Disability Insurance (SSDI) will also stop. But you’ll still be able to access medical care if needed. Generally, your correctional facility will both provide and pay for your care.

When you’re released, Medicare will resume its coverage as long as you’re still enrolled. Make sure to continue paying any Medicare premiums via direct payment while you’re in prison so you don’t have to deal with late enrollment penalties or gaps in coverage. If you can’t afford to pay your premium, look into a Medicare Savings Program.

How to Join Medicare While Incarcerated

To enroll in Medicare Part A and Part B, send a letter by certified mail to the Social Security Administration (SSA). This letter should include:

  • Your name (and your signature)
  • Your Social Security number
  • A clear statement that you want to enroll
  • The date coverage should be effective (and the date of the letter)

 You won’t have Medicare coverage until you are no longer incarcerated, but you may need to start paying monthly premiums right away.

Leaving Incarceration

If you continue to pay for Medicare coverage while incarcerated, you’ll have two months after your release to sign up for Medicare and join a plan. Choose a Medicare Advantage Plan or Medicare Prescription Drug Plan

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Please visit our website or call us at 888-928-1456 TTY:711 to explore Medicare coverage options to fit your needs and budget.

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays, coinsurance, limitations, and exclusions may apply.

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