I had Medicare when I entered prison or jail. What happens to it while I’m incarcerated?

All your Medicare benefits get suspended (paused) while you’re incarcerated. The rules for staying enrolled and restarting your benefits upon release are different for each Part of Medicare.[1608]

> Your Part A (hospital insurance) enrollment stays in place. Although you won’t get Part A benefits while incarcerated, you don’t have to do anything to stay enrolled. When you’re released, your access to Part A benefits should be automatically restored.[1609]

> Your Part B (medical insurance) is more complicated, since you can only stay enrolled by paying premiums.[1610]

    If you keep paying premiums, you’ll stay enrolled, although you won’t get Medicare benefits while incarcerated.
    If you stop paying premiums, your coverage will be ended; and for every 12 months that pass before you re-enroll, your premium amount will be higher by 10%.[1611] Also, you can re-enroll in Part B only during the General Enrollment Period (“GEP”), which runs January through March, and coverage starts July 1 of the year that you enroll. Depending on your release date, this may cause a gap in your medical coverage.[1612]

These rules create a dilemma if you’re someone who can’t afford to keep paying Part B premiums while incarcerated, and won’t be able to afford higher premiums upon release. If you were on Medicare and SSDI before incarceration, you may be able to address this dilemma by applying for SSDI while incarcerated (see PG. 491).

> Your Part C (Medicare Advantage plan) and Part D (prescription drug plan) will end when you’re incarcerated. You’re no longer eligible to be enrolled in these plans while the prison or jail is providing your health care. If you want Part C and/or Part D after release, you’ll have to re-enroll (for details, see PG. 474).[1613]

  1. 1608

    If You Already Have Medicare When You are Incarcerated, MedicareInteractive.org, http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1782.

  2. 1609

    If You Become Eligible for Medicare While Incarcerated, MedicareInteractive.org, http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1783.

  3. 1610

    If You Already Have Medicare When You are Incarcerated, MedicareInteractive.org, http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1782.

  4. 1611

    Medicare Part B Late Enrollment Penalty, MedicareInteractive.org, http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=316, http://www.bazelon.org/LinkClick.aspx?fileticket=1OxXzw1kOBc%3d&tabid=353.

  5. 1612

    If You Become Eligible for Medicare While Incarcerated,

    MedicareInteractive.org, http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1783, http://www.bazelon.org/LinkClick.aspx?fileticket=1OxXzw1kOBc%3d&tabid=353.

  6. 1613

    http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1784.