Incarceration can affect your Medicare coverage (you are incarcerated if you are in prison, jail, or otherwise in the custody of penal authorities). If you had Medicare before your arrest, you will remain eligible for the program while you are incarcerated. However, Medicare generally will not pay for your medical care. Instead your correctional facility will provide and pay for your care. Once you are released, Medicare will resume coverage if you remained enrolled.
Once you are incarcerated for 30 days or more and are convicted of a crime, any Social Security retirement benefits or Social Security Disability Insurance (SSDI) you receive will stop. Your benefits can be reinstated after your release. Note that if you are under 65 and qualify for Medicare due to disability, you must reinstate your SSDI in order to resume Medicare coverage. To learn about the requirements for reinstating your benefits, contact the Social Security Administration (SSA).
It is usually best to keep Medicare Part A and Part B coverage while you are incarcerated. Although Medicare will not cover your care, keeping it will ensure that you avoid late enrollment penalties and gaps in coverage when you are released. Most people pay no premium for Part A but do pay a monthly premium for Part B. (See below for information about benefits that can help pay your Part B premium.) To keep Part B benefits while incarcerated, you will need to keep paying your Part B premiums. For those who are not incarcerated, these premiums are deducted from Social Security benefits each month. Since incarcerated individuals have their Social Security benefits suspended, you would need to pay the Part B premium by setting up direct payment with Medicare. You can do this by calling 1-800-MEDICARE within 30 days of your conviction.
If you cannot afford to continue paying the Part B premium during your incarceration:
- You should actively withdraw from Part B instead of being disenrolled to avoid owing premiums to SSA. If you do nothing, SSA will continue to bill you for Part B and disenroll you after you fail to pay your premiums. When you re-enroll in Part B upon release, SSA will deduct any unpaid premiums from your Social Security benefits.
- See whether you qualify for a Medicare Savings Program (MSP). MSPs pay your Part B premiums, help you enroll in Medicare outside typical enrollment periods, and waive premium penalties. In some states, you may be able to apply for an MSP while you are incarcerated. If you do qualify for an MSP, aim to enroll into the MSP in the two months before your release. Typically, you should receive a decision within 45 days of filing an application. If your state does not allow you to apply for an MSP while you are incarcerated, apply as soon as you are released. Be sure to apply for an MSP in the state you will reside in after release. If you had an MSP before your incarceration, it will typically stop once you are taken into custody. You will likely need to re-apply for benefits to start upon your release.
For more information regarding eligibility and application requirements for an MSP in your state, contact your local Medicaid office or your State Health Insurance Assistance Program (SHIP).