My dad is 67 and was released from prison at the beginning of February. He didn’t enroll in Medicare when he turned 65 while he was incarcerated, so now he is back home and without health insurance. How should he enroll in Medicare now? Will he owe a late enrollment penalty?
-Abigail (Fort Wayne, IN)
It is usually best if someone enrolls in Medicare when they are first eligible. As you mentioned, many people who delay enrolling in Medicare must wait for the General Enrollment Period and then may owe a late enrollment penalty for life.
Beginning this year, though, if someone misses a first-time enrollment period, there are certain situations when they might qualify for an exceptional circumstances Special Enrollment Period (SEP). One of these new SEPs is for people who were are released from the custody of a penal authority, including a prison, after January 1, 2023.
To be eligible for this SEP, your father would have to:
- Be eligible for Medicare
- Have failed to enroll in Medicare while he was incarcerated
- Be released on or after January 1, 2023
Note that Medicare defines “incarcerated” as individuals who are in the custody of certain authorities, including people under arrest, imprisoned, residing in halfway houses, living under home detention, or confined completely or partially in any way under a penal statue or rule.
If he is eligible, the SEP lasts for twelve months.
- The SEP starts the day he was released.
- The SEP ends the last day of the twelfth month after his release.
He can choose to have his coverage begin on the first of the month after he signs up, or to have it begin up to six months retroactively (but not before January 1, 2023, or before his release ). If he uses this SEP to enroll in Medicare, he will not owe a late enrollment penalty. To use this SEP, your father should contact SSA.
If your father then wants to enroll in a Medicare Advantage Plan or stand-alone Part D prescription drug plan, he should contact 1-800-MEDICARE (1-800-633-4227) to learn more about his enrollment period options. He may qualify for a Medicare Advantage or Part D SEP or have other enrollment periods available, depending on when he enrolls in Part B.
Best of luck to him as he enrolls in Medicare!