by Eike Blohm, MD
A change in Medicare rules ends a years-long policy of forcing elderly prisoners to pay for benefits they are literally not free to use or else face life-long penalties.
Americans 65 years and older are covered by Medicare, the government-run health insurance. Medicare consists of several parts: Part A covers hospitalizations; Part B covers doctor’s office visits and outpatient procedures; Part C is Part A & B offered through a private insurer with additional benefits like dental or vision; Part D covers prescriptions.
Enrollment in Part A is automatic and free. Enrollment in Part B is not automatic, though, and it is not free but costs about $135 per month depending on income. Failure to enroll in Part B by age 65 increases the premium by 10% for each year of delay. Thus, a person who did not enroll at age 65 but age 70 will pay a 50% higher premium for the rest of his life.
This created a problem for elderly prisoners. They could pay the Part B premium while incarcerated, although Medicare is precluded from providing services to prisoners. Or they could pay higher premiums after release from prison, adding to the financial hardship many returning citizens already face. Others had the choice made for them; it is impossible to pay the Part B premium while working a prison job that pays 12 cents per hour.
Now Medicare has created a Special Enrollment Period for returning citizens. A recently released person has 12 months to enroll for Part B without facing penalties, no matter his age.
For those currently incarcerated and unenrolled, this means that they do not have to pay the Part B premium but can safely await release to sign up. Prisoners who have already enrolled and are paying the monthly premium (or have a family member pay for them) can contact Medicare and disenroll from Part B, then simply re-enroll during the Special Enrollment Period after release. Unfortunately, there will be no reimbursement for the premiums already paid.
Returned citizens released prior to January 1, 2023 who have received a penalty on the Part B premium are stuck with it at this time. While Medicare can change its enrollment rules, the premium penalty is a statutory matter and requires Congress to change existing law.
Even though the changes do not apply retroactively, it is good that the unfair practice of forcing prisoners to pay health insurance premiums for services they cannot use is coming to an end. Readers who wish to contact Medicare can do so at 1-800-MEDICARE (633-4227).
Source: Prison Policy Initiative
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