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Prisoner Health Alert: Elderly Prisoners No Longer Required to Pay for Medicare Part B

by Eike Blohm, MD

A change in Medicare rules ends years of forcing elderly prisoners to pay for benefits they cannot use or 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; enrollment in Part A is automatic and free. 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. Of those, enrollment in Part Bis not automatic and not free but costs about $135 per month depending on income. Part Bis mandatory, and failure to enroll increases the premium by 10% for each year. Thus, a person who did not enroll at age 65 but age 70 will pay a 50% higher premium for the rest of their life.

This created a problem for elderly prisoners. They could either 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 their age.

For those currently incarcerated and unenrolled, this means that they do not have to pay the Part B premium but can safely await their 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, they will not be reimbursed for the premiums already paid.

Returned citizens released prior to January 1, 2023, who have received a penalty on their 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 laws.

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 __________ (the prison’s resource library could not get me the address, please add)


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