In some cases, incarceration may lead to disenrollment from your Medicare plan. However, there are special rules for reinstatement of coverage upon release.

Incarcerated individuals and their families face unique challenges related to Medicare coverage.

If you’re enrolled in Medicare when you enter custody, you could be disenrolled from your plan if you miss premium payments or have a plan through a private insurance carrier. If you become eligible for Medicare while in custody, you may miss your Medicare initial enrollment period (IEP).

For incarceration to affect your Medicare coverage, you need to be considered “in the custody of penal authorities” by Medicare’s definition.

This includes being in jail, prison, or a mental health facility, as ordered by criminal law. This definition does not apply to people who are on parole, probation, or awaiting trial.

Read on to learn how incarceration affects the different parts of Medicare, how to reenroll upon release, and more.

Incarcerated individuals who are eligible for Medicare can maintain their Original Medicare (parts A and B) coverage while in custody.

However, although you can maintain Original Medicare coverage during incarceration, Medicare will not pay for any services you receive. Rather, the penal institution where you’re incarcerated will provide your healthcare.

Additionally, you may enroll or reenroll in Medicare while in custody by contacting the Social Security Administration (SSA).

Generally, you’ll be automatically enrolled in Medicare if you turn 65 years old while receiving Social Security benefits. However, since Social Security benefits are discontinued while a person is in custody, you would need to enroll in Medicare manually during your IEP.

Incarceration affects each part of Medicare in different ways.

Part A

If you’re eligible for premium-free Part A while incarcerated, your coverage will continue throughout your time in custody.

If you aren’t eligible for premium-free Part A, you’re entitled to enroll in Part A coverage while in custody. However, continued coverage is dependent on making monthly premium payments. If you cease paying the premium, you will be disenrolled from Part A.

Part B

To maintain Part B coverage while incarcerated, you’ll have to continue paying the monthly premium. In 2025, the Part B premium starts at $185.

If you stop paying it, Medicare will disenroll you from Part B.

Medicare Advantage (Part C)

To be eligible for a Medicare Advantage plan, you must live within the plan’s service area. If you’re incarcerated, you’re considered outside the service area of Medicare Advantage.

If you have a Medicare Advantage plan at the time of incarceration, you will be disenrolled from the plan.

Part D

Like Medicare Advantage plans, Part D plans are also offered by private insurance companies and vary based on a person’s location.

If you are in custody, you will be disenrolled from your Part D plan.

If you lose Medicare coverage while incarcerated or wish to switch your coverage, you can do so upon your release.

Before 2023, if you were released from custody, you had to wait until the Medicare general enrollment period (GEP) to sign up for Medicare. This could result in months without Medicare coverage and potential late enrollment penalties.

Since January 1, 2023, individuals released from custody qualify for an exceptional condition special enrollment period (SEP) for formerly incarcerated (in custody) individuals.

This SEP begins the day of your release and ends on the last day of the 12th month after your release. If you miss the SEP for formerly incarcerated individuals, you’ll need to wait until the next GEP to reenroll.

After release, consider contacting the SSA to ask about signing up for Medicare. You can do so via phone at 800-772-1213 (TTY: 800-325-0778).

Consequences of not reenrolling

For Part A, Part B, and Part D, Medicare-eligible individuals can face late enrollment penalties for going without Medicare coverage.

If you lose Medicare coverage while in custody and do not enroll during the SEP after your release, you may face penalties when you go to enroll at a later time.

These penalties come in the form of higher monthly premium payments. Each penalty has a different calculation, but some can last for as long as you’re enrolled.

You can maintain your Original Medicare coverage while you’re incarcerated if you continue paying any required premiums.

If you have a Medicare Advantage (Part C) or Part D plan at the time of incarceration, you will be disenrolled when you enter custody, as the plan will consider you outside of its coverage area.

You can reenroll in Medicare — or enroll for the first time, if you became eligible while incarcerated but missed your initial enrollment period — during a special enrollment period that begins when you’re released.

In the United States, incarcerated individuals have a right to adequate healthcare.

However, this care is not always free. There may be fees, such as copayments, associated with different services or medications.

Being in the custody of penal authorities may affect your Medicare coverage.

While you are allowed to maintain Original Medicare coverage or enroll in Medicare while in custody, you cannot have a Medicare plan through a private insurer.

Once you’re released, you’ll qualify for a special enrollment period during which you can reenroll in Medicare if you lost your coverage while incarcerated.