Medicare Now Available to Those on Probation and Parole
On November 1, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finalized a rule change that updates the definition of who is “in custody” and therefore ineligible for Medicare health coverage. As of that date, those under community supervision—including those released on bail, probation and parole, as well as those assigned to a hallway house—are no longer included in the definition of “in custody.”
That opens Medicare health coverage for those who are otherwise eligible while under community supervision—some 340,000 people. Further, those being released from incarceration to community supervision are also now included in the definition of those eligible for Medicare’s special enrollment period—meaning they do not have to wait for the next annual open enrollment period to roll around.
Medicare is federally funded health insurance coverage for all Americans 65 and over, as well as those on disability. Part A provides partial hospitalization coverage for no premium. Part B provides partial reimbursement for healthcare expenses outside of hospitals, subject to deductibles; it carries a $185 monthly premium in 2025. Part C includes both parts A and B in a “Medicare replacement” plan offered by private health insurers in each state, usually for the same premium. Part D offers additional prescription drug coverage, for an additional fee. Subsidies are available for those financially unable to pay Part B or D premiums. See: CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC).
CMS had previously excluded those on community supervision because government health benefits—including Medicaid—are not available to those already receiving healthcare from a government-funded prison or jail. The previous definition had mistakenly assumed that those on community supervision were provided such care, when in fact they are not.
The change will help older returning prisoners, as well as those with disabilities; those on community supervision are more likely to suffer from serious medical conditions like Hepatitis B or C, and they are also far less likely to have health insurance.
Additional source: Prison Policy Initiative
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