Natalie Kean: Good day everybody and welcome to at present’s webinar presentation entitled Entry to Medicare for Individuals Leaving Incarceration. My identify is Natalie Kean and I’m the director of Federal Well being Advocacy on the well being staff at Justice in Growing older. I’m joined at present by my colleague Rachel Gershon, a senior lawyer additionally on our well being staff. Earlier than we start, I wish to go over a number of webinar logistics. All contributors are on mute, however we welcome your participation in at present’s presentation by means of the Q&A perform within the Zoom management panel. Additionally accessible within the Zoom management panel, is the CC button, which allows closed captioning. We shall be watching the participant questions as they arrive in all through the webinar and we’ll uplift high-level themes through the Q&A phase on the finish of at present’s presentation. We are going to tackle questions we don’t get to throughout at present’s webinar by way of electronic mail. You may also use the Q&A perform to request technical help with Zoom, and our workers will do our greatest to help you.
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Earlier than we start the content material of at present’s presentation, we wished to share a bit of bit extra about Justice in Growing older. We’re a nationwide group that makes use of the ability of regulation to struggle senior poverty by securing entry to reasonably priced healthcare, financial safety, and the courts for older adults with restricted sources. Since 1972, we’ve centered our efforts totally on combating for individuals who have been marginalized and excluded from justice comparable to ladies, folks of colour, LGBTQ+ people and folks with restricted English proficiency. Justice in Growing older is dedicated to advancing fairness for low-income older adults in financial safety, healthcare, housing, and elder justice. We try to handle the enduring harms and inequities brought on by systemic racism and different types of discrimination that uniquely influence low-income older adults in marginalized communities.
Justice in Growing older offers a wealth of knowledge just like the webinar you’re viewing at present. We additionally create truth sheets, difficulty briefs, alerts, and different supplies to maintain you updated with essential developments. Should you’re not already a member of our community, we encourage you to affix by going to our web site and signing up or by emailing information@justiceinaging.org. And now we’re prepared to supply an outline of what we’ll speak about at present. So Rachel goes to start with some background on older adults and reentry and notably entry to healthcare for older adults who’re leaving incarceration. She is going to go over enrolling in Medicare at reentry after which we’ll speak extra about entry to Medicare as soon as somebody is enrolled. And that is notably essential for people who find themselves required to be beneath neighborhood supervision. Lastly, we’ll speak about concerns for people who find themselves dually eligible for each Medicare and Medicaid at reentry. And we’ll save a while on the finish of the webinar for questions. And with that I’ll flip it over to Rachel.
Rachel Gershon: Thanks a lot, Natalie. I’m happy to be giving this presentation at present. So we’re going to begin with form of a background overview of older adults and reentry. Subsequent slide, please. So we’ve been seeing that almost 1 / 4, so one in 4 of all people in jail are over 50 years of age, and this quantity has been rising for years. It’s partly an impact of the obligatory minimums and harsh felony justice insurance policies that had been enacted within the ’90s and early 2000s. Older adults in jail face extra psychological and bodily well being challenges than their neighborhood dwelling friends, together with greater charges of cognitive points and extra points with navigating actions of day by day residing. As soon as an individual leaves jail or jail, entry to healthcare is important, particularly for older adults addressing bodily, psychological, and long-term care wants. And we particularly know that that is essential within the first few weeks after launch from incarceration to instantly get entry to drugs, to companies, to psychological well being therapy is de facto essential for establishing an individual in the neighborhood and serving to them reside their full life. Subsequent slide.
So why is Medicare essential for reentry? So one of many primary paths for an individual leaving incarceration is Medicaid. We frequently hear about Medicaid, which is the medical insurance for low earnings people in America. One other program, Medicare can also be crucial. An individual may be on Medicaid alone, they will also be on Medicare alone, or each on the identical time. So Medicare is a federal well being program. It’s accessible to people age 65 and over and in addition accessible to sure folks with disabilities beneath the age of 65. Medicare often is the solely protection that an older grownup is eligible for. Medicare can cowl many companies for older adults and it has a large supplier community.
So together with some companies like substance use dysfunction therapy, psychological well being, prescribed drugs, hospital, outpatient, a variety of companies. When in comparison with Medicaid, Medicare can provide a wider supplier community in most states. And Medicare is designed to begin when an individual first turns into eligible, even when the individual turns into eligible whereas incarcerated. Late enrollment can set off late enrollment penalties and we’ll speak later on this presentation about tips on how to keep away from these late enrollment penalties even when an individual doesn’t join immediately. After which lastly, as I discussed, people can enroll in each Medicaid and Medicare on the identical time. Subsequent slide.
There’s been some current enhancements to Medicare at reentry. There’s a brand new rule that was finalized late final 12 months to enhance entry to healthcare for older adults and folks with disabilities. These adjustments slender Medicare’s definition of custody and removes enrollment limitations. So for instance, it permits folks to reside in the neighborhood beneath supervision like parole and probation and nonetheless entry Medicare. It aligns Medicare coverage with Medicaid coverage, which is de facto useful when designing reentry applications that work for each. And it saves cash for state Medicaid applications by making Medicare accessible when an individual is eligible for Medicare. Subsequent slide.
Now I’m going to show to the precise activity of enrolling in Medicare after reentry. Subsequent slide. As I discussed earlier than, Medicare has restrictions for when an individual can enroll. You’ll be able to’t simply enroll in Medicare each week of the 12 months, for instance. You’ll be able to enroll throughout an preliminary enrollment interval, which is the seven months round when a primary an individual first turns into eligible, like after they flip 65. You’ll be able to enroll through the normal enrollment interval of January by means of March every year. Nevertheless, enrolling throughout normal enrollment can lead an individual topic to late enrollment penalties. After which lastly, should you match into a selected class, you may be eligible for what’s known as a particular enrollment interval, which is a selected time when an individual can enroll typically with out late enrollment penalties. In order that’s actually essential for avoiding these late enrollment penalties. Subsequent slide.
So late enrollment penalties can occur on many elements of Medicare’s premiums. So enrolling late after that preliminary enrollment can set off late enrollment penalties. Individuals who use particular enrollment intervals can typically keep away from late enrollment penalties. Probably the most widespread penalties is on Half B, outpatient companies and it provides 10% for every year that you simply’re late enrolling. Subsequent slide. So I’ll give an instance of Jerry. So Jerry turned 65 in January 2023 whereas he was incarcerated. He didn’t enroll in Medicare Half B, he was launched in 2025. If Jerry enrolls in Medicare utilizing the final enrollment interval and never a particular enrollment, he would owe $222 a month in Half B premiums representing a 20% late enrollment penalty for enrolling two years late. If Jerry enrolls as an alternative utilizing a post-incarceration particular enrollment interval, he would owe $185 a month in Half B premiums and this late enrollment penalty, the $222 will final all through when he’s enrolled in Medicare, so it’s fairly vital. Let’s go to the subsequent slide.
So the particular enrollment for submit incarceration can be utilized for Half A, specifically individuals who must pay premiums for Half A. Half B, which everybody has to pay premiums for Half B, In order that’s way more widespread. People are eligible for the post-incarceration particular enrollment interval in the event that they’ve been launched from confinement in a jail, jail, or different penal establishment or correctional facility throughout the final 12 months. They’re eligible for Medicare they usually didn’t enroll in Medicare as a consequence of being confined. Let’s go to the subsequent slide. People who’ve been launched from confinement throughout the previous 12 months are eligible. You may be launched to the neighborhood with out supervision and be eligible for the particular enrollment. You may also be launched with supervision, so on parole or probation and be eligible for SEP, together with these on probation parole, should you’re topic to house confinement, or residing in a midway home. Subsequent slide.
To use for the particular enrollment interval, you should use the social safety utility kind 10797 which is obtainable on-line and people may utilizing the post-incarceration SEP, particular enrollment interval, can entry Medicare Half A or Half B retroactively, however must pay premiums. If utilizing post-incarceration particular enrollment interval, there’s no late enrollment penalties for Half A and B. Let’s go to the subsequent slide. The Social Safety Administration collects knowledge from jails, prisons and psychological well being establishments and different entities to find out when an individual has been launched from confinement. For an individual who has been launched from incarceration, confinement, and are at present on parole, probation, or house detention or confinement, SSA knowledge ought to point out that they’ve been launched and due to this fact if it’s been inside 12 months, they’re eligible for this particular enrollment interval. People who’re in a midway house or are eligible for the particular enrollment interval, in the event that they had been launched from confinement throughout the final 12 months, they might have further paperwork challenges with the SSA. We’re nonetheless ready to listen to how that works. Subsequent slide.
If the Social Safety Administration doesn’t have knowledge exhibiting launch, there’s a pathway. So the brand new particular enrollment interval rule permits for the facilities for Medicare and Medicaid companies, CMS, to just accept different documentation of launch and this will embrace discharge paperwork or different paperwork as proof of launch and we put the websites there for the precise websites and SSA may settle for these paperwork. Subsequent slide. So to offer an instance, Mr. Carver, age 68 has been in state jail for 5 years. So he turned 65 whereas he was incarcerated. He’s by no means been enrolled in Medicare. He accomplished his sentence and was launched from custody with out supervision on February fifth, 2025.
Due to his work historical past, he qualifies for premium-free Half A. So meaning he doesn’t pay a premium for that half, a hospital insurance coverage and he’s not going to be topic to guide enrollment penalties on Half A hospital insurance coverage. Though his earnings upon launch is low, he acquired an inheritance from his brother and that makes his property too excessive for him to qualify for Medicaid, although Medicare is trying prefer it is likely to be his solely choice. Let’s go to the subsequent slide. So Mr. Carver used most of his time within the first couple months in the neighborhood working to safe steady housing and he didn’t apply for Medicare till June tenth. He was in a position to make use of the post-incarceration particular enrollment interval to use for Half B protection and his protection may start on July 1st, however as a result of he incurred hundreds of {dollars} in medical payments in Could and June, Mr. Carver opted to pay premiums for retroactive protection again to February and that coated his care.
A notice, since Mr. Carver is also eligible for premium-free Half A, he can join at any time for premium-free Half A. So he does that on the identical time he utilized for Half B. He doesn’t want an enrollment interval for premium Half A, and his Half A can begin six months retroactively and simply common guidelines for Half An indication-up. Subsequent slide. A notice that Mr. Carver doesn’t have the choice of solely paying Half B retroactive protection for Could and June, the months by which he incurred bills. If he chooses retroactive, he should pay premiums for all uncovered months as much as and together with the month of launch, however not six months. It’s a bit of difficult, however the primary story is that making use of for retroactive protection has some guidelines round it requiring a sure variety of months to enroll. Subsequent slide.
A notice about Half D as in canine. That is Medicare protection of medicines that you simply get at a pharmacy. People can enroll in Medicare Half D prescription protection as soon as they’ve both Half A or Half B, they usually don’t want a particular enrollment interval. Notice that Half D protection just isn’t retroactive. After which lastly, the low-income subsidy is obtainable to assist with premiums, value sharing, and if an individual is enrolled in low earnings subsidy, they’ll keep away from late enrollment penalties on that Half D premium. Subsequent slide. So that’s the part on tips on how to enroll in Medicare after launch from incarceration. Now I’m going to show it over to Natalie for Medicare for folks beneath neighborhood supervision. Thanks.
Natalie Kean: Thanks a lot, Rachel. In order Rachel talked about, Medicare lately modified its guidelines that particularly influence people who find themselves launched from jail or jail however nonetheless beneath some type of supervision. And relating to incarceration, the rationale why that is essential is that being enrolled in Medicare doesn’t essentially imply Medicare will really pay for care or companies. So Medicare guidelines typically prohibit fee when one other entity comparable to a jail or jail is answerable for the person’s healthcare prices. And the brink Medicare applies to determine when it ought to pay or not is whether or not the individual is in custody.
Fortunately, who Medicare considers to be in custody is now way more slender than it was beforehand. In order of January 1st of this 12 months, custody is now primarily based on being bodily confined. So that features bodily confinement in jail, jail, penitentiary, or the same establishment. It additionally contains being outdoors of a carceral establishment whereas on medical furlough. It contains being escaped from confinement and it contains being required to reside in a psychological well being facility beneath a penal statute or rule. So beneath this new rule, the primary checklist on this slide of individuals in custody are folks that Medicare presumes another person is masking the price of care and won’t pay for care even when an individual is enrolled.
Now, the brand new guidelines take into account people who find themselves residing in the neighborhood beneath supervision to not be in custody. So due to this fact, Medicare fee is allowed for folks, together with those that are launched to the neighborhood pending trial, that features folks in pretrial neighborhood supervision, and folks launched pursuant to money bail. It contains people who find themselves on parole, on probation, people who find themselves beneath house detention or house confinement. And it additionally contains people who find themselves required to reside in midway homes or different community-based transitional services. Neither of those lists are exhaustive, however having the classes of people who find themselves not in custody is de facto useful as a result of there was loads of ambiguity earlier than about fee and it was troublesome for individuals who had been in reality eligible for Medicare and perhaps even enrolled to entry their Medicare protection. So these adjustments to the custody definition are welcomed and essential.
So let’s stroll by means of a number of examples right here. Ms. Nunez is 68 years previous and left a carceral establishment in late February 2025. She is required to reside in a midway home for one 12 months. As a result of she’s required to reside in a midway home, she can’t really obtain her social safety advantages, however beneath the brand new guidelines she is eligible for Medicare. So what does Ms. Nunez have to do? When she is launched, she calls the Social Safety Administration to supply documentation of her launch and ensure that she is eligible for the particular enrollment interval that Rachel talked about. She makes use of that SEP to use for Medicare in March and her protection started April 1st. She additionally enrolled in a Medicare Half D plan for prescribed drugs and that protection started in April as properly.
As a result of Ms. Nunez just isn’t receiving social safety advantages whereas residing within the midway home, she must pay her Half B premium immediately. So this protection has been actually essential for Ms. Nunez. She was capable of get her Welcome to Medicare go to, fill her prescriptions and get therapy for a knee harm that she has had for some years. Had Ms. Nunez been launched final 12 months or earlier, she might not have been capable of enroll in Medicare and he or she may have confronted, even when she did get enrolled, she may have confronted fee points due to Medicare’s beforehand broad custody definition. And so this can be a good instance of the distinction that this rule change has made.
So now we’re going to stroll by means of some concerns and examples for people who find themselves duly eligible for each Medicare and Medicaid. As Rachel talked about at first, once more, many individuals leaving incarceration are eligible for Medicaid as a result of they’ve little earnings and financial savings, however folks will also be eligible for each Medicare and Medicaid on the identical time. And these persons are generally known as twin eligible or typically known as duals. Medicaid is a extremely essential further profit for folks with Medicare. It will possibly assist make Medicare reasonably priced by masking premiums and in some circumstances, value sharing. Medicaid additionally covers loads of advantages that Medicare doesn’t. Most significantly, long-term care. So this contains long-term stays in nursing services in addition to a variety of house and community-based companies on an ongoing foundation. It can also cowl different wraparound advantages relying on the state, issues comparable to dental, imaginative and prescient, and listening to. People who find themselves eligible for Medicaid, relying on the state of affairs might not want the post-incarceration SEP.
So Medicaid eligibility and enrollment can influence Medicare enrollment and vice versa. Components that influence whether or not and the way an individual enrolls in Medicare or Medicaid embrace whether or not they’re at present enrolled in both Medicare or Medicaid, whether or not they’re receiving social safety advantages, and whether or not they’re entitled to premium-free Half A or required to pay a premium for his or her Half A protection. So let’s stroll by means of a number of examples for example. First is Mr. Broz. He’s eligible for premium-free Half A and he’s already enrolled in Medicaid. He’s 66 years previous and completed serving a three-year sentence. Mr. Broz enrolled in free Half A when he turned 65 whereas he was imprisoned. Previous to incarceration, he had Medicaid protection by means of enlargement. His state’s coverage is to droop that Medicaid protection throughout your entire interval of incarceration moderately than disenroll.
So previous to Mr. Broz’s launch, his state Medicaid program moved his suspended enrollment from the enlargement Medicaid class into the Medicaid Aged and Disabled group as a result of he had turned 65 and was not eligible for enlargement. Upon launch, Mr. Broz’s state enrolled him in Half B of Medicare and started paying his Half B premium. He was already enrolled in Medicaid and already had his Medicare Half A began so it was very straightforward for Mr. Broz to activate each his Medicare and Medicaid advantages and he doesn’t want to make use of the Medicare post-incarceration SEP.
Now as a special instance, Ms. Low is eligible for each Medicare and Medicaid, however she just isn’t enrolled in both program. Ms. Low is 70 years previous and was in state jail for 10 years. And in November of final 12 months, she started serving the final two years of her sentence in the neighborhood beneath parole. So although Ms. Low was beforehand enrolled in Medicaid, her state’s coverage was to disenroll her after one 12 months of incarceration. So she is not enrolled in Medicaid. Upon launch, Ms. Low calls SSA and enrolls in free Medicare Half A. She had ample work credit to be eligible without cost Half A and he or she used the post-incarceration particular enrollment interval to enroll in Half B. Now, Ms. Low has only a small social safety test as her earnings and he or she doesn’t have any financial savings or different property, so Ms. Low additionally utilized for her state Medicaid program upon launch. Her state enrolled her in a Medicare Financial savings Program and began paying her Medicare Half B premium immediately.
Now we’ll check out Mr. Wilson who just isn’t eligible for premium-free Medicare Half A. Mr. Wilson is 80 years previous and was incarcerated in federal jail for 60 years. He was granted parole this month. As a result of Mr. Wilson was incarcerated at age 20, he doesn’t have sufficient work historical past to qualify for premium-free Half A. Previous to his launch, Mr. Wilson meets with a social employee who helps him apply for Medicaid and he’s discovered eligible. As soon as launched, Mr. Wilson contacts a SHIP counselor in his state to assist him enroll in Medicare Half A and Half B. Now, as a result of Mr. Wilson doesn’t have work historical past to qualify without cost Half A, he faces a steep Half A premium, it’s over $500 a month in 2025. However he can keep away from this premium through the use of his Medicaid protection and he must work with an advocate to make use of one thing known as the conditional half A enrollment course of in order that his Medicaid protection of the premium for Half A can begin on the identical time that his Medicare does.
So these are examples. As you possibly can inform, and I feel Rachel talked about, it may be fairly difficult that we now have some useful sources together with our difficulty temporary on the particular enrollment interval that we now have up to date with the examples we shared at present and extra examples in addition to loads of actually sensible suggestions for advocates to make use of to assist folks get enrolled and use their Medicare protection. We even have a brief truth sheet explaining the adjustments to Medicare’s custody definition and what meaning for older adults leaving incarceration. Justice in Growing older additionally does loads of work on entry to different advantages for older adults leaving incarceration, together with social safety, SSI, and housing advantages. And so the third hyperlink right here is to all of our sources on reentry for older adults. And thru the Nationwide Middle on Regulation and Elder Rights, we now have an entire bunch of trainings on Medicare fundamentals and superior subjects in addition to Medicaid and data on folks duly eligible for each.
So we actually encourage advocates to make use of these sources. They’re all free and accessible. After which the Facilities for Medicare and Medicaid Companies only in the near past launched a pamphlet for suppliers, for Medicare suppliers entitled Sufferers in Custody beneath a Penal Authority. And though it has a dry title, it’s a great useful resource that basically outlines from Medicare’s perspective, these guidelines. And in our difficulty temporary, we cite a few locations the place you should use this doc to assist your purchasers get entry to their Medicare protection. So for instance, it is likely to be useful for a consumer to convey this with them to a physician’s go to to guarantee the physician that they’re enrolled in Medicare and might use their Medicare protection although they’re on parole, for instance. And so with that, I feel we now have loads of time for some questions. Rachel, do you need to kick issues off?
Rachel Gershon: Oh, completely. So in a minute… Is there echo? Oh, no. Okay. Oh, nice. Thanks, Natalie. So in a minute I’m going to ask Natalie to speak about individuals who change into eligible whereas they’re incarcerated, all types of issues like, do you have to join? What occurs should you cease paying your premiums? What occurs as soon as you allow? However I’ll give Natalie a minute to assemble herself after that nice presentation. And I’m going to reply quite a few questions that got here up round affordability and the way does an individual handle to entry Medicare with their premiums for Half B and Half D following incarceration. So on the whole, as lots of you realize on this name, there are Medicaid applications known as the Medicare Financial savings Program. They go by loads of totally different names, however they may help pay for Half A premiums if you need to pay a Half A premium, Half B premiums. And typically they pay for value sharing too, so like deductibles, co-payments, co-insurance. We now have different supplies on Medicare Financial savings Applications that go into the main points.
However a fast reply is sure, an individual re-entering into the neighborhood can apply for these Medicare Financial savings Applications. Among the Medicare Financial savings Applications shall be retroactive for 3 months should you’re eligible throughout that point, some others usually are not. So it will get a bit of difficult for this webinar. However on the whole, there are Medicare Financial savings Applications accessible for fee of premiums and typically value sharing after re-entry. There’s additionally, as I discussed, low-income subsidy, often known as Further Assist that may assist pay for Half D, the treatment premiums and in addition assist with a few of the value sharing as properly. Quite a lot of astute folks within the query and solutions seen that the particular enrollment interval doesn’t enable you to with Half D late enrollment penalties. That’s the place this low-income subsidy Further Assist can actually assist with that late enrollment penalty as properly. So now I’m going to show it to Natalie to speak a couple of vary of questions of when an individual turns into eligible for Medicare whereas incarcerated or is available in with Medicare, what occurs with premiums, getting companies paid whereas incarcerated and as soon as you allow?
Natalie Kean: Certain. So yeah, I noticed a few of these questions and I feel just a few primary data that may be useful to reply loads of them is that being incarcerated doesn’t stop you from being enrolled in Medicare. However the fee guidelines that I talked about do stop Medicare from paying for protection for people who find themselves in custody. And now meaning people who find themselves in bodily custody in a jail or jail. So that you may be enrolled in Medicare, however Medicare might not pay on your companies. If you’re entitled to premium-free Half A, that enrollment can proceed if you are incarcerated. Should you change into eligible for premium-free Half A throughout incarceration, that may take some motion in your half throughout your preliminary enrollment interval to get that began since you’re not receiving social safety advantages.
So that’s not routinely triggered. Now if you wish to enroll or keep enrolled in Medicare Half B, your premiums must proceed to be paid with the intention to hold enrollment going throughout incarceration. And so I feel only a factor to find out about that is the particular enrollment interval is de facto essential as a result of many individuals can’t afford to pay a Medicare Half B premium whereas they’re incarcerated and so they aren’t enrolled in Medicare. And so this particular enrollment interval provides folks that chance to enroll in Medicare whether or not they had been enrolled beforehand or missed their preliminary enrollment interval as a result of they had been incarcerated. Rachel, is there something you’d like so as to add or one other query?
Rachel Gershon: That was nice, thanks. And I’ll add, and forgive me should you mentioned this, I used to be studying questions so I could have missed it. If an individual leaves incarceration and finds out, oh no, I owe three months of premiums for my Half B as a result of I went into incarceration with Half B, there was a grace interval the place they gave you time to pay your premiums after which they minimize you off, however you continue to owe these three months. There are pathways accessible for asking for a waiver, for asking for an installment plan even when that cash has already been taken out of a social safety test. So we now have sources round that and are pleased to share about what to do with late premiums for Medicare. I’m going to ask Natalie form of a primary query of, so for Medicare and Medicaid, do you need to be 65 years or older or are there different pathways to these coverages?
Natalie Kean: There are different pathways. For Medicaid, there are various different pathways to protection, however the uniform rule round Medicaid is that you’ve restricted earnings and sources. So it’s not solely primarily based upon your age or incapacity, but in addition your earnings and financial savings. For Medicare, you may be eligible in case you are youthful than 65 and disabled and that may be a course of that goes by means of the Social Safety Administration. When somebody is set disabled beneath the social safety guidelines, there’s typically a two-year ready interval earlier than Medicare protection begins.
Rachel Gershon: Thanks a lot. So no, you wouldn’t have to be 65 years or older to be on Medicaid or Medicare. There was a query that got here up that requested, “Who can we ask for assist?” This can be a difficult program. My recommendation is to get to know your SHIP counselors in your space as a primary step, State Well being Insurance coverage Help Applications. They will go by many alternative names. You’ll find them on-line at shiphelp.org and they’re free, unbiased recommendation on Medicare points. Along with SHIP counselors, many states have reentry applications together with reentry counselors that assist folks join medical insurance. In order that can also be useful resource to go to. I’m going to reply yet another query earlier than I flip over to Natalie about how does the reconciliation invoice that simply handed, how does that have an effect on Medicaid help with Medicare premiums, these Medicare Financial savings Applications that I discussed.
So whereas the reconciliation invoice does have an effect on some guidelines that require states to make it simpler to enroll in these applications, the invoice doesn’t have an effect on eligibility for these applications. So should you’re eligible, should you would’ve been eligible earlier than the invoice comes into impact for these Medicare Financial savings Applications, these applications that enable you to pay for Medicare eligibility, you’ll nonetheless be eligible after the invoice comes into impact. Natalie, are you seeing some questions you need to reply or would you like me to throw you a query or two?
Natalie Kean: I noticed some questions on should you’re in a midway home and you’ll’t get social safety advantages, how are you going to pay on your premiums? That could be a nice query that the rule change that we’re speaking about doesn’t clear up for, however simply to make clear, there’s some distinction between eligibility for social safety, retirement advantages or different advantages and Medicare eligibility and fee. So a kind of variations proper now’s people who find themselves required to reside in midway homes will not be eligible for his or her social safety advantages, however they are often eligible for Medicare and for Medicaid. So if somebody is residing in a midway home, they might have employment and will use that earnings to pay their Half B premium. But when they’re low earnings and meet their state’s eligibility standards for the Medicare Financial savings Applications for instance, they may get assist with these Medicare premiums. So that’s an alternative choice, however it’s true, there could also be some people who find themselves nonetheless caught not with the ability to afford protection.
Rachel Gershon: Yeah, and simply flagging that the Medicare and Medicaid guidelines for midway homes are a bit of totally different. So that you may run into some points there. I noticed some questions extra about conditional Half A, and I’m simply going to offer a broad overview of why conditional Half A is essential and notice that we now have further about conditional Half A. So in lots of circumstances we see an individual who’s eligible for Half A hospital insurance coverage, however they must pay a premium and they’re additionally eligible for his or her state to pay for that premium. And the massive query is how do they get enrolled and have the state pay for that assist on the identical time that they get enrolled into Medicare Half A?
And the conditional Half A course of helps you go to social safety first, join conditional Half A. So that you’re not really coated beneath Half A at that time. It’s simply it’s able to be turned on as quickly as your state approves you for that Medicare Financial savings Program assist with the Half A premium. In order that’s form of the broad overview of why we speak about conditional Half A course of typically and we now have further sources for tips on how to work by means of that course of. And I’m pleased to reply extra questions or flip it over to Natalie if she has them.
Natalie Kean: Yeah, I noticed one which perhaps you had already queued up for your self Rachel, however how lengthy after launch from incarceration does the particular enrollment interval run?
Rachel Gershon: Completely. So it runs 12 months after launch from incarceration. So let’s say you allow jail in January and also you’re on probation for the subsequent three months. The beginning of your particular enrollment interval is in January whenever you depart that incarceration although you’re going to supervision. So that you’d be eligible for that particular enrollment interval for a full 12 months after that January time interval.
Natalie Kean: Thanks. After which there’s a query concerning the enrollment utility for the particular enrollment interval. Somebody mentioned they noticed it on-line and it nonetheless appears prefer it has previous data. Has that been up to date?
Rachel Gershon: It has not been up to date but. We’re hopeful that it will likely be up to date. So we actually encourage you to convey that CMS, that new Medicare studying program useful resource that simply printed this week speaking concerning the particular enrollment interval. So you possibly can convey that to Social Safety to point out how this works. There’s additionally some social safety steerage, they’re known as the SSA, for Social Safety Administration, POMS. And we now have these particular references in some written supplies that can come out after this webinar to convey with you. However we do acknowledge that that utility continues to be referencing previous definitions of incarceration that could be complicated for folk.
Somebody requested what occurs if they may join a Medicare Benefit plan, that we didn’t actually speak about. And on the whole, to join a Medicare Benefit plan, you want to be on Half A and B. In order that form of follows. When you’re on Medicare Half A and B, you possibly can join a Medicare Benefit plan. There are particular instances when you possibly can join Medicare Benefit as properly. So we hear concerning the enrollment intervals for signing up for Medicare. There’s additionally enrollment intervals for signing up for Medicare Benefit. It makes use of loads of the identical language together with there’s particular enrollment intervals for signing up for Medicare Benefit and there’s sources on the market for that. However we’re pleased to comply with up with any particular questions round Medicare Benefit.
Natalie Kean: That’s nice. Yeah, I noticed a query about what you simply referenced, the SSA steerage is the POMS, P-O-M-S. In order that instructs folks working at SSA on tips on how to course of these purposes and numerous conditions that individuals might name in about.
Rachel Gershon: Great, thanks. I’m taking a look at new questions. There’s LIS, query mark. That stands for the low-income subsidy. It’s typically additionally known as Further Assist. So it’s each an acronym and has quite a few names for it and LIS, low earnings subsidy, often known as Further Assistance is a program administered by means of the Social Safety Administration and it helps together with your Half D treatment premiums and price sharing. There’s additionally a query, I’m simply going to learn it and reply it. “If an individual is already enrolled in Medicare, in order that they’re age 67, they go to jail for 2 years, will they owe the premiums from throughout that point? So are they going to come back out of jail owing two years of premiums?” The brief reply is not any.
So you probably have Half B and also you’re paying premiums on that Half B and also you’re incarcerated and also you don’t pay premiums, Medicare will wait for 3 months simply in case you’re going to pay premiums after which they may shut off that Half B. And after they shut off that Half B, gained’t owe premiums after that. However whenever you get out of incarceration, you could discover that you simply owe these Half B premiums and it’s known as late Medicare premiums. And there’s quite a few choices for coping with that for these three months of premiums that an individual didn’t pay. And we now have written sources about that.
Natalie Kean: There’s a query about, “Are you able to name your native social safety workplace to get assist with first steps?” Sure, we do suggest for these of you on this webinar to make use of the sources on the slide right here that can assist you be prepared to assist the Social Safety Workplace perceive the particular enrollment interval and which part of the steerage and issues that they need to be taking a look at. And simply to notice too, Rachel gave an instance at first of somebody who in the event that they enrolled through the normal enrollment interval would face late enrollment penalties, however utilizing the particular enrollment interval, they don’t.
And so it’s crucial, particularly if somebody is enrolling through the normal enrollment interval, January by means of March, that it’s clear to SSA that they’re utilizing, that they need to use the particular enrollment interval. One other useful resource and in addition for post-enrollment points with fee and issues like that’s 1-800-MEDICARE. They will join you with the Medicare Beneficiary Ombudsman workplace. After which Rachel and I are additionally accessible to assist with technical help and are definitely to listen to about any specific points that people are having. Rachel, had been there any final questions you wished to reply?
Rachel Gershon: Yeah, I’ve a final query I need to point out. I’m so grateful for all of the questions which have are available and I do know that we haven’t addressed all of them. And specifically, there’s some particular questions like this specific place, is that thought of incarcerated or not? And we’ll do our greatest to get out to you one of the best of our data reply on these questions as they arrive up. So there’s a query, “How lengthy do you need to pay the penalty, the late enrollment penalty, for Half B? Please clarify.” So sadly, the late enrollment for Half B lasts for so long as you have got Medicare.
Nevertheless, there are a number of methods to keep away from it should you’re enrolling late. A method is to make use of a particular enrollment interval. One other approach is a few of these Medicare Financial savings Applications, the state pays that late enrollment penalty for you, or CMS won’t cost it relying on the state you’re in. And relying on the state you’re in, typically even after you’re not eligible for that Medicare Financial savings Program, you gained’t have that late enrollment penalty. And we’re pleased to reply particular technical help on the ins and outs of this difficult program. So it appears like we’re nearing the tip. I’ll hand it off to Natalie for any final questions.
Natalie Kean: Yeah, thanks, Rachel. And thanks everybody for becoming a member of us at present. As I mentioned, be happy to achieve out to Rachel and me with any further questions and please don’t overlook to finish the submit webinar survey. Your suggestions on our webinars is de facto essential to us and helps us inform what different trainings and sources we may be offering. I hope everybody has an awesome remainder of your day.
