Jail and Prison Inmates – How they Receive Medi-Cal Health Coverage Pre and Post Release

General information

Since the passing of AB 720 in 2013 and implementation of the Affordable Care Act in 2014, as well as several other policy initiatives, there have been many changes to the Medi-Cal program as it relates to prison and jail inmates. There have also been several changes for those individuals who are on Medi-Cal and become incarcerated, as well as individuals who are being released from prison or jail. 

Often times the various inmate initiatives and programs can be mistaken for one another, so the following information seeks to explain the difference between the programs. CWDA has played a proactive role with counties, partner organizations including the California State Association of Counties (CSAC), and state entities including the California State Department of Health Care Services (DHCS), and the California Department of Corrections and Rehabilitation (CDCR) to better streamline efforts for the various inmate programs and initiatives.      

State Prison Inmates

Medi-Cal Inmate Eligibility Program (MCIEP): State prison inmates may be eligible for a special Medi-Cal program for inmates known as Medi-Cal Inmate Eligibility Program if they meet the eligibility criteria of the program and receive acute hospital care off-prison grounds for a period of 24 hours or longer. State MCIEP for prisoners is handled at the state level through DHCS.

Pre-Release: State prison inmates who are set to parole work with CDCR to submit a pre-release Medi-Cal application to the county that they will reside in post-prison release. CWDA has worked closely with CDCR and DHCS to develop a process for CDCR and the counties to coordinate together in order to process pre-release Medi-Cal applications for inmates so they can have access to benefits upon being released from prison.  

County Jail Inmates

Medi-Cal Inmate Eligibility Program (MCIEP): Similar to the state MCIEP program for prisoners, county jails can also submit applications for jail inmates who require acute hospital care off-jail grounds for a period of 24 hours or longer.  These applications are processed by county human services departments. 

Pre-Release and Parole: Many jails work locally with their county human services departments to provide a pre-release application process similar to that used by CDCR, or an opportunity for parolees to apply for Medi-Cal post-release.

Medi-Cal Suspension

Prior to implementation of the ACA, individuals who became incarcerated were no longer eligible to Medi-Cal benefits until they were released from prison or jail.  Beginning with incarcerated juveniles just prior to ACA implementation, Medi-Cal benefits would no longer be discontinued and would rather be suspended for up to one year. Post-ACA implementation, the model of Medi-Cal benefit suspension has expanded to all inmates so now individuals who are juveniles or adults in state prison or county jail are eligible to have their Medi-Cal benefits suspended for up-to one year rather than being discontinued. If the individual is incarcerated for longer than a year, they may be able to utilize one of the pre-release processes mentioned above to help re-instate their Medi-Cal benefits upon release from a facility.   

Resources

DHCS has provided several pieces of policy guidance regarding the various inmate related programs and initiatives:

MCIEP

State

County

Pre-release Medi-Cal
Benefit Suspension

Adults

Juveniles