Can I get health care through Covered California while I’m incarcerated?

No. You cannot get health care through Covered California while you are incarcerated, but you may apply for Medi-Cal once you are nearing your release date (more information on Medi-Cal starting on PG. 466). Or if you prefer to have private health care through Covered California, you may apply once you are released (see below for more details).

Helpful HintIf you’re currently serving a sentence in jail or prison, special rules apply to you for applying for health insurance:[1558]

While you’re incarcerated:

    You are eligible to enroll in Medi-Cal while incarcerated. You may apply on your own, or through any enrollment program available at your facility.[1559] You can’t start using a Medi-Cal health care plan while you’re incarcerated; but if you enroll before your release, you may be able to get health care more quickly once you’re out.[1560] To learn more about Medi-Cal and how to enroll while incarcerated, go to PG. 466. You are not eligible to buy a private health care plan through Covered California, and the Individual Mandate (see PG. 462) doesn’t apply to you as long as you’re incarcerated following a criminal conviction. This means you don’t have to worry about paying a penalty, or applying for an exemption from the penalty, during your incarceration.[1561]

Once you’re released:You may be eligible to enroll in health care through Covered California; and the Individual Mandate (see PG. 462) may now apply to you. This means you may now be legally required to have health care, or pay a tax penalty—unless you get an exemption (read more about exemptions on PG. 463).

    If you want to enroll in Medi-Cal, and you didn’t already enroll while incarcerated, you can apply at any time after your release. For details about Medi-Cal, go to PG. 466.If you want to buy a private health care plan (and also get tax credits to help pay for it), you have 60 days after your release to notify Covered California, get approved for a Special Enrollment Period (see PG. 464), submit a Covered California application, and enroll in a health care plan. If you don’t complete this process in 60 days, you must wait for the next Open Enrollment period (see PG. 463), and you may have to pay a penalty.[1562]
  1. 1558

    Note: These special rules do not apply to you if you are on probation, parole, or home confinement; or if you are being “detained pre-trial”—in other words, being held in jail or prison but have not yet been convicted of a crime. Incarcerated People, HealthCare.gov, https://www.healthcare.gov/incarcerated-people/, http://www.safeandjust.org/resources/HealthEnrollmentToolkit. Also, please note that at the time of production of the “Roadmap to Reentry: A California Legal Guide,” the California Centers for Medicare & Medicaid Services (CMS) was drafting new rules that would allow for applications prior to some “qualifying life events,” including release from incarceration. But this proposed rule is not currently in effect. ↑

  2. 1559

    Incarcerated People, HealthCare.gov, https://www.healthcare.gov/incarcerated-people/. ↑

  3. 1560

    Exception: You may use health care while incarcerated for the purpose of paying for medical expenses occurred during an inpatient stay in a non-correctional health facility (such as a hospital), if that stay lasts longer than 24 hours. For more information, please visit: http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/MC Inmate Eligibility Program.pdf. ↑

  4. 1561

    Note: You are not considered “incarcerated,” if you are on probation, parole, on home confinement; or if you are being detained while you await trial. See Incarcerated People, HealthCare.gov, https://www.healthcare.gov/incarcerated-people/. ↑

  5. 1562

    Incarcerated People, HealthCare.gov, https://www.healthcare.gov/incarcerated-people/. ↑