Health coverage for incarcerated people

If you’re incarcerated, some special rules apply to your health care options.

Incarceration and the Marketplace

For purposes of the Marketplace, “incarcerated” means serving a term in prison or jail.

  • Incarceration doesn’t mean living at home or in a residential facility under supervision of the criminal justice system, or living there voluntarily. In other words, incarceration doesn’t include being on probation, parole, or home confinement.

  • You’re not considered incarcerated if you’re in jail or prison pending disposition of charges—in other words, being held but not convicted of a crime.

If you’re incarcerated, you can’t use the Marketplace to buy a private insurance plan. But after you’re released you can.

The Marketplace after release from incarceration

When you apply for health coverage after being released from incarceration, you may qualify for lower costs on monthly premiums and out-of-pocket costs. This will depend on your household size and income during the year you’re seeking coverage.

After you’re released, you have a 60-day Special Enrollment Period to sign up for private health coverage. During this time, you can enroll in private health insurance even if it’s outside the Marketplace Open Enrollment Period.

After this 60-day Special Enrollment Period, you can’t buy private health insurance until the next Marketplace Open Enrollment Period (unless you qualify for another Special Enrollment Period).

Incarcerated people and the fee for being uninsured

Because you aren’t eligible to buy private health insurance through the Marketplace while in prison or jail, you don’t have to pay the penalty that some others without insurance must pay for plan years through 2018.

After you’re released, you must either have health coverage, pay the fee, or get an exemption for 2018 plans and earlier. (Note: Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies.).

If you’re incarcerated pending disposition of charges

If you’re in jail or prison but haven’t been convicted of a crime, you can create an account or log in to use the Marketplace to buy a private health insurance plan. This assumes you are otherwise eligible to get coverage through the Marketplace.

Incarceration and Medicaid

If you’re incarcerated you can use the Marketplace to apply for Medicaid coverage in your state. Medicaid won’t pay for your medical care while you’re in prison or jail. But if you enroll in Medicaid while you’re incarcerated you may be able to get needed care more quickly after you’re released.

There are 3 ways to apply for Medicaid:

State Medicaid policies and incarceration

A number of state Medicaid policies may influence your decision to apply for Medicaid while in jail or prison. These include:

  • Whether your state has decided to expand Medicaid coverage to all adults with incomes up to 138% of the federal poverty level

  • Whether incarcerated people can stay enrolled while in prison or jail. Remember that enrolling in Medicaid while incarcerated doesn’t allow Medicaid to pay the cost of your care while in prison or jail. But it may help you get needed care more quickly after you’re released.