For purposes of MA eligibility, other than eligibility for inpatient hospital services, the needs of an inmate in a correctional institution are met by the government agency that runs the facility. These facilities include the following:
Correctional institutions that are supervised or controlled by the Department of Corrections.
Jails run by local authorities.
42 CFR 435.1008(2)b 42 CFR 435.1009
If an inmate meets all other rules for eligibility, he or she can apply for and get MA in any of the following situations:
The individual is an inmate of a State Correctional Institution (SCI) or County Correctional facility, and is admitted for inpatient services to a hospital that is separate from the correctional institution.
The individual lives in any community residential facility under contract to or operated by a state, county, or local prison authority and is eligible in other ways for GA-related MA.
The individual is serving time in a correctional institution for only a portion of the week, such as weekends. The CAO must not stop MA for the days the individual is kept in jail or prison.
The individual is a juvenile in a Juvenile Detention Center while waiting for the final decision of a court to be made.
NOTE: A juvenile becomes ineligible for MA when the final decision of the court is made and the juvenile is placed in a secure residential facility, such as a Youth Forestry Camp or Youth Development Center.
The individual is living in a Community Corrections Center operated by the State Department of Corrections.
An individual is not considered an inmate of a correctional institution at any of the following times:
Before his or her arrest.
When he or she is released on bail.
After being released from custody, even though the individual may still be under a court's control through probation, parole or house arrest.
When he or she is placed in a Juvenile Forensic Unit for court-ordered psychiatric services.
NOTE: Juvenile Forensic Units are considered medical facilities.
When he or she is living in a public educational or vocational training institution to get an education or vocational training.
When he or she is living in a public institution while waiting for other living arrangements that meet his or her needs.
Updated February 14, 2012, Replacing February 8, 2002