Key 1
Eligibility |
Identify individuals who may be eligible for SSI/SSDI and Medicaid early in the incarceration process. |
Recommendation
| D |
Ensure timely access to Medicaid after release for eligible individuals by suspending, instead of terminating, Medicaid benefits during incarceration. |
Related Examples
The following examples illustrate how some jurisdictions have implemented this recommendation. By highlighting certain examples in this chart, however, the Justice Center is not promoting them as "best practices." They are simply efforts that involve partnerships, resourcefulness, or even longtime practices for other communities to consider.
Related Background Information
The information highlighted here provides background information on terms, processes, and other items mentioned in the recommendation.
How Incarceration Affects Eligibility
Complex rules affect eligibility for federal benefits when someone enters a correctional facility. Federal laws prohibit federal financial participation (FFP), also known as matching payments, to support benefits to individuals in state-run institutions, including correctional facilities and Institutions for Mental Disease (IMDs).[1]
While the federal statute bans FFP, it does not specify that states must terminate Medicaid benefit eligibility for individuals entering correctional facilities or IMDs. Yet, in practice, most states do terminate rather than suspend benefit eligibility for incarcerated individuals or terminate benefits after a certain period of time. A study conducted by the Council of State Governments in 2000 found that 46 states and two territories have policies that require termination of Medicaid supports for people in jail.
[2]
Rules governing Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) eligibility when beneficiaries enter jail or prison are different than those that affect Medicaid. Benefits are not terminated when individuals enter a correctional facility and may never be terminated, depending on the length of stay in a correctional facility and type of conviction, among other factors. For a thorough discussion of the impact of incarceration on SSI/SSDI and Medicaid, please see the Council of State Governments Justice Center’s Criminal Justice/Mental Health Consensus Project Report, Appendix C.
[1] FFP may be allowed for specific services provided to IMD residents under age 21 or, in some cases, under age 22 or age 65 years and older. (see Draper DA, McHugh MC, Achman L, Kuo S. Medicaid Financing of State and County Psychiatric Hospitals. DHHS Pub. No. (SMA) 03-3830 Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2003.)
[2] C. Brown, “Jailing the Mentally Ill,” State Government News, April 2001, 28. In addition, while state policies may require termination of Medicaid upon incarceration, in practice, eligibility may not be terminated until the state Medicaid agency is made aware of the incarceration at a later date or an individual who is incarcerated does not file a necessary continuation with the state agency.
