Health Coverage for Incarcerated Individuals

If you’re currently incarcerated, you’re not eligible to purchase a Marketplace health plan. However, once you’re released, you can use the Marketplace to secure health coverage.

What Does “Incarcerated” Mean for the Marketplace?

For the purposes of the Marketplace, being “incarcerated” means serving a term in prison or jail. You are not considered incarcerated if you are:

• On probation, parole, or house arrest, living at home, in a residential facility, or a halfway house (either under supervision of the criminal justice system or voluntarily).
• In jail or prison while awaiting the outcome of charges (being held but not yet convicted).

Pending Disposition of Charges

If you’re in jail or prison awaiting the outcome of charges (“pending disposition”), you can still create an account or log in to the Marketplace to apply for and, if eligible, enroll in a plan. If you’re convicted, you’ll lose eligibility for Marketplace coverage while serving your sentence.

After Release from Incarceration

Once you’re released, you have a 60-day Special Enrollment Period to apply for and select a Marketplace health plan. During this time, you may also qualify for reduced monthly premiums and out-of-pocket costs.

If you plan to file taxes with a spouse or another household member already enrolled in a Marketplace plan, they can update their application to add you to their coverage.

Important: If you don’t select a plan during your Special Enrollment Period, you’ll have to wait until the next Marketplace Open Enrollment Period unless you experience another qualifying life event.

Medicaid Coverage While Incarcerated

While incarcerated, you can use the Marketplace to apply for Medicaid in your state. Although Medicaid won’t cover your medical care while you’re in prison or jail, enrolling before your release can help you access care more quickly afterward.

To determine if applying for Medicaid before your release is beneficial, check whether your state:

• Has expanded Medicaid coverage to all adults with incomes up to 138% of the federal poverty level. If so, you only need to qualify based on household income.
• Allows you to maintain Medicaid coverage while incarcerated. Contact your state’s Medicaid agency for specific details.