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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 January 2024 Subchapter Subject Page ending with Page M0140 INCARCERATED INDIVIDUALS M0140.001 1

M0140.000 Incarcerated Individuals General Information

A. Introduction An incarcerated individual, or offender, is an inmate of a public institution. Inmates include those under the authority of the Virginia Department of Corrections (DOC), held in a regional or local jail, those on work release, and inmates of a Virginia Department of Juvenile Justice (DJJ) facility. For juveniles not in a facility but within the authority of DJJ, see section M0280.300 D. See section M0280.301 regarding an individual who is not considered to be an inmate of a public institution. An individual released from jail under a court probation order due to a medical emergency is NOT an inmate of a public institution because he is no longer incarcerated. B. Policy Principles An individual is not eligible for full benefit Medicaid coverage while incarcerated. These individuals may apply for medical assistance and (if approved) receive coverage limited to inpatient hospitalization services. Inpatient hospitalization may include long-term inpatient services, such as admission to a rehabilitation facility. Children under 19 are eligible for 12 months of continuous in-patient hospitalization coverage.

The offender must meet eligibility requirements for a full-benefit covered group. Medicaid non-financial eligibility requirements include • Virginia residency requirements (see M0230) • Citizenship or immigration status (see M0220) • A Social Security Number (SSN) or proof of application for an SSN (see M0240) • Institutional status requirement of being an inmate in a public institution (see M0280)

Medicaid financial eligibility requirements for the individuals covered group include • Resources (if applicable) within resource limit (Chapter M06 for F&C; Chapter S11 for ABD) • Income within income limit (Chapter M04 & M07 for F&C covered groups; Chapter S08 for ABD covered groups)

C. Covered Group The individual is evaluated for eligibility in the covered group in which they would otherwise be eligible except for being incarcerated. The primary covered groups an offender may meet include: • MAGI Adults (M0330.250) • Pregnant Women (M0330.400) • Child Under Age 19 (M0330.300) • Aged, Blind or Disabled (M0320.300) • Former Foster Care Child Under Age 26 Years (M0330.109) D. Immigration Status Requirements An incarcerated person must meet immigration requirements (see M0220). A non-citizen who meets all Medicaid eligibility requirements except for immigration status and has received an inpatient hospitalization may be evaluated for coverage as an Emergency Services Alien see M0140.200.C.3