Yes, people with felony convictions can get Medicaid. A criminal record is not part of the eligibility calculation — Medicaid looks at income, household size, residency, and citizenship, and nothing in federal law bars someone with a felony from enrolling.1MACPAC. Medicaid and the Criminal Justice System The real obstacle is incarceration itself, and even that barrier eased significantly on January 1, 2026, when a new federal rule started requiring every state to keep enrollment intact during a jail or prison stay instead of canceling it.
A Felony Conviction Is Not a Disqualifier
No federal law blocks people with felony convictions from Medicaid, and the type of felony doesn’t change that. Violent offenses, property crimes, and drug offenses are all treated the same way for Medicaid purposes.1MACPAC. Medicaid and the Criminal Justice System
The drug felony point is worth spelling out because it confuses people. A 1996 federal welfare law permanently barred people with drug-related felony convictions from receiving TANF cash assistance and SNAP food benefits, though most states have opted out of or modified that ban. That restriction never applied to Medicaid. If you have a drug felony on your record and you otherwise meet the income and residency rules, you can enroll.
In practice, a conviction often makes someone more likely to qualify, not less. The loss of income that tends to follow a conviction or a prison stay can push a household below the eligibility threshold, especially in the 40 states and Washington, D.C. that expanded Medicaid under the Affordable Care Act to cover adults under 65 earning up to 138% of the federal poverty level.2HealthCare.gov. Medicaid Expansion and What It Means for You In the states that haven’t expanded, non-disabled adults without children still have a harder path regardless of criminal history.
What Incarceration Actually Blocks
The barrier for people in the criminal justice system isn’t the conviction — it’s being locked up. Federal law contains what’s called the inmate exclusion, which prohibits federal Medicaid dollars from paying for healthcare provided to anyone held in a public institution, including state and federal prisons, local jails, and detention facilities.3Office of the Law Revision Counsel. 42 US Code 1396d – Definitions While you’re in custody, the correctional facility is legally responsible for your medical care.
There is one narrow exception. If you’re admitted as an inpatient to a hospital or other medical institution for a stay of 24 hours or more, Medicaid can cover those inpatient services even though you’re still technically in custody.4Centers for Medicare & Medicaid Services. State Health Official Letter – Facilitating Successful Reentry for Individuals Transitioning from Incarceration Routine outside doctor visits and emergency room trips that don’t result in a 24-hour admission generally don’t qualify.
Here’s the key distinction: the inmate exclusion is a payment restriction, not an eligibility bar. You can be enrolled in Medicaid while incarcerated. The program just won’t pay for your care during that period.4Centers for Medicare & Medicaid Services. State Health Official Letter – Facilitating Successful Reentry for Individuals Transitioning from Incarceration That distinction is what makes the 2026 rule change matter.
The 2026 Rule: Coverage Is Suspended, Not Terminated
Before 2026, each state decided for itself whether to fully terminate a person’s Medicaid when they entered jail or prison, or just suspend it. States that terminated coverage forced released people to reapply from scratch — a bureaucratic ordeal at the worst possible moment. States that suspended coverage could switch it back on quickly after release.
That patchwork ended on January 1, 2026. Under a provision in the Consolidated Appropriations Act of 2024, states are now prohibited from terminating Medicaid or CHIP enrollment solely because someone is incarcerated. States must suspend coverage instead.5Centers for Medicare & Medicaid Services. CMCS Informational Bulletin – Prohibition on Termination of Enrollment Due to Incarceration The rule applies to adults and juveniles, in jails and prisons, regardless of sentence length.
The practical effect is significant. When coverage is suspended, the state still has your eligibility information. Reactivation after release can happen in days rather than the weeks or months a new application would take. You don’t have to re-gather documents and prove eligibility from scratch at a moment when you may have no fixed address and limited access to records.
Getting Medicaid Active After Release
If your Medicaid was suspended during incarceration — which, as of 2026, should be the case everywhere — reactivation happens once the state Medicaid agency receives notice of your release. The speed depends on how fast the jail or prison communicates with the agency. Some states can reactivate coverage within 24 hours. Others take up to 30 days.6MACPAC. Access to Medicaid Coverage and Care for Adults Leaving Incarceration
If you weren’t enrolled before going in, or you need to file a new application for any reason, you can apply online through your state’s Medicaid portal, by phone, by mail, or in person at a local social services office. You’ll generally need your name and date of birth, a mailing address, proof of income (or a statement that you have none), proof of residency, and a Social Security number. Missing documents shouldn’t stop you from applying — submit the application and provide supporting documentation later.
Applying Before You Get Out
You don’t have to wait until release day. Filing an application while still incarcerated lets the state determine your eligibility in advance so coverage is ready when you walk out. If your facility has a reentry coordinator or social worker, they can usually help with the paperwork.
Presumptive Eligibility
A small number of states use presumptive eligibility to give people leaving incarceration immediate, temporary Medicaid coverage based on a quick self-reported income assessment.6MACPAC. Access to Medicaid Coverage and Care for Adults Leaving Incarceration The coverage is temporary, and you still need to complete a full application to keep it, but it closes the dangerous gap between release and full enrollment for people who need medications or treatment right away.
Pre-Release Services in Some States
Eighteen states have gone beyond suspension and now provide Medicaid-funded services to incarcerated people during the 30 to 90 days before their expected release date. These programs run under Section 1115 demonstration waivers approved by CMS, and they include Arizona, California, Colorado, Hawaii, Illinois, Kentucky, Maryland, Massachusetts, Montana, New Hampshire, New Mexico, North Carolina, Oregon, Pennsylvania, Utah, Vermont, Washington, and West Virginia. More states have applications pending.7Medicaid.gov. Reentry Section 1115 Demonstrations
Every reentry demonstration must include at minimum:
- Case management: assessment of physical health, behavioral health, and social needs, plus help scheduling post-release appointments and connecting with community providers.
- Medication-assisted treatment for substance use disorders, including counseling.
- A 30-day supply of prescription medications at the time of release so there is no gap in treatment.
States can also request approval to cover services like hepatitis C treatment, family planning, and peer support for behavioral health.7Medicaid.gov. Reentry Section 1115 Demonstrations If you’re in one of these states, ask your case manager or reentry coordinator about enrolling in the pre-release program.
What Medicaid Covers Once It’s Active
Once your coverage is on, it works the same as it does for anyone else on Medicaid. Specifics vary by state, but the program generally covers doctor visits, hospital care, prescription medications, mental health and substance use treatment, lab work, and preventive screenings. Medicaid is the single largest payer for mental health and substance use disorder services in the country, which matters for many people leaving incarceration.
If you were receiving medication-assisted treatment for opioid use disorder or medications for a chronic condition while incarcerated, getting coverage reactivated quickly is essential to avoid a lapse. Ask your reentry coordinator to help connect you with a community provider before your release date, especially in a state with a reentry waiver that covers that transition planning.