Two things changed here that most people leaving custody have never been told. The first is that Medi-Cal is no longer terminated when you go in — it is suspended, and the suspension ends the day you are no longer an inmate. The second is that California is building a benefit that starts care before release rather than after. That second one is real but uneven, and this page is careful about which is which.
Your coverage was suspended, not cancelled
Since 1 January 2023, if you were a Medi-Cal beneficiary when you became an inmate, your benefits are suspended effective that date — and the suspension "shall end on the date the individual is no longer an inmate of a public institution, if otherwise eligible."¹ Separately, the Penal Code says a county jail inmate enrolled in Medi-Cal "shall remain eligible for, and shall not be terminated from, the program due to their incarceration."²
The old one-year cap is gone. Under the prior rules, suspension ended at one year, after which coverage was actually terminated and people came out with nothing. From January 2023 there is no time limit — the suspension runs until release.¹
Be clear-eyed about what suspension means while you are inside: the statute says services "shall not be available to inmates of public institutions whose Medi-Cal benefits have been suspended."¹ The exceptions are inpatient hospital care, the pre-release benefit below, and certain services for people under 21.
Somebody is supposed to help you apply
Since 1 January 2023, every county board of supervisors must designate an entity to help county jail inmates apply for or enrol in coverage, and — in consultation with the chief probation officer — to do the same for young people in county juvenile facilities.³ The fact that an applicant is an inmate "shall not, in and of itself, preclude a county human services agency from processing an application."³
There is also a mandatory behavioural health handoff. The state was required to develop and implement "a mandatory process by which county jails and county juvenile facilities coordinate with Medi-Cal managed care plans and Medi-Cal behavioral health delivery systems to facilitate continued behavioral health treatment in the community" for people who were receiving behavioural health services before release.³
The reentry benefit — what it is, and where it exists
California was approved in January 2023 to provide targeted Medi-Cal services for up to 90 days before an expected release date.⁴ The state statute frames the same window.⁵ The approved package includes:⁴
- case management in the facility
- physical and behavioral health clinical consultation, in person or by telehealth
- laboratory and radiology services
- medications and medication administration, including medication-assisted treatment for all types of substance use disorder, with counselling
- community health worker and navigator services
- on release, prescribed and over-the-counter medications — a minimum 30-day supply — and durable medical equipment
Where it exists is the catch. This rolls out facility by facility. The first jails and youth facilities went live on 1 October 2024; every state prison went live on 1 February 2025. As of the state's own January 2026 count, 64 facilities were live — all 31 prisons, 21 jails and 10 youth correctional facilities.⁶ **All remaining county facilities must go live by 1 October 2026.**⁶ The state's public roster was last updated in June 2026 and lists scheduled dates, most of them 10/1/2026 — so we cannot tell you from a document whether your county jail is live today. Ask.
For facilities that do participate, the medication rules are strict. To go live, a facility must offer at least one agonist medication — methadone or buprenorphine — plus all approved drugs for alcohol use disorder; have protocols for starting treatment during incarceration for people not previously on it; continue any agonist medication prescribed in the community for the duration of incarceration; offer naloxone and instructions on its use to everyone at release regardless of any opioid history; and provide a full supply of active medications in hand at release with a refill in place.⁷
A note on scope: we could not find a California statute requiring every jail and prison to offer medication for addiction treatment. What is verified is that these are conditions of participating in the reentry programme — binding on participating facilities.
For young people, part of this is a federal mandate
Federal law now requires, for an eligible person under 21 (and for former foster youth up to 26), screening and diagnostic services meeting reasonable standards — including behavioural health screening — in the 30 days before a scheduled release or as soon as practicable after, plus targeted case management including referrals, for 30 days before and at least 30 days after release. These provisions took effect 1 January 2025.⁸ Children's coverage may be suspended but not terminated, must be redetermined before release, and must be restored on release without a new application.⁸ The federal agency also stated that implementation "must not effectuate a delay of an individual's release."⁸
In California, screening and diagnostic services equivalent to the full children's benefit are available only to people under 21.⁹ What that benefit is, and how much wider it is than the adult one →
After release: care management you may qualify for
"Individuals Transitioning from Incarceration" is a defined population for Enhanced Care Management — community-based, interdisciplinary care management through a Medi-Cal managed care plan. An adult qualifies if they are leaving, or left within the past 12 months, a correctional facility and have at least one of: a mental illness, a substance use disorder, a chronic or significant condition, an intellectual or developmental disability, a traumatic brain injury, HIV, or is pregnant or postpartum. For people under 21 — and former foster youth 18 to 26 — no additional condition is required.¹⁰ Everyone who received pre-release services is eligible for it.¹⁰
One honest distinction: Enhanced Care Management is a plan benefit; "Community Supports" are not. Housing navigation, housing deposits, recuperative care, sobering centres and the rest are optional for plans to offer and optional for members to accept.¹¹ They are worth asking about. They are not something you can demand.
If none of this happened, here is day one
Call the county behavioral health line. It is a separate door and it does not depend on the reentry programme having worked. For an adult, county specialty mental health opens on a significant impairment or a probable significant deterioration, plus a diagnosed or suspected disorder.¹² For anyone under 21, having ever been detained or committed to a juvenile justice facility is itself a qualifying pathway — no diagnosis required.¹² Your county's line →
Ask for the "behavioral health link." County behavioral health agencies were required to be ready to receive these links, which connect someone to a community provider within 14 days before release.¹³ If yours was never made, say the words.
Get the suspension lifted. It ends by operation of law on release, but it is processed by the county human services agency — and incarceration alone is not a reason to refuse to process an application.¹ ³
If drug or alcohol treatment is the need, the county's substance use system must run a 24/7 toll-free number for people seeking services.¹³
Do this: on the day you get out, call two numbers — the county behavioral health access line and the county human services agency — and use these words: "I was released on [date], my Medi-Cal was suspended and should now be active, and I need a behavioral health appointment." If you were told about a discharge plan inside, ask for a copy of it. And if you left with a prescription and no refill, that is exactly what the participating-facility rules were written to prevent; say so.
Sources
- Welfare & Institutions Code §14011.10(a), (e)(1)–(2) and (g), as amended by SB 184 (Stats. 2022, Ch. 47), effective 30 June 2022 — suspension effective the date a person becomes an inmate, ending "on the date the individual is no longer an inmate of a public institution, if otherwise eligible," and the statement that suspended benefits are not available in custody. The one-year suspension cap applied only through 31 December 2022 — leginfo.legislature.ca.gov. Federal basis at 42 C.F.R. §§435.1009–435.1010.
- Penal Code §4011.11(c) — leginfo.legislature.ca.gov.
- Penal Code §4011.11(h)(1), (e) and (h)(5)(A).
- Centers for Medicare & Medicaid Services approval of California's section 1115 demonstration amendment, 26 January 2023, authorising pre-release services "for up to 90 days immediately prior to the individual's expected date of release from a participating state prison, county jail, or youth correctional facility," and listing the covered services and the minimum 30-day medication supply on release — medicaid.gov. Federal framework: CMS State Medicaid Director letter SMD #23-003, 17 April 2023.
- Welfare & Institutions Code §14184.800(a)–(b), added by AB 133 (2021) and amended by SB 184 (Stats. 2022, Ch. 47) — leginfo.legislature.ca.gov.
- Department of Health Care Services justice-involved reentry initiative materials, January 2026 — 31 prisons, 21 jails and 10 youth correctional facilities live, and "all remaining county correctional facilities must go-live with the JI Reentry Initiative by October 1, 2026." The department's go-live roster was last updated 11 June 2026 and publishes scheduled dates — dhcs.ca.gov. CMS's October 2024 approval provides for phase-in "beginning as soon as October 2024 and no later than October 2026."
- Department of Health Care Services, Justice-Involved Reentry Initiative correctional facility readiness assessment, revised January 2026 — the medication-assisted treatment conditions a facility must meet to go live, including naloxone at release "regardless of any history of OUD."
- Consolidated Appropriations Act, 2023, §§5121–5122, as described in CMS State Health Official letter SHO #24-004 — mandatory screening, diagnostic and targeted case management services for eligible juveniles, effective 1 January 2025; suspension rather than termination of children's coverage, redetermination before release, and restoration without a new application — medicaid.gov.
- Department of Health Care Services, CalAIM justice-involved policy and operational guide — screening and diagnostic services equivalent to the children's benefit are available only to those under 21, and California implements the federal juvenile provisions across all facilities from 1 October 2024 to 30 September 2026.
- Department of Health Care Services, CalAIM Enhanced Care Management policy guide, updated January 2026 — the "Individuals Transitioning from Incarceration" population of focus, its adult and youth criteria, and the statement that all members who received pre-release services are eligible. Managed care requirements at All Plan Letter 23-032.
- Department of Health Care Services All Plan Letter 21-017 (revised), 1 March 2022 — "Community Supports are optional services for MCPs to provide and are optional for managed care Members" — dhcs.ca.gov.
- Department of Health Care Services Behavioral Health Information Notice 26-002, 20 January 2026 — the access criteria county behavioral health plans apply, including juvenile justice involvement as a standalone pathway for members under 21.
- Department of Health Care Services Behavioral Health Information Notice 24-001 — the requirement that substance use plans maintain a 24/7 toll-free number, and behavioral health links to community providers within 14 days before release, with county readiness assessments due 1 April 2024.
Read on the statutes, federal approvals and state guidance on 18 August 2026. One caution on durability: the federal approval for California's pre-release services runs through 31 December 2026, and a renewal had not been confirmed when this page was written. This page describes the rules; it is not legal advice.