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 when you are no longer an inmate (for adults, "to the extent permissible under federal law"). 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 unless required by federal law, they become otherwise ineligible, or the inmate's suspension of benefits has ended" under the Welfare and Institutions Code.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 FDA-approved drugs for alcohol and other non-opioid substance use disorders; 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, "as clinically appropriate."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 release, or not later than one week (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 Separately — and since 2018, under the SUPPORT Act — a child's Medicaid 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 told states to ensure their implementation processes "do 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 — except transitional rent, which every plan must offer from 1 January 2026 — and optional for members to accept.¹¹ They are worth asking about. Apart from transitional rent, 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 delivery systems 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, in counties with a Drug Medi-Cal Organized Delivery System, the substance use plan 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, as described in CMS State Health Official letter SHO #24-004 (23 July 2024) — mandatory screening, diagnostic and targeted case management services for eligible juveniles "in the 30 days prior to release (or not later than one week, or as soon as practicable, after release from the public institution)," effective 1 January 2025; and the instruction that state processes "do not effectuate a delay of an individual's release or lead to increased involvement in the juvenile and adult justice systems" — medicaid.gov. The suspend-not-terminate, redetermination and restoration rules for Medicaid-eligible juveniles are older: 42 U.S.C. §1396a(a)(84), added by the SUPPORT for Patients and Communities Act, Pub. L. 115-271 §1001 (24 October 2018) — govinfo.gov.
- Department of Health Care Services, CalAIM Justice-Involved Initiative policy and operational guide (October 2023 edition; a 2026 revision was not retrievable at verification) — the pre-release eligibility of all youth under 21 and former foster youth under 26. The statement that EPSDT-equivalent screening is limited to those under 21 and the 1 October 2024–30 September 2026 implementation window could not be re-verified against the current guide on 12 September 2026 and are held pending legal review.
- 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, Community Supports Policy Guide, Volume 1, updated April 2025 — "Community Supports—with the exception of Transitional Rent, which is mandatory for MCPs to offer beginning January 1, 2026—are optional for MCPs to offer and for Members to utilize" — 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 23-059, 8 November 2023 — behavioral health links from correctional facilities to county Medi-Cal behavioral health delivery systems; and Behavioral Health Information Notice 24-001, 21 December 2023 — for Drug Medi-Cal Organized Delivery System plans, "All DMC-ODS plans shall have a 24/7 toll free number," the 14-days-before-release referral duty, and implementation of all BH Link components "by October 1, 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.
While still inside: Can my relative get psychiatric care in county jail? →