V Incarcerated

Revised 12/17/2024

Policy

A change in the status of an inmate can affect a customer’s eligibility.

1) Customer is reported as incarcerated

In general, AHCCCS cannot pay for any services while a person is incarcerated. When a change is reported that a customer is incarcerated, eligibility will continue, and enrollment will be suspended.

2) Customer is released from incarceration

In general, benefits will resume on the day the customer released.

Exception:

Eligible juveniles may receive certain AHCCCS services in the 30-day period prior to release, see MA1302D for more information.

Definitions

Term	Definition
Eligible Juveniles	A person who become incarcerated while enrolled in Medicaid or are determined eligible for Medicaid while incarcerated and is: Under 21 years of age or Former foster youth up to the age of 26
Inmate of a Penal Institution	A person who is: An inmate in a federal or state prison; An inmate of a county, city, or tribal jail; An inmate of a prison or jail, prior to arraignment, conviction, or sentencing; Incarcerated but can leave prison on work release or work furlough, and must return at specific intervals; A child in a juvenile detention center due to criminal activity or held as a material witness; A person involuntarily placed in a secure treatment facility that is part of the criminal justice system.
Not an Inmate of a Public Institution	A person who is: After arrest, but before booking, escorted by police to a hospital for medical treatment and held under guard; Voluntarily living in a public institution; Released on probation, parole, or a release order with the condition of home arrest, work release, community service, or medical treatment; or Admitted as an inpatient to a medical institution; A child held in a juvenile detention center for the care, protection, or in the best interest of the child, if there is a specific plan for that person that makes the stay at the detention center temporary; A child on intensive probation with the condition of home arrest, treatment in a psychiatric hospital, or a residential treatment center, or outpatient treatment; A child in a juvenile detention center after disposition when there is a plan to release the child to the community, and the release is only pending arrangements suitable to the child’s needs.
Public Institution	An institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control. The term “public institution” does NOT include: Medical institutions; Intermediate care facilities; Publicly operated community residence that serves no more than 16 residents; or State-licensed child care institutions for foster children that house no more than 25 children.
Voluntarily living in a public institution	Living in a public institution by choice, not as an extension of incarceration. The person is free to leave the institution if he or she chooses.

Proof

Proof of incarceration includes:

The customer’s statement;
Electronic records of incarceration from the Arizona Department of Corrections Rehabilitation and Reentry (ADCRR) or a county jail;

NOTE When the customer’s statement conflicts with other information or proof, the detention facility is contacted to confirm the person’s status.

Programs Affected

This applies to all programs.

Timeframes

Changes must be reported as soon as the future event becomes known. Unanticipated changes must be reported within 10 calendar days of the date the change occurred.

Programs and Legal Authorities

Program

Legal Authorities

All Programs (except KidsCare)

42 CFR 435.1009 and 1010

42 CFR 435.916

AAC R9-22-310

AAC R9-28-406

AAC R9-22-1915

AAC R9-22-2003

KidsCare

42 CFR 457.310 (c)(2)(i)

42 CFR 457.343

ARS 36-2983(G)(4)

AAC R9-31-303(9)