Medicaid Coverage for Incarcerated Individuals

 
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Medicaid & Long-Term Care
 
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What you need to know

​​​​​​​​​​​​​​Nebraska Medicaid seeks to improve health outcomes for individuals transitioning out of public institutions. In Nebraska, a public institution is a facility where individuals are involuntarily held under law enforcement authority, such as juvenile detention centers, adult jails and lockups, and correctional institutions.

Federal law generally prohibits Medicaid from covering services for individuals who are inmates of public institutions. An exception exists for individuals admitted to a medical institution for over 24 hours. Section 5121 of the Consolidated Appropriations Act of 2023 introduced a new exception for youth and young adults transitioning from from public institution, allowing Medicaid to cover specific services during the 30-day period preceding release from the facility​.


Medicaid Services for Youth and Young Adults in Carceral Settings – Beginning October 19, 2025

In accordance with Section 5121 of the Consolidated Appropriations Act of 2023, Nebraska Medicaid will begin offering a limited set of health services to qualifying youth and young adults held in public institutions, starting October 19, 2025.

In the 30 days prior to an individual's release from a public institution (or as soon as practicable after their release), Nebraska Medicaid will coordinate with the public institution to provide targeted case management, screenings and diagnostic services which meet reasonable standards of medical and dental practice. ​

In the 30 days prior to an individual's release from a public institution, and for at least 30 days following their release, Nebraska Medicaid will continue to provide targeted case management.

For more information, see Services for Eligible Incarcerated Youth and Young Adults below. ​



Enrollment Assistance for Incarcerated Individuals

Nebraska Medicaid provides assistance with Medicaid applications for individuals who are pending release from a covered public institution, in accordance with Nebraska Revised Statute 47-706​. 

Nebraska Medicaid provides enrollment assistance to incarcerated individuals in covered facilities who request this assistance prior to their release. Any incarcerated individual can opt out of enrollment assistance and/or decline to apply for Medicaid. ​​

Covered Facilities include the following: 

  • State Facilities: 
    • DCS Community Corrections Center – Omaha
    • DCS Omaha Correctional Center
    • DCS Nebraska Correctional Center for Women – York
    • DCS Tecumseh State Correctional Institution
    • DCS Work Ethic Camp – McCook
    • DCS Reception and Treatment Center – Lincoln
    • DCS Nebraska State Penitentiary – Lincoln
    • DCS Community Corrections Center – Lincoln
    • DCS Nebraska Correctional Youth Facility – Omaha 
  • County Facilities: 
    • Douglas County Youth Center
    • Douglas County Department of Corrections
    • Douglas County Department of Corrections-Criminal Justice Center
    • Lancaster Youth Services Center
    • Lancaster Department of Corrections
    • Sarpy Juvenile Justice Center
    • Sarpy Department of Corrections​

Services for Eligible Incarcerated Youth and Young Adults

Beginning October 19, 2025, Nebraska Medicaid offers a limited set of health services to qualifying young adults who are transitioning out of public institutions, in accordance with Section 5121​ of the Consolidated Appropriations Act of 2023.

​Who Qualifies: 

To receive pre-release services, individuals must:

  • Be under 21 years old and enrolled in any Medicaid group, or be between 18–26 years old and part of the Former Foster Care (FFC) group, and
  • ​Be incarcerated in a public institution, adjudicated, and within 30 days of community release.

Services Covered During the 30-Day Pre-Release Period:

  • Targeted Case Management (TCM): Includes comprehensive needs assessments, creation of individualized care plans, coordination of services, and follow-up.
  • Screening and Diagnostic Services: Services for those under 21 follow the guidelines by the American Academy of Pediatrics, and include medical, behavioral, dental, and vision screenings. Immunizations must follow CDC guidelines.
  • Immunizations: Administered based on the CDC's recommended schedule.
  • Diagnostic Testing: Provided when screenings indicate a medical necessity for further evaluation.

Services Covered During the 30-Day Post- Release Period:

  • Targeted Case Management (TCM): Includes comprehensive needs assessments, creation of individualized care plans, coordination of services, and follow-up.​​

Frequently Asked Questions

Information for Providers and Health Plans