Oregon Oregon Health Authority, Health Systems Division: Medical Assistance Programs

Rule Rule 410-200-0140
Eligibility for Inmates

(1) An inmate of a public institution is not eligible for HSD Medical Program benefits, except for individuals residing in an Institution for Mental Disease (IMD), including the Oregon State Hospital, who are:
(a) Under age 21;
(b) Age 21 if they were admitted to the IMD before their 21st birthday; or
(c) Age 65 or older.
(2) If an HSD Medical Program beneficiary becomes an inmate of a public institution, medical benefits shall be suspended for the duration of the incarceration period.
(3) The effective date of the suspension of benefits is the day following the date on which the individual became incarcerated.
(4) Suspended benefits shall be restored to the release date without the need for a new application when:
(a) The individual reports their release to the Agency within ten calendar days of the release date;
(b) The individual reports their release to the Agency more than ten calendar days from the release date, and there is good cause for the late reporting; or
(c) The inmate is released to a medical facility and begins receiving treatment as an inpatient with an expected stay of at least 24 hours, providing the facility is not associated with the institution where the individual was an inmate.
(5) Once benefits are restored as described in section (4):
(a) If the individual is released prior to their eligibility renewal date, the eligibility renewal date will be maintained; or
(b) If the individual is released after the eligibility renewal date has passed, benefits shall be restored and a redetermination of eligibility processed.

Last accessed
Jun. 8, 2021