Medical Care levels in Federal Prison

U.S. federal prisons provide essential medical care, dental care and mental health care to prisoners across the country. However, the level of care varies from institution to institution, depending on the medical care level of the institution.

Below is a breakdown of the various medical care levels in the Federal Bureau of Prisons.

Note: Private federal prisons have their own medical care levels. Please refer to the individual private prisons, or review the private prison websites for more information.

For more information on general medical and dental care in federal prisons, see our Medical and Dental Care in Prison page.

Medical Care Levels Overview

Medical Care Level 1 inmates are less than 70 years of age with limited medical needs easily managed by clinical evaluations every six months. Conditions include mild asthma, diet-controlled diabetes, and stable HIV-patients not requiring medication.

Care Level 1 inmates with mental health conditions are stable, requiring health services appointments no more than every six months. More acute services requiring crisis intervention are short-lived, occurring no more than every two years, and are resolved without hospitalization.

Medical Care Level 2 inmates are stable outpatients requiring quarterly clinical evaluations.  Medical consultation or evaluation may be required from time-to-time, but are not regularly needed. Conditions include medication-controlled diabetes, epilepsy, or emphysema.

Care level 2 inmates with mental health conditions are managed through health services appointments no more than monthly to quarterly. More acute services requiring crisis intervention are short-lived, occurring no more than every two years, and are resolved without hospitalization.

Medical Care Level 3 inmates are fragile patients requiring frequent clinical contact, daily to monthly, to avoid hospitalization for catastrophic events.  They may require assistance with daily activities, such as bathing, dressing, or eating – but do not require daily nursing care. Conditions include cancer, advanced HIV disease, severe mental illness, severe congestive heart failure, and end-stage liver disease, which may periodically require hospitalization.

Care level 3 inmates with mental health conditions may periodically require stabilization through hospitalization.

Medical Care Level 4 inmates require significantly enhanced medical and limited inpatient services only provided by a BOP Medical Referral Center (MRC). Conditions include cancer on active treatment, dialysis, quadriplegia, stroke or head injury patients, major surgical treatment, and high-risk pregnancy.

Care level 4 inmates with mental health conditions are acute or chronic, resulting in severe impairment of functioning, and requiring 24-hour treatment through nursing care or assistance.

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