The primary goal was to describe the health care coverage of detained youth. An exploratory second goal was to describe the possible relationship between redetention and coverage. Health care coverage status was abstracted from electronic detention center records for 1,614 adolescents in an urban detention center (October 2006 to December 2007). The majority of detained youth reported having Medicaid coverage (66%); 18% had private insurance and 17% had no insurance. Lack of insurance was more prevalent among older, male, and Hispanic youth. A substantial minority of detained youth were uninsured or had inconsistent coverage over time. While having insurance does not guarantee appropriate health care, lack of insurance is a barrier that should be addressed to facilitate coordination of medical and mental health care once the youth is released into the community.