How To Transfer Medicaid To Another State

What happens if you and your family travel to another state? As a family caregiver, you should understand how to maintain Medicaid coverage for yourself or your loved one when moving to a new state. Proper planning and following the correct procedures can help avoid lapses in coverage. Medicaid benefits obtained in one state may not automatically transfer when relocating across state lines.

Can I use my Medicaid coverage in a different state?

Medicaid gives health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, older adults, and people with disabilities. This federal program represents a significant part of state and federal budgets. The program can vary significantly between states since Medicaid has joint federal and state administration. 

Medicaid coverage obtained in one state may not transfer automatically when moving across state lines. Family caregivers who depend on Medicaid for themselves or those they care for must understand how to maintain benefits when relocating.

Exceptions for limited cross-state Medicaid coverage

Each state runs its own Medicaid program within federal guidelines. So, in general, Medicaid benefits are state-specific. There are a few exceptions that allow limited cross-state Medicaid coverage:

• Children enrolled in Medicaid can get care from providers in other states as long as the provider accepts Medicaid from the child's home state. This allows continuity of care when traveling or temporarily out of state.
• Some states have reciprocal agreements with neighboring states to cover medical services received by border residents of the partner states.
• Medicaid may pay for emergency and urgent care obtained out of state, though routine care accessed across state lines typically does not qualify for reimbursement. 
• When permanently moving between states, Medicaid recipients can request a temporary Medicaid plan to prevent a gap in coverage during the transition period.

Beyond these exceptions, Medicaid coverage does not carry over when crossing state borders. Those relocating must apply for Medicaid based on the new state's eligibility rules and begin coverage under that state's program.

What about Home and Community Based Services waivers?

Still receiving long-term care benefits when relocated is more complicated for those on a Home and Community Based Services (HCBS) Medicaid Waiver. Medicaid waivers allow individuals to receive long-term care services in various settings, preventing the need for nursing home placement. 

Transferring HCBS Medicaid Waiver services is complicated because each state has its own waivers, and the services may not align. For instance, some states have Assisted Living Waivers, while others do not. This means that someone receiving services in one state may not have a comparable waiver in another state. Unlike State Medicaid Plans, Waivers have a cap on participants. Once all slots are filled, a waiting list forms. If there is a comparable waiver, your loved one will need to reapply for that waiver, and/or there may be a waiting list for benefits.

Research to find out if a comparable Waiver is available, if there is a waiting list, and the wait time. If there is no comparable Waiver or the waiting time is long, you may have to apply for State Plan Medicaid benefits and live in a nursing home until Waiver services are available. Professional Medicaid Planners can assist in such situations.

Learn about the different types of Medicaid waivers >>

How to apply for Medicaid in another state

Since Medicaid varies by state, getting covered in a new state involves submitting a complete application, just like applying for the first time. Here are the key steps:

1. Verify your care recipient qualifies for Medicaid in the new state based on income and asset limits. Eligibility criteria differ, so check the rules even if they had Medicaid before. Use online tools to check what categories your care recipient may qualify under.
2. If required, select a Medicaid-managed care plan from the options available in your county. Review provider networks, prescription formularies, quality ratings, and benefits to choose the best fit.
3. Submit a Medicaid application through the marketplace in the new state or directly to the state Medicaid agency online, by paper form, by phone, or in person.
4. Provide all documentation to prove state residency, identity, income, household size, and other eligibility factors. The required paperwork may be extensive. 
5. Complete an in-person or phone interview if the state agency requests to clarify application details. 
6. After applying, wait for a determination of eligibility and enrollment in a health plan if applicable. This process can take over 45 days. Check status periodically.

Once approved, obtain new Medicaid ID cards and use coverage through the new state's program. Notify the prior state Medicaid agency to terminate previous benefits.

How long does it take to apply for Medicaid in a new state?

The time it takes to get approved for Medicaid in a new state can vary depending on several factors, including the state's specific Medicaid policies and procedures, the completeness of the application, and the volume of applications being processed.

After applying, it can take between 15 and 90 days to get a letter of approval. Be sure to submit a complete and accurate application to avoid delays.

Many states offer retroactive Medicaid coverage, meaning you can receive coverage for medical services before your application's approval, though you may need to pay out-of-pocket for services until the retroactive coverage begins.

Transferring Medicaid when relocating

Family caregivers must reapply based on new state rules to transfer benefits across state lines. Planning avoids problems. Check eligibility early and have the paperwork ready. Pick the right health plan and coordinate care in the new state. Keeping the same care keeps your loved one healthy. 

While bureaucracy makes transferring Medicaid challenging, being prepared helps it go smoothly. With advanced preparation, family caregivers can maintain crucial benefits during relocation. Even with challenges, switching states is possible.