Medicaid State-to-State Transfer Rules
Overview of Rules
Much to the surprise and dismay of many, Medicaid coverage and benefits cannot be simply switched from one state to another. While Medicaid is often thought of as a federal program, each state is given the flexibility to set their own eligibility requirements. Therefore each state evaluates its applicants independently from each other state. Those wishing to transfer their coverage must re-apply for Medicaid in the new state.
Further complicating matters is the fact that someone cannot be eligible for Medicaid in two states at the same time. Therefore, in order to apply for Medicaid in a new state, the individual must first close out their Medicaid coverage with the old state.
Having given these warnings, it should be mentioned that while this process is difficult, it is not impossible and there is some good news. Even though each state has different eligibility requirements for Medicaid, usually their income and assets limits are very similar. Most people who are financially eligible in one state can qualify in their new state with little or no re-structuring of their finances. More good news is that, relatively speaking, the Medicaid application, review and approval process is fairly quick. Depending on the state, it will usually take between 15 - 90 days to receive a letter of approval. Finally, Medicaid coverage is frequently made retroactive to the date of application.
Recommended Process for Transferring Medicaid
To limit the challenges associated with moving from one state to another while under Medicaid coverage, the following steps are recommended.
1) Determine the new state's Medicaid eligibility requirements for your coverage group well in advance of the move.
2) Work with a Medicaid planning professional
to ensure the applicant is eligible in the new state and prepare all the necessary paperwork for application prior to moving
3) Be aware that the applicant will very likely have to pay out-of-pocket for their care for several weeks or months. Therefore, applicants should find affordable care in their new state of residence prior to making the move. Usually they can be reimbursed by Medicaid but know that the Medicaid reimbursements rates are not high, therefore it is important to find affordable care
4) Time the move around the end of the month. In some states, it takes until the end of the month to end Medicaid coverage regardless of the date on which the individual notified their Medicaid office that they will be moving. Since one cannot be covered by Medicaid in two states concurrently, one's coverage must end in the old state, before the application can be submitted in the new state.
5) Submit the application in the new state immediately upon making the move to the new state.
Transferring Medicaid when on HCBS or 1915 Waivers
While transferring Medicaid from state to state is difficult, it is even more challenging for those individuals who are receiving Home and Community Based Services through a Medicaid Waiver program.
Medicaid Waivers are programs that allow individuals who would typically require nursing home care to receive care services at home, in assisted living residences and in adult day care. Each state has its own set of Medicaid Waivers and very often these do not align with waivers in other states. For example, some states do not have assisted living waivers
. Furthermore, Medicaid Waivers are not entitlements. There are usually a limited number of spaces available for any one waiver and long wait lists or Interest Lists can exist. Therefore, an individual wishing to transfer from one Medicaid Waiver in one state to a similar program in a new state may find there is no comparative program or may be required to spend months or even years on a waiting list for services.
Individuals on Medicaid Waivers need to think very carefully about making a move from one state to another. Furthermore, they should be aware that an extended stay in a nursing home may be necessary as they move from a Medicaid Waiver to regular Medicaid and are wait-listed for the new state's Medicaid Waiver.
Page Reviewed / Updated - Feb. 2013