Can Medicaid Be Transferred From State To State

Date:

Effective Date Of Coverage

Does Medicaid Automatically Transfer if I move to another State?

Once an individual is determined eligible for Medicaid, coverage is effective either on the date of application or the first day of the month of application. Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.

How To Transfer Medicaid Between States

Using Medicaid Out of State

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You might be wondering if you can usde your Medicaid coverage in any state? The answer is No. Because each state has its own Medicaid eligibility requirements, you can’t just transfer coverage from one state to another, nor can you use your coverage when you’re temporarily visiting another state.

Should a beneficiary need to be admitted to a hospital in another state or if he must receive essential, regular psychiatric care or medications from an out-of-state provider, the home state will not pay for the services through Medicaid. In these situations, a caregiver or other family member is often required to sign an agreement to pay for the services before the person with special needs can receive care.

How long does it take to transfer Medicaid to another state?

Technically, there’s no formal program or option that allows you to transfer your Medicaid coverage from one state to another. Therefore, if you’re relocating, you’ll need to re-apply for Medicaid in the state you’re planning to reside in.

A common concern is the lapse of benefits between canceling ones Medicaid plan in their original state and reapplying in the state in which they are relocating.

You can also consider hiring aTexas Elder Law Attorney specializing in Medicaid planning to help with the process.

Application Process

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What Is The Highest Income To Qualify For Medicaid

Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.

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Switching Medicaid To Your New Home

During your reapplication process, youll be working with a Medicaid caseworker in your new state of residency. When your caseworker determines that your Medicaid coverage has been closed in your previous state, your new application is ready for processing. Whether you are re-applying for Medicaid benefits online or in person, youll need to have all of the required documents on hand before filling out your application. This ensures that the process goes quickly and smoothly.After applying for Medicaid benefits, you should get your letter of approval within 15 to 90 days. In most instances, when applicants meet the states Medicaid eligibility requirements, their requalification date is the date of application and coverage is retroactive. This means that your medical care should still be eligible for coverage during the time between closing your old account and opening your new account.

It would be a good idea to check with the Medicaid office in your new state to find out exactly how long this retroactive period covers before closing out your old account.

Tips For Transferring Medicaid Services To A New State

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If youre about to move to a new state and need to get Medicaid benefits there, keep the following points in mind:

1. Research eligibility requirements: Before you move to a new state, cancel your current benefits, or apply for new ones, do as much research as you can. Find out what your new state requires for eligibility and how you can gather the information necessary to prove youre qualified. There are many different types of Medicaid, so youll need to look at the specific type you need in your new state.

2. Think about timing: The specific time of month you decide to move and apply can impact the outcome of your application. For example, some programs wont close your coverage until the month ends. And youre not allowed to get benefits in two states at once. So, planning when to cancel your benefits accordingly is the wisest course of action.

Check into the average processing times for the specific program you need. If youre pregnant, for example, you can typically get a shorter waiting period than other applicants.

3. Get a Functional Assessment: States use a functional assessment process to gain information on your needs and health status. They use this information to determine whether youre eligible for Medicaid-covered care and services. Have a functional assessment done in the state youre moving to. Depending on how serious your health condition is, finding out that youre ineligible in a new state may change your moving plans.

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Medicaid Benefits Do Not Transfer From State To State

If Medicaid is paying for all or part of your loved ones nursing home costs, a move to another state will be more challenging than if she is a private-pay resident. This is because Medicaid programs are administered on a state level, and there is no option for transferring coverage from one state to another. In fact, under federal law, you cannot be eligible for Medicaid in two states at the same time. Steps for moving to a nursing home in a new state include:

  • Locate a nursing home in the new state. You will need to find a facility that has open Medicaid beds and apply for admission. It would also be smart to review the Medicaid requirements in the new state because, even though federal law regulates Medicaid programs, each state sets its own requirements, and you want to be sure your loved one will qualify.
  • Dis-enroll from Medicaid. You will have to close out your loved ones coverage in the state she is leaving before you can apply in a new state. Ideally, you will time the move for the end of a month because thats when her coverage will end once its canceled.
  • Move to the new nursing home. Once your loved one is in the new facility, she can apply for Medicaid in that state. The nursing home should be able to help with the application process. It can take up to 90 days to get approval, but Medicaid benefits are retroactive, so any unpaid, qualified medical expenses during this retroactive period will be covered.

Tips For Moving To Another State With Medicare

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If youre moving to another state with Medicare, youre going to want the best tips! Before relocating, you might want to learn more about how Medicare works in your new state. Also, you may want to prepare yourself for a change in premium or coverage options depending on your current policy.

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Know The Law Regarding Medicaid Transfers

The eligibility rules for Medicaid’s old-age and nursing home coverage can affect the validity of some asset transfers, impoverishing you or your loved ones. Knowing the do’s and don’t of asset transfers is essential.

When developing a comprehensive plan to avoid challenges to asset transfers, don’t forget about the federal government and its ability to challenge transfers when administering Medicaid benefits.

Often, transfers of assets also are used to protect assets from the extreme expense of nursing home care. Nursing home care costs $80,000 a year or more in many parts of the country. Therefore, you should be aware of some of the basic issues involved in asset transfers relating to nursing home care.

Just as a creditor can challenge transfers of personal or business assets, the government may challenge transfers of assets if you apply for Medicaid benefits.

Warning

Before transferring any assets, you should always seek professional advice from an attorney or financial advisor. The following information should be used strictly as a guideline. Exemptions can be different depending on the state you’re in and are subject to change. The consequences of making transfers that are not eligible for exemption can be severe and include rendering the applicant ineligible for Medicaid.

Moving Out Of State With Medicaid: State Eligibility Requirements

Medicaid

Although Medicaid is federally funded, each state runs its own Medicaid program and eligibility requirements for Medicaid Long Term Care coverage can change from state to state. The differences in requirements prevents a simple transfer of Medicaid Long Term Care coverage from state to state just because someone was eligible for Medicaid in one state does not mean they will be eligible for Medicaid in another state.

Financial Eligibility

Medicaid Long Term Care is intended for people with limited financial means. In order to be eligible, a person must meet an asset limit and an income limit. The good news for a Medicaid recipient moving from one state to another is that these financial limits are fairly consistent across states generally speaking, the limit is $2,000 for assets and either $841 / month or $2,523 / month for income. So, when a relocating Medicaid recipient is re-applying for Medicaid in their new state, chances are good they will be financially eligible because they were already judged to be financially eligible in their old state.

Functional Eligibility

In addition to meeting financial requirements, many Medicaid Long Term Care applicants are also required to meet a functional requirement. The functional requirement is needing a Nursing Home Level Of Care. However, the definition of Nursing Home Level of Care varies by state, which means functional requirements for eligibility vary by state.

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What Is An Estate

An estate is property, such as money, a house, or other things of value that a person leaves to family members or others when he or she dies. MERP does not apply to all property that a person may own.

Examples of property that the state will not collect on include:

  • Life insurance policies that name a person to receive the payment.
  • Bank accounts that are paid on death to another person.

Are Medicaid Benefits The Same From State To State

Each state administers its own Medicaid benefits, but federal rules require all states to provide certain mandatory services. Examples of mandatory benefits include inpatient and outpatient hospital services, doctor visits, lab and X-rays, home health services and nursing facility services for adults, among other mandatory services. States are also required to cover a more comprehensive set of services for children under age 21.

States can choose to cover additional optional benefits that are not required by federal law. For example, federal rules do not require states to cover prescription drugs, but all state Medicaid programs offer prescription drug benefits. Other common optional benefits include dental care, vision services, hearing aids and personal care services for older adults and people with disabilities.

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How To Obtain New Medicaid Coverage When Moving

If you currently carry Medicaid coverage and youre going to move to a new state, you will need to apply for benefits in the state to which you are moving. Its often best to get this process started as early as possible so that benefits will be available once you establish residency in the new state.

Before you can re-apply for Medicaid in the new state, you must first close out your coverage in your old state of residence. The good news? You can apply for Medicaid as soon as you move because theres no minimum residency time requirement.

A new application will need to be filed in the state to which you are moving, and you will need to meet the states requirements for Medicaid even if you have previously qualified in a different state. Having Medicaid benefits in one state does not guarantee that you will qualify in another state.

To find out if youre eligible for Medicaid in your new state, you can check the states Medicaid program website for information. You can also get in touch with the Medicaid office in the local area where you are relocating.

Will The State Ever Reduce The Amount Owed

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Yes, if you or someone else spends money to maintain your home while you are in a qualified home, these costs can be deducted from the MERP claim. If you or someone else spends money to pay for care that helps you live at home longer before entering a nursing home, those costs for such care provided on or after you become eligible for Medicaid benefits can be deducted as well.

The heirs must have receipts and copies of payments to show what was spent on the person’s home or services when they ask the state to deduct these amounts from the MERP claim. The state may allow deductions from an estate recovery claim for necessary and reasonable expenses, such as:

  • Home maintenance costs, such as real estate taxes, utility bills, insurance, home repairs, and home maintenance expenses, such as lawn care for recipients receiving Medicaid-covered services in a nursing facility.
  • The direct payment of the costs of care provided for a deceased Medicaid recipient that enabled the recipient to remain in his or her home and thereby delayed institutionalization.

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Moving A Nursing Home Resident From One State To Another

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Itâs a fairly common scenario: an older person, whose adult children may live in different states, begins to need more care than they can get at home. The older person and their family make the decision that nursing home care is needed, and a place is selected. Often, itâs near the older personâs home, perhaps in the hope that they will be well enough to move back to their house at some point. Perhaps one of the adult children lives nearby and can visit regularly.

The older person gets settled in long-term care, and time passes. The nursing home resident qualifies for Medicaid assistance to pay for their care. But eventually, it becomes clear that they will need to move to another facility, one in another state. Maybe it becomes clear that they will never be able to live independently in their home again. Perhaps the adult child who had been living nearby got transferred out of state for work, and now there is no family in the area to visit. Maybe the adult children decide that it would be better to have mom or dad closer to one of them in a different part of the country.

Whatever the reason for the move, families need to be aware of the financial implications of moving a nursing home resident across state lines. And if possible, the move should be planned in advance, to ensure the resident qualifies for coverage in the new state as soon as they can and to protect assets from the nursing home.

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) Research both the old states and the new states Medicaid level of care requirements. Sincesome states have a higher level of care need, it may be possible that your loved one will not be eligible.Consider having a loved one assessed medically in the new state before giving up the old statescoverage.

2) If it is determined that a loved one will be medically eligible, then research the new states Medicaidfinancial eligibility requirements well in advanceof the move to make sure a loved one is qualified.

3) Work with a Medicaid planning professional to ensure theapplicant is eligible in the new state and prepare all the necessary paperwork for application beforemoving.

4) Be aware that the applicant will very likely have to pay out-of-pocket for their care for several weeks ormonths. Therefore, applicants should find affordable care in their new state of residence beforemaking the move. Often, they can be reimbursed by Medicaid but know that the Medicaid reimbursementrates are not high. Therefore, it is important to find affordable care providers inthe new state.

6) Submit the application in the new state immediately upon moving to the new state.

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Certain Assets Income Are Exempt From Spend

The following assets generally are exempt from the Medicaid spend-down requirement:

  • $2,000 in cash, stocks or property owned by the applicant
  • If the Medicaid recipient is married, but the spouse is not on Medicare and continues to live in the couple’s home, a “spousal impoverishment allowance” is exempt. The exact amount of the spousal impoverishment allowance is determined by the state. However, the federal government sets minimum and maximum limits.
  • the Medicaid recipient’s home but only if
  • the applicant is likely to return home or
  • one of the following individuals continues to live in the home:
  • the applicant’s spouse
  • a child under age 21
  • a child over age 21 who is disabled
  • a brother or sister who owns part of the house and has resided there for at least one year
  • essential household items
  • personal effects
  • burial funds of up to $1,500 each for a married couple, and up to $1,200 for a single applicant for an irrevocable burial fund, these amounts are raised to $5,000 each for a married couple, and $2,500 for a single applicant
  • one motor vehicle. Most states place a limitation on the fair market value, allowing up to $4,500, although some have an unlimited amount and others a lower amount. Some states permit the individual to keep one motor vehicle owned by either spouse, automatically, with no limit on the value others can keep one motor vehicle, with no limit on value, only if the vehicle is used for any of the following reasons:
  • transportation to and from employment
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