How Long Does Approval Take
Depending on where youre moving to, and what services you need, processing can take between a week and 90 days from the day after your application submission.
Many programs for Arizonas Medicaid system take 45 days to process.
You are eligible immediately after moving as states arent allowed to have a minimum length of residency for providing services. This means you can apply the first day you live in Arizona or the new state youre moving to.
What Are Medicaid State To State Transfer Rules Understanding How State
Definition of Medicaid State to State Transfer Rules
Medicaid State to State transfer rules are laws and regulations that provide guidance for transferring ones Medicaid benefits when moving between states. While many people might think of Medicaid as a Federally-administered program, it is a joint benefit provided by both the Federal and State governments. Each state has its own set of eligibility requirements. As such, there are systems that must be followed in order to transfer and continue receiving Medicaid benefits when a recipient moves from state to state.
How Medicaid State to State Transfer Rules Work
Imagine that you receive Medicaid benefits and decide that you would like to move closer to your family, who happen to live in a different state. You may think that you can simply move and have your benefits transfer with you to your new home, but youd be wrong. It can be incredibly frustrating for a senior or their family to discover that Medicaid benefits dont just transfer when you relocate to another state. Theres also an additional complication: A person cannot receive Medicaid benefits in two states at the same time, which means that they must first close their Medicaid benefits in their originating state before applying in the state theyre relocating to.
How to Transfer Medicaid Benefits Between States
Exceptions To Transfer Penalties
All assets transferred for less than fair market value were returned to the client or the clients spouse
Once a penalty is established, all assets must be returned in order to reconsider the penalty. This includes multiple assets transferred to one person, or multiple assets transferred to multiple people. If all assets are not returned, the penalty remains using all uncompensated value, including assets that were originally transferred but returned.
Likewise, if an application is made after some assets are returned a penalty is calculated for the net uncompensated value, based on the total assets transferred less any assets returned .
Example: Not all assets returned before penalty established: Harry enters a nursing home in September. In October Harry transfers $50,000 to his son. Later in October, the son gets legal advice from attorney to transfer what is left back to Harry. In November Harrys son gives back $40,000. Harry uses $20,000 to pay off his current bills, he spends $6000 on a burial plan, and has enough left to pay privately until January. In February he has $2,000 in resources and applies for Medicaid. The uncompensated transfer is $10,000 .
Uncompensated value in a month does not exceed the daily private nursing facility rate in that month
As long as the uncompensated value of all transfers in one month does not exceed the daily private nursing facility rate for that month, there is no penalty in that month.
The asset transferred was an excluded resource
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Have You Notified Social Security About Your Address Change
Make sure you notify Social Security of your change of address. The Social Security Administration handles Medicare enrollment. If you receive Social Security benefits, you can change your address online by accessing My Social Security and answering a few security questions prior to making the change if you have set up a My Social Security account.
Alternatively, you can call the Social Security Administration at 1-800-772-1213 and speak to one of their representatives from Monday through Friday, from 7AM to 7PM. You can also visit the Social Security office nearest you and fill out a change of address form.
If you receive your retirement or disability benefits from the Railroad Retirement Board , notify the agency either through its website or by calling 1-877-772-5772 Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
Do you have questions about Medicare when moving to another state? Learn more about me by clicking the View profile link below. There are also links that let you schedule a phone appointment or have me email you more information. Want to compare plans on your own? Use the Find Plans button on this page.
New To Medicare?
Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.
Elder Wills Estates Trusts Special Needs Tax & Business Law Attorney John Sweeney
Sweeney Legal, LLC, provides legal, practical, and business counsel to Seniors, families, and businesses in the Fairfield, Connecticut area, including the communities of Bridgeport CT, Bethel CT, Brookfield CT, Danbury CT, Darien CT, Easton CT, Fairfield CT, New Canaan CT, Newtown CT, Norwalk CT, Redding CT, Ridgefield CT, Stamford CT, Weston CT, Westport CT and Wilton CT. John is also licensed in New York serving Westchester County including the towns of Bedford NY, Lewisboro NY, Mount Kisco NY, North Salem NY, Pound Ridge NY, Somers NY and South Salem NY.
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In Some Cases Transferring Your House Or Other Assets To Spouses Or Children Are Exceptions To The Medicaid Rule Against Transferring Assets
While Medicaid finances most long-term care in this country, Medicaid is supposed to be “the payer of last resort” when it comes to long-term care. Medicaid pays for long-term care only for those who are poor or who have become poor after paying for medical expenses or nursing homes.
Many people try to give away their assets to relatives in order to qualify for Medicaid. But when an applicant gives away property within five years of applying for Medicaid coverage of long-term care, Medicaid presumes that the gifts was made to qualify for Medicaid. This will trigger a period of ineligibility for Medicaid long-term care benefits on the theory that those assets could have been used to pay for the individual’s care.
Not all transfers, however, trigger a period of ineligibility for Medicaid. Federal and state Medicaid laws contain various exceptions to the rule against making gifts within five years of applying for Medicaid for long-term care . Following is a brief review of the most common exceptions.
Does Medicaid Transfer From One State To Another
While Medicaid is a federal program available nationwide, each state has the ability to establish its own eligibility policies. If a move is in your future, its important to understand what factors should be evaluated to help you determine if you will be eligible for Medicaid in a different state.
Financial Requirements
Unlike Medicare, Medicaid is a needs-based program that looks at a combination of income and assets for each applicant to determine their eligibility for services. Because states set their own limits for income and assets, your eligibility can change if you move. Although these differences in limits between each state may not be very much, these policies can also change throughout the year, which makes planning carefully all the more important.
Financial requirements for Medicaid eligibility are classified under the following categories:
Other factors that decide financial limits include age and disability status. People over the age of 65 may have different income and asset limits than those under the age of 65. Blind or disabled individuals can also have different eligibility requirements in each state.
Some states also conduct whats called a look-back period, which checks to see if applicants have transferred their assets to non-applicants in order to be eligible. If these transfers are deemed inappropriately handled, there may be an additional waiting period before the applicant can become eligible.
Differences in Level of Care Requirements
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The Home: Medicaid Rules
Noncountable asset. The home of the applicant is subject to very special rules established in both state and federal Medicaid law. As a general rule, a home is exempt if all of the following conditions are met:
- It is occupied by the applicant and/or the applicant’s spouse.
- The total equity value is less than $543,000 , and
- Title must usually be held in the name of the applicant and/or the applicant’s spouse.
Transfer rules. However, in most cases, the house cannot be gifted to someone without penalty . But there are exceptions to this rule. Under federal law, when title to the applicant’s home is transferred to another, this will trigger a period of ineligibility for Medicaid coverage of long-term care unless the transfer is made to one of the following individuals:
- the spouse of the applicant
- a child of the applicant who is under age 21
- a child of the applicant who is blind or permanently and totally disabled
- the sibling of the applicant who has an equity interest in the home and who has been residing in the home for a period of at least one year immediately before the date the applicant becomes institutionalized, or
- a son or daughter of the applicant who has been residing in the home for at least two years immediately before the date the applicant becomes institutionalized, and who provided the applicant with care, which permitted the applicant to reside at home rather than in an institution or facility.
Need Help Applying For Altcs In Arizona
If youre moving to Arizona and need help setting up Medicaid, speaking with a lawyer is a good place to start. The application process itself can be complex and confusing, and making mistakes can set you back in attaining benefits and services. If your situation is complicated or you need help meeting the eligibility requirements, one of our attorneys can answer your questions.
Contact the JacksonWhite Elder Law team today at and learn how we can help to ensure you receive the maximum ALTCS benefits available, while preserving as many of your assets as possible.
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Understanding Moving To Another State With Medigap
Since Medicare is a federal program, coverage is the same across the United States. You wont qualify for a Special Enrollment Period if you have Original Medicare and a Medigap plan because these plans operate in all states the same way. But, you can always shop coverage in your new state, you just might go through underwriting when you apply for a new plan.
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You Have The Right To:
- transfer to another room in the facility if you wish
- be given 30 days notice before transfer or discharge, except in cases where the resident is at risk of harming themselves or others, when the resident could be discharged earlier
- file an appeal to the New York State Department of Health in response to an involuntary transfer or discharge, for which a hearing can be held under the auspices of the Department
- examine your own medical records
- remain in the facility pending the appeal determination
- a post-transfer hearing within 30 days of transfer if you did not request a hearing prior to transfer if you win the appeal you will return to the first available bed in the facility
- retain your bed if you have been involuntarily transferred until after the appeal decision is reached
- information such as the name, address and telephone number of the New York State Department of Health, the New York State Long Term Care Ombudsman and the Commission on Quality of Care and Advocacy for Persons with Disabilities.
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Variations In The Medicaid Program
Do Medicaid benefits vary from state to state? Although requirements for eligibility are different between states, the asset and income limits are similar. If youre financially eligible in your old state, youll most likely get benefits in your new location.
If youre moving from Arizona to a new state with stricter limits, you might have to rearrange your finances and assets a bit before you will be eligible.
How Does Medicare Work When You Move To A Different State
Medicare is a federal healthcare program for people age 65 and over, as well as those who have certain health conditions or disabilities.
Because its a federal program, Medicare provides services in every part of the country. It doesnt matter which state you live in your basic Medicare coverage will stay the same.
Although your Medicare coverage wont end or change when you move, youll often need to find new healthcare professionals who participate in Medicare. Doctors must accept Medicares payment terms and meet certain requirements to participate in the program.
Regardless of where you live, participating doctors and healthcare professionals will submit a bill to Medicare for the services they provide to you.
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Transfers Between States Using Medicaid
Moving between two states and using Medicaid can be difficult, but its not impossible. Medicaid is administered and operated by each individual state, but there is a federal requirement that no person can receive Medicaid benefits from two states at the same time.
A resident of one state must close out their Medicaid case before applying for Medicaid in another state. Its important to note that benefits are allowed to be retroactive back to the date of application. However, new cases might take 30 to 90 days to be approved. New residents to that state would need to make private arrangements for payments to senior long-term care homes until those benefits kicked in.
Because each state sets their own Medicaid regulations, its important to determine if the potential new states definitions of level of care are the same as those of the original states. Some state Medicaid programs set limits to the level of care provided at different types of facilities. It might be a good idea to get a medical evaluation within the new state to determine how you will be classified in the new states Medicaid program.
How Will My Health Insurance Provider Network Change When I Move To A New State
Particularly in the individual market, health insurers have been moving towards HMOs and narrower networks. So its becoming rare for plans to offer network coverage in multiple states. Be prepared for the fact that you will almost certainly have a new provider network with your new plan.
Its also important to note that even if your health insurer is a big-name carrier that offers plans throughout the country, it will have different individual market plans in each state. So although you might have a Cigna plan already, and Cigna might also be available in the individual market in the state where youre moving, youll need to re-enroll in the new plan once you move.
And although Blue Cross Blue Shield is a household name in the health insurance market, their coverage varies from state to state. The Blue Cross Blue Shield name is licensed by 36 different health insurance carriers across the country a Blue Cross Blue Shield plan in one state is not the same as a Blue Cross Blue Shield plan in another state.
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Effective Date Of Coverage
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.
Moving A Nursing Home Resident From One State To Another
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It’s 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, it’s near the older person’s 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.
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