As each state has its own eligibility for Medicaid requirements, you will not be able to use your coverage in a different state, unless it is a medical emergency.
You will not be able to use Medicare in any other instance whilst temporarily in a different state.
Medicaid offers coverage for millions of people across the United States. Within numerous states, this coverage may even surpass the benefits of having private health insurance via an employer.
This is because both the federal and state governments fund Medicaid. Which means that its coverage is more expansive.
However, each individual state does have the option to set its own standards to determine eligibility. In this sense, transferring coverage between states is not always a possibility.
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Why Can’t I Transfer Medicaid Benefits to Another State?
There is no formal option to allow you to transfer your coverage from state-to-state. Thus, if you are planning on relocating, you will need to ensure that you reapply for Medicaid within your new state.
The good part is you can reapply to Medicaid once you have moved. This will help you to avoid any potential lapses in health benefits.
It typically takes up to 90 days to be approved for Medicaid, and you application should be made online.
Applications should take no more than 90 days as there are federal rules in place in order to process these applications on the basis of disability.
Other forms of Medicaid applications should take no longer than 45 days to process. It is important to note that you are not able to be covered at the same time in different states.
Thus, to transfer your medical coverage, you will need to ensure that you have terminated your original coverage and applied for new coverage in the state that you have relocated to.
The vast majority of states will provide retroactive coverage. Allowing you to be covered up to three months before application approval.
However, you may also be made to pay for services yourself until this retroactive coverage begins.
You will be rendered eligible for reimbursement thereafter: as long as you have kept copies of your medical receipts for any services that occurred during this gap in coverage.
What are the Eligibility Requirements for Medicaid?
Each state has its own requirements for eligibility, and this can pose a challenge for some people.
Even if you have met the requirements of one state, it doesn’t mean you meet the eligibility requirements of another.
Thus, Medicaid eligibility will depend on numerous factors that include the following elements:
- Level of income
- Available assets
- Medical expenses
- Level of care requirements
- Long term care
The overall threshold for income levels is typically the same across the United States.
In recent years, the ACA has called for all of the states to expand the eligibility criteria for Medicaid to adults with a total household income of 138% of the national poverty level.
However, the Supreme Court has also ruled that this is entirely optional. As a result, there are still twelve states that have chosen not to expand their eligibility rules.
Someone who lives in Illinois and is enrolled in Medicaid under the expanded eligibility rules, wouldn’t be eligible of they decide to move to Texas or Florida.
This is because Florida and Texas have chosen not to expand Medicaid eligibility and thus, they would become ineligible for coverage upon moving.
Program requirements and levels of care will vary from state-to-state.
Thus, if you have long-term medical requirements, you should research thoroughly into the Medicaid requirements within the state that you are moving to in order to ascertain whether relocating is still the best option for you.
You should also bear in mind that if you are eligible for Supplemental Security Income, you will automatically be eligible for Medicaid within many Staes.
This is because 33 states grant automatic eligibility to those people who are in receipt of SSI.
The leftover states will make their own determinations based on legibility, although these regulations typically follow the same guidelines for SSI.
Those who receive SSI payments may be deemed as eligible for coverage. However, they will need to submit separate applications for coverage within specific states.
Medicaid has played a pivotal role in the supplementation of Medicare for those who are aged over 65. As it provides imperative longer-term coverage for millions of people who have limited assets.
Will Medicaid Cover Me in Other States?
You will not be covered for services within a state that is not your home residence.
Typically, you will only be able to use your Medicaid coverage out-of-state if you are in an emergency situation that requires immediate hospital care.
There’s sometimes the option available for pre-approved treatments in a different state. Medicaid covers this upon the issuance of authorization.
You may also be able to use your coverage if you receive treatment in a bordering state, to which residents of your state travel often in order to receive care.
As always, you should ascertain whether Medicaid will cover the cost of your care prior to pursuing these options in order to avoid running up unwanted bills.
Conclusion
You can only use Medicaid out-of-state in life threatening emergency situations. In cases that require immediate medical care.
Thus, it can’t be used out-of-state in many cases. You should also ascertain whether you will still be covered by Medicaid when moving to a different state.
Frequently Asked Questions
Emergency Medicaid covers medical emergencies that: Place the patient’s health in serious jeopardy; Impair the patient’s bodily functions; or. Cause serious dysfunction of any bodily organ or part.
All health insurance plans regardless of the state of purchase will cover emergency services at any hospital in the United States, with the exception of Hawaii. However, non-emergency care, like primary care visits, might not be covered.
If you have Original Medicare, you have coverage anywhere in the U.S. and its territories. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take Original Medicare.
