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Can I use my Medicaid coverage in any state?

You can't take it with you: If you're relocating, you'll need to reapply for Medicaid in the state where you're planning to reside.

Q. Can I use my Medicaid coverage in any state?

A: 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.

Medicaid offers health coverage to millions of Americans, and in many states, that coverage matches or even surpasses that of private health insurance. Medicaid is jointly funded by the federal government and state governments, but each state has the option to set its own rules and requirements for eligibility. As such, transferring your Medicaid coverage from one state to another isn’t always easy.

Transferring Medicaid benefits 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 reapply for Medicaid in the state you’re planning to reside in.

The good news is that you’re allowed to apply for Medicaid in your new state immediately after relocating, and doing so can help you avoid a lapse in benefits. It generally takes anywhere from 15 to 90 days to receive a letter of approval once you apply for Medicaid, and you can usually submit your application online.

One thing you should know about Medicaid is that you can’t be covered by it in two different states at the same time. Therefore, to transfer your coverage – so to speak – you’ll need to first terminate your original Medicaid coverage and then apply in your new state once you’ve relocated.

Most states offer retroactive Medicaid coverage, which allows you to receive coverage for up to three months prior to the date of your application’s approval. However, you may be forced to pay for healthcare services out of pocket until that retroactive coverage kicks in and renders you eligible for reimbursement. To this end, make sure to retain copies of all medical receipts for services received during your coverage gap.

Eligibility requirements

The challenge of applying for Medicaid in a new state is that each state has its own requirements for eligibility, so just because you’re entitled to coverage in one state doesn’t mean it’s guaranteed in another. Medicaid eligibility hinges on three factors:

  • Income level
  • Level of assets
  • Level of care requirements

The thresholds for income level and asset level eligibility are fairly similar across states. Level of care requirements, on the other hand, are more open to interpretation, so while you may qualify for Medicaid based on medical need in one state, that won’t necessarily hold true in another. Be sure to research the rules of the state to which you’re seeking relocation to ensure that your coverage will be able to continue.

Keep in mind that if you’re eligible for Supplemental Security Income, you’ll often automatically qualify for Medicaid – but some states have stricter criteria, so don’t assume that you’re eligible just because you get SSI.

Traveling to another state

If you’re traveling to another state and fall ill, you may be out of luck – Medicaid won’t cover the cost of services in a state that isn’t your home state. Generally, you can only use your Medicaid coverage out-of-state if you encounter a true life-threatening emergency that requires immediate care (meaning, there isn’t time to transport you back to your home state for care).

That said, sometimes, pre-approved treatment at an out-of-state facility is covered by Medicaid, but only when proper authorization is obtained. Similarly, Medicaid coverage may kick in if you receive treatment in an out-of-state facility that borders yours, and in which residents of your state routinely seek care. Again, you must make sure Medicaid will cover such care before pursuing it, or you risk getting stuck with the associated bills.


Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management. 

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Christy Simmons
Christy Simmons
1 year ago

Moved from California to Colorado need to reapply for Medicaid ASAP to keep my Perscriptions for behavioral health

Steve Anderson
Steve Anderson
1 year ago

Christy, click the “Apply online” button on our Colorado Medicaid page to apply for Medicaid.

jayson
jayson
1 year ago

Kind of a crock that they don’t make an exception when travelling to another state. Seriously…if you break a leg in California while visiting relatives, you have to fly all the way back for your medical care or have it done in California and pay for it yourself? Shows you why government shouldn’t be in charge of anything.

Justin
Justin
1 year ago
Reply to  jayson

No, what that shows is that the federal government should pass laws allowing Medicaid to be offered nationally rather than decided by a state-wide legislative body…

Egon
Egon
7 months ago
Reply to  Justin

For the record Justin is right. This is a failing of the federal government, not individual states.

Louise Norris
Louise Norris
9 months ago
Reply to  jayson

Emergency coverage is provided outside the home state, although depending on the state, it may only extend to the care necessary to stabilize the patient in the ER.

Renee
Renee
6 months ago
Reply to  Louise Norris

This happened to my grand baby. The doctors appointment was covered but her prescription was not

Carol Tagliaferro
Carol Tagliaferro
1 year ago

Medicaid recipients in NJ should be allowed to go to hospitals in the NY and Philadelphia metro area. They are called “border providers” and several other states allow their Medicaid recipients to do just that. I know first hand that even when NJ approves an out-of-state emergency the doctors/hospital do not have to accept the payment because they are not under any financial obligation to do so. A family can go bankrupt very easily under these circumstances. NJ doesn’t want out-of-state providers because of the red tape involved with billing, it has nothing to do with additional funding. Once an out-of-state provider fills out the proper paperwork to become a nJ Medicaid provider the billing becomes very easy. Instead of filling out a large quantity of paperwork for each individual who goes out of state,, it makes more sense to have our border providers fill out the paper work once and make them an in-network provider which will make billing just as easy as if they were an instate provider. As this article states, if a Medicaid individual needs to go to the hospital out of state, “they may be out of luck.” There is nothing fair or morally acceptable about that practice. Just like Medicare people pay into Medicaid, as well. So why then are Medicare recipients allowed to go out of state and Medicaid is not. This practice is unacceptable and we should be embarrassed that we allow this travesty to continue.

Rosie
Rosie
1 year ago

Do you know if this “border provider” works the same with nursing home? Like if a patient is in a nursing home in NJ with their Medicaid will they be willing to pay for NY nursing home if the patient wants to transfer? or it doesn’t apply?

Katie Brown
Katie Brown
1 year ago

Let’s say you need a limb preserving surgery aka if you don’t get this surgery, you most likely will lose lower limb use and eventually bladder/bowl function. The surgery will allow you to walk without mobility aids. You have a rare disease, and there is a specialist in Rhode Island willing to treat, but you live in CA. No known surgeons will treat or are knowledgable of rare disease. I realize exceptions are probably rare, but have you ever heard of one in a situation like this?
Also, if RI and CA both carry a medicaid community option from UHC..would it be wiser to switch to UHC in CA?

Louise Norris
1 year ago
Reply to  Katie Brown

Hi Katie,
I reached out to UHC Community Plan to see what information they could provide. They said situations like this do happen, and prior authorization for an out-of-state specialist is possible if there are no in-state specialists who can treat the issue. They said that you can reach out to Medi-Cal directly (800-430-4263) to start the process of changing your managed care plan to UHC (I’m assuming the managed care plan you have now doesn’t have providers in Rhode Island?). If and when you do that, your primary care provider could initiate the process of seeking an exception to the in-state rule, in order to try to get prior authorization for the RI specialist. You’ll want to get input from your primary care provider and Medi-Cal about this before making any changes to your coverage. And know that prior authorization requests, especially when there’s an out-of-state exception being sought, are never guaranteed. I don’t want to get your hopes up, but it sounds like it’s possible that your treatment could be authorized, depending on how the prior authorization review goes. Best of luck!

Kerrie
Kerrie
1 year ago

I have children that are receivig medicaid in montana for an adoption qualification. How do i transfer this to south dakota

Steve Anderson
Steve Anderson
1 year ago
Reply to  Kerrie

A good place to start would be the South Dakota Medicaid program: https://dss.sd.gov/medicaid/generalinfo/medicalprograms.aspx#chip (Contacts listed at the very bottom of the page.)

Eleanor Gause
Eleanor Gause
1 year ago

Mentally handicapped daughter fell Christmas Eve in Michigan. She is a Kentucky medicare/medicaid resident. Her injury required Trauma orthopedic surgical
repair repair. Can I appeal for medicaid coverage?

Maurie Backman
Maurie Backman
1 year ago
Reply to  Eleanor Gause

It always pays to appeal these decisions, as sometimes emergency care is covered even when it’s out of state.

Vany
Vany
1 year ago

Relocating from NJ to Washington. Worried may not have coverage for some time during transition. Anyone know how easy it is to apply in Washington?

Steve Anderson
Steve Anderson
1 year ago
Reply to  Vany

Application details are available on this page: https://www.healthinsurance.org/washington-medicaid/

LeRoy Robinson
LeRoy Robinson
1 year ago

If a person goes to another state for vacation, they have Medicaid, what do they do for medical?

Maurie Backman
Maurie Backman
1 year ago
Reply to  LeRoy Robinson

If a person travels out of state and needs medical care, Medicaid may not pick up that tab. Travel insurance may help in this situation.

Lisa Brooks
Lisa Brooks
11 months ago

I have a special needs daughter that will be relocating with me. Can i start the process before she gets to Georgia? I do not want her benefits to lapse, from a to b!

Steve Anderson
Steve Anderson
11 months ago
Reply to  Lisa Brooks

I think you’d definitely want to contact the Georgia Medicaid office in advance of your move and apprise them of your situation.

Jocelyn Manzano
Jocelyn Manzano
11 months ago

I have an NJ medicaid im moving california july 1st. Is it ok to apply now for transfer or better to apply after i relocate to new state? Thanks

Steve Anderson
Steve Anderson
11 months ago

Your best bet would be to ask Medi-Cal how to proceed. Here’s their number: (800) 300-1506

Edie
Edie
11 months ago

My daughter just moved from NY to AR and has been unable to terminate her coverage in NY because no one will return her calls. Not sure how to terminate NY coverage to apply in new state??

Steve Anderson
Steve Anderson
11 months ago
Reply to  Edie

Here’s the customer service number for the NY Medicaid office, Edie: 1-800-505-5678. Here’s out state Medicaid overview: https://www.healthinsurance.org/new-york-medicaid/

Jennifer
Jennifer
11 months ago

So I am 7 months pregnant. Moved states for domestic violence reasons. Will my Medicaid not transfer?

Steve Anderson
Steve Anderson
11 months ago
Reply to  Jennifer

I’d suggest you contact the Medicaid office in the state you moved to. You can click on your state here for contact information: https://www.healthinsurance.org/medicaid/

Kandace Rich
Kandace Rich
11 months ago

My grandson is traveling from Montana to Minnesota in a week for his 2 months summer visitation with his mother. Am worried with the Pandemic. Is he only covered for life threatening situations and does he need prior approval from Montana and / or Minnesota?

John Joseph Hagerty
John Joseph Hagerty
11 months ago

I’m 22, just graduated from college and don’t have a job. My residency is in Washington state, but I’m living in California. Can I apply for CA Medicaid?

Anna
Anna
10 months ago

Yes you can apply for Medicaid! I did this while I was in college. It’s called Medi-Cal in California. Also apply for foodstamps if you lack income and support.

Josh Schultz
Josh Schultz
10 months ago

Anna is right. Your residency for Medicaid purposes is different than for voting or a driver’s license. The only thing that’s usually required is you have to intend to continue living in California after you apply.

Julie A Fromm
Julie A Fromm
10 months ago

My boyfriend has a life threatening situation where the sleep Doctor’s said his sleep apnea is so critical that, he may stop breathing and never wake up. He has AZ Medicaid and has been approved for a special procedure, only problem is the Doctor’s that know how to perform the procedure don’t accept his Insurance, woild this be possible for a near by state to be approved for? Please help, we are despirate!!! Thank you.

Josh Schultz
Josh Schultz
10 months ago
Reply to  Julie A Fromm

I am sorry to hear about your boyfriend’s situation. If you are asking whether he can receive Medicaid in a different state while still covered in Arizona — or whether Arizona Medicaid will pay for him to see an out-of-state doctor — the answer to those questions is unfortunately no. But since his insurance has approved the procedure, they should be able to help him find a provider who will perform it. You might try contacting AHCCC, the state’s Medicaid agency, to ask for help with this.

Jamie
Jamie
10 months ago

My brother was recently in a life threatening motorcycle accident in Illinois – but he has Medicaid in Michigan. He was airlifted to another hospital in Michigan and was on a ventilator and received care in Illinois. The bills are rolling in. He did survive the crash – thank god! But wouldNt this fall under the life threatening emergency that requires immediate care?? Therefore, it should be covered? If so- who does one contact about these bills and further explanation and planning? He is clearly out of a job due to a TBI and cannot pay these bills.

Josh Schultz
Josh Schultz
10 months ago
Reply to  Jamie

I am very sorry to hear about your brother. Motorcycle or auto insurance would pay for these things first (depending on if he was insured and who was liable, of course). Only afterwards would Medicaid be liable. And unfortunately, whether Medicaid would pay for his care in Illinois depends on the specific rules in Michigan. I recommend contacting Michigan Medicaid at 1-800-642-3195.

Sam
Sam
10 months ago

My son will join West Virginia university for the next 4 coming years and his medicaid in New york ….How can i expand the Medicaid coverage to other state ? or should he apply for a new one in WV and he still under 18?

Louise Norris
Louise Norris
9 months ago
Reply to  Sam

You should reach out to NY Medicaid and to your Medicaid managed care insurance company if you have one. They can give you more concrete answers about exactly what your son should do with his coverage. But in general, he would only be covered for emergency services while he’s outside of WV, if he continues to be enrolled in NY’s Medicaid program. West Virginia has expanded Medicaid under the ACA just like NY, so he could switch to WV coverage when he moves there. New York’s eligibility guidelines for people under age 19 are a little more generous than West Virginia’s, so you’d want to double-check to make sure he’d be eligible for Medicaid in WV: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html
Once he’s 19, the eligibility rules would be the same in both states, with Medicaid for people who earn up to 138% of the poverty level (NY’s says 200% on that chart, because they’re also counting The Essential Plan, which is New York’s Basic Health Program). If he’s still counted as your tax dependent, the whole household’s income would be used to determine his eligibility.

T. Cundiff
T. Cundiff
9 months ago

Child with out of state medicaid staying with me for a while. need to get a well check up to enroll in school. can current medicaid be used or does she have to reapply for medicaid in my state?

Louise Norris
Louise Norris
9 months ago
Reply to  T. Cundiff

It’s unlikely that the child’s current Medicaid coverage will pay for anything other than emergency care while out-of-state. But to be sure, you’d need to contact the home state Medicaid office or the managed care insurer that provides the Medicaid coverage. They may advise that the child should be enrolled in Medicaid in your state instead, depending on the specifics of how long you expect the child to say with you.

Megan eileen Jones
Megan eileen Jones
9 months ago

if my child is covered under state insurance in another state and visits me during the summer do I have to pay out of pocket or can I get them insured through my state when they are here?

Louise Norris
Louise Norris
9 months ago

You should contact the Medicaid office in the state that currently insures your child, as well as the Medicaid office in your own state, and ask them how to proceed. A person cannot be covered under two states’ Medicaid programs simultaneously, so their existing Medicaid coverage would have to be terminated before they could enroll in Medicaid in your state, assuming they’d be eligible to do so.
Each state has its own rules for Medicaid eligibility and residency requirements, so you’d need to be certain that your child would eligible for Medicaid in your state during the summer before canceling their coverage in their home state. Then you and/or the child’s guardian in their home state would need to reverse the process at the end of the summer – canceling coverage in your state and reinstating coverage in the other state.

denise schwarz
denise schwarz
9 months ago

my daughter received Maryland medical assistance when I adopted her from foster care because she was considered special needs. I want to move to Virginia. will she still be eligible for medical assistance?

Marie
Marie
9 months ago

My son has Medicaid in Maryland currently, but will be going to college in South Carolina where the college requires minimum ACA insurance. He will need to either see if he qualifies for South Carolina Medicaid (they have not expanded so not sure he will or only until 19?) or purchase the college’s plan. Can you shed light on SC Medicaid in this situation? If he purchases the college plan, can he hold onto Maryland Medicaid to use when he comes home?

Trudy Fisher
Trudy Fisher
9 months ago

Hello, relocating to American school for the deaf in Hartford, CT from Great Falls, Montana.. My son had suffered PTSD, Autism, and deaf.. He needs more help and resources.. He is not getting anywhere help from Medicaid in MOntana.. REfused providing same as other state.. how you recommended for transfer other medicaid..

Steve Anderson
Steve Anderson
9 months ago
Reply to  Trudy Fisher

Trudy, your best bet is to contact the Medicaid agency in Connecticut. https://portal.ct.gov/HUSKY/How-to-Contact-Us

Mary
Mary
9 months ago

Waiting on SSDI determination in Iowa; have IA Medicaid & food stamps. Friend has been letting me live with him for free, but sold his house faster than expected & we are now living in his RV. However, he plans to winter in Texas. Without him, I’m homeless. Am applying for housing assistance, but there’s a waiting list.
Can I get an exception to be able to get my Rxs filled in TX for 6 months?

Louise Norris
Louise Norris
9 months ago
Reply to  Mary

You’ll need to contact Iowa Medicaid directly to see if they have an exception process or a mail-order pharmacy system that you could use. The contact information should be on your ID card (it will vary depending on which managed care company provides your coverage, or whether you have fee-for-service coverage; here’s a list of contact information: https://dhs.iowa.gov/ime/about/contacts/member-services )

Cristina
Cristina
9 months ago

Hi, I am 4 months pregnant and my son is 8 months old, we are planing to move from FL to NJ because I lost my job and my fiancé’s salary barely cover our expenses. Thanks God, my son and I were approved for medicaid after losing my job, but I do not know if I should apply before moving or wait until I move, what will you recommend? And how long does it take for them to approve your application if you had the medicaid in another state?.

Steve Anderson
Steve Anderson
9 months ago
Reply to  Cristina

Cristina, these are definitely questions for the folks who run the Medicaid program in New Jersey. https://www.state.nj.us/humanservices/dmahs/clients/medicaid/

Chaplain Rodger DeRamus
Chaplain Rodger DeRamus
9 months ago

Hello, I have a Brother-In-Law who was awarded Medicaid in Florida. He was living in Daytona, but later he had to move to Alabama. Now he is having some serious problems with some of his right arm and a blood clot right above his heart. The problem with his arm is caused from smoking and the veins are all clogged up and he can’t use his arm. Now he can’t get the doctors here in Alabama to touch him. He needs surgery to remove the blood clot and the veins need to be unclogged in his neck that could be causing the problems in his arm.
He won’t go to a doctor here in Alabama because of his insurance problems, Medicaid and Medicare, so it is just keeps piling up, he is just a walking medical problem. He needs help bad or he’s going to die.

Louise Norris
Louise Norris
9 months ago

I’m sorry to hear that your brother in law is struggling. It sounds like he’s enrolled in Medicare, and also qualified for Medicaid assistance in Florida? Has he checked to see if he’d he’d be eligible for Medicaid in Alabama to supplement his Medicare coverage? If he’s enrolled in Original Medicare (Medicare Parts A and B, directly from the federal government), that coverage will work in any state. And if he qualified for Medicaid to provide supplemental coverage while he was in Florida, he may be eligible for Alabama Medicaid now that he’s living there. I would recommend that you or he reach out to the Alabama Medicaid office (1-334-242-5000) and the Alabama State Health Insurance Assistance Program, which can provide Medicare-specific help: 1-800-243-5463.

Melissa
Melissa
8 months ago

If I am temporarily moving out of state to nearby state for 6 months, is it worth it to change medicare coverage back and forth or to keep the state of residency medicaid and travel back in case medical issues should arise? I need infusions every other month for gi issue so I would have to travel back at least 3 times if I make no change and could schedule other appointments in groups if necessary. What is your opinion on this?

Louise Norris
Louise Norris
8 months ago
Reply to  Melissa

Just to clarify, you’re talking about Medicaid as opposed to Medicare, correct? If so, you’ll want to check the eligibility rules in the state where you’re going to be living temporarily. If you’re currently in a state that has expanded Medicaid and the other state has not, you might find that you’re not eligible for Medicaid in the second state.
But assuming you’re eligible for Medicaid in each state, it’s probably worth the paperwork to get coverage in the new state, unless you’ll be right over the border and traveling back would be no big deal. You’d need to travel back for everything except emergency care, and even for emergency care, some states’ Medicaid programs will only pay for stabilization in the ER (and not the additional inpatient care you might need after leaving the ER in an emergency situation).
My recommendation is to talk directly with both states’ Medicaid programs and see exactly what would be required in terms of eligibility, enrollment, and proof of residency, as well as how the current state’s program deals with out-of-state emergencies.

Dee
Dee
8 months ago

Hello! I am attending school for three months in another state. How does school play into the the Medicaid equation?

Steve Anderson
Steve Anderson
8 months ago
Reply to  Dee

Dee, there’s a lot of information about Medicaid in this guide to student health insurance: https://www.healthinsurance.org/obamacare/student-health-insurance-required-reading/

Dee
Dee
8 months ago

Hello! I am attending school in another state for 3 months and am on Medicaid. How will that work in my new temporary state? Still no coverage?

Louise Norris
Louise Norris
8 months ago
Reply to  Dee

Dee, you would need to reach out to the Medicaid department in the state where you’re going to school, to see if your plan to live there for three months would be adequate in terms of establishing residency and qualifying for Medicaid in that state. You cannot be covered under two states’ Medicaid programs at one time, so you would need to terminate your Medicaid coverage in the other state in order to enroll in the new state, and then repeat the process when you move back. Depending on what the state tells you in terms of their residency and eligibility requirements, that may or may not be worthwhile. You should have coverage for emergency care under your home state’s Medicaid program while you’re at school, but you would need to travel back to that state for anything else if you remain covered under that state’s program.

Riza NZ
Riza NZ
8 months ago

I don’t know what to do about moving with my autistic child who is on medication they very much need. It sounds like I won’t even know if we are covered until 3 months in and then I would have to go about finding a new psychiatrist. . .

Louise Norris
Louise Norris
8 months ago
Reply to  Riza NZ

Did the new state tell you that you’d have to wait three months? Most states allow for retroactive coverage (back to the start of the month you apply, or even a previous month in some cases, as long as you were living in the state at that point), although your Medicaid coverage in the new state can’t start until your coverage in the previous state ends, since you can’t have Medicaid in two states at the same time.
You would almost certainly need to find a new psychiatrist in the new state. But it should be possible to have seamless coverage. You’ll want to reach out to the new state’s Medicaid office before you move, to find out exactly how their eligibility and enrollment process works.

Fran Rothel
Fran Rothel
8 months ago

Still in Louisiana because of covid restrictions to fly home to NY. Now hurricane Luara. I am a diabetic and my doctor wants blood drawn. I have a tele communication visit soon. Where do I get blood work drawn? I won’t be home until Christmas by the looks of this nightmare. Please help!!!

Louise Norris
Louise Norris
8 months ago
Reply to  Fran Rothel

It sounds like your Medicaid coverage is from New York? If so, you’ll need to reach out to NY Medicaid directly: https://www.health.ny.gov/health_care/medicaid/program/contact.htm or, if you have a managed care plan (ie, a health insurer that contracts with the state to provide your Medicaid coverage), you’ll need to call that insurer – there should be a customer service number on your ID card. You can check with them to see if they have a way to authorize an out-of-state blood draw due to your specific extenuating circumstances.

Katie
Katie
8 months ago

I’m moving to Louisiana and I’m currently a Texas resident. My son is special needs and sees specialists he has seen since birth in Texas. He has Medicaid and I intend to apply for Medicaid for him in Louisiana when we move. But I want to keep his specialists and travel to Texas for visits. Is there a chance LA Medicaid will cover it? I would like to add, the city in Louisiana we will be residing in is less than 50 miles from the Texas border.

Louise Norris
Louise Norris
8 months ago
Reply to  Katie

You will need to contact LA Medicaid directly and run this by them. Their customer service number is 1-888-342-6207 or you can email them at
MyMedicaid@la.gov
States and Medicaid managed care providers sometimes have Medicaid contracts with out-of-state providers, especially if they’re close to the border.

Michelle
Michelle
8 months ago

What if specialist is only in another state?

Louise Norris
Louise Norris
8 months ago
Reply to  Michelle

You’ll need to contact the state that provides your Medicaid, or your Medicaid managed care insurer. States and Medicaid managed care insurers sometimes have Medicaid contracts with out-of-state providers or can make exceptions for specialist visits in situations like this. If there truly are no specialists for the condition in your state, that would be one of the circumstances when Medicaid will cover out-of-state care: https://www.macpac.gov/wp-content/uploads/2020/01/Medicaid-Payment-Policy-for-Out-of-State-Hospital-Services.pdf

Shelby Kraft
Shelby Kraft
8 months ago

I recently broke something in my back, have scoliosis, bone spurs on the spine, fluid in my bone marrow, bulging disks, and need to see a specialist that many people in my state(Kansas) has recommended a dr in ft Collins Colorado! How can I get this approved to go see that dr

Louise Norris
Louise Norris
8 months ago
Reply to  Shelby Kraft

If the doctor in Fort Collins regularly sees patients from out-of-state, they may have some tips for you. But you’ll ultimately need to try to work it out with KanCare or your KanCare managed care insurer. It will help if you can show documentation to prove that this specialist is the only one who can treat the issues you’re facing, or that there aren’t any specialists in Kansas who have experience dealing with the particular mix of diagnoses you have.

Jordan Muse
Jordan Muse
8 months ago

I moved from Alabama to Florida. How do I transfer Alabama medicaid insurance to Florida for my children?

MAURIE BACKMAN
MAURIE BACKMAN
8 months ago
Reply to  Jordan Muse

Unfortunately, you can’t just transfer your Medicaid coverage from one state to another. Each state sets its own rules, and so you’ll have to close out your Medicaid in Alabama and then apply again in Florida, assuming you’re officially a resident now. You can learn more about Florida Medicaid here: https://www.flmedicaidmanagedcare.com/

Matthew V Sailors
Matthew V Sailors
8 months ago

What if I was rushed to Chicago from Indiana I live in a bording Town to Illinois for treatment from a motorcycle crash

MAURIE BACKMAN
MAURIE BACKMAN
8 months ago

Sometimes, in these situations, Medicaid will provide coverage even if you are out of state, whether because you’re talking about a bordering state or an emergency situation. You’ll need to consult your specific Medicare office or administrator to see what coverage you were entitled to.

Sarah
Sarah
6 months ago

What if you live out of your home state for school? Will Medicaid still cover you?

Steve Anderson
Steve Anderson
6 months ago
Reply to  Sarah

Sarah, this post explains how Medicaid works for students who aren’t studying in their home state.
https://www.healthinsurance.org/obamacare/student-health-insurance-required-reading/

CYNTHIA Anzurez
CYNTHIA Anzurez
3 months ago

We live in Wyoming but my daughter is going to a military school in Montana. If she has an emergency and needs to go to the e.r. might it be covered? We live in Wyoming so that is where she has coverage. If she will be living at the school for 5 months should we apply in MT?

Louise Norris
Editor
3 months ago

If her coverage is through Wyoming Medicaid, you’ll need to reach out to them directly to find out exactly what their rules are for emergency situations out of state. If she’s also eligible for Medicaid in Montana, she could apply there, but she’d have to give up her Wyoming Medicaid during the time she’s covered by Montana’s Medicaid program, as a person can only be covered by one state’s Medicaid plan at any given time.
It’s also possible that the school in Montana offers coverage for its students, which might be something you’d want to consider for the time while she’s living away from home.

Mena
Mena
3 months ago

Medicaid only covers out of state if it’s an e.r. visit. Emergencies happen so of course they have to! Would be nice to see an out of state doctor with Medicaid.

Last edited 3 months ago by Mena
Louise Norris
Editor
3 months ago
Reply to  Mena

You can check with your state Medicaid office or Medicaid managed care insurer to see if they’ll grant a case-by-case exception. That’s sometimes available if the closest doctor is across a state line, or if the doctors best able to treat the condition are out of state.

Kim
Kim
3 months ago

If I moved to Florida but my Medicaid doesn’t start until March 1 but I have prescriptions in Maryland will my Maryland Medicaid cover it

Louise Norris
Editor
3 months ago
Reply to  Kim

If your Maryland Medicaid is still in effect until the end of February, it should cover your prescriptions as long as they’re filled through a pharmacy that works with the Maryland Medicaid program. But as is always the case, you’ll need to contact your Medicaid program directly in order to determine coverage for specific benefits.

linda johnson
linda johnson
2 months ago

Does an out of state non par Managed Medicaid Plan have to pay based on their States Medicaid FFS rates for services provided outside of their state?

Louise Norris
Editor
2 months ago
Reply to  linda johnson

In general, Medicaid (fee-for-service or managed care) does not typically cover out-of-state care. But there are exceptions, including emergency care, circumstances when an out-of-state provider is closer, a metro area straddles two states, etc.
According to a recent MACPAC report, there is considerable flexibility in terms of how states handle payments in these situations. This report has some data that may be useful to you (see page 4): https://www.macpac.gov/wp-content/uploads/2020/01/Medicaid-Payment-Policy-for-Out-of-State-Hospital-Services.pdf But they note that they don’t have data for how managed care plans pay out-of-state hospitals.

Jovelyn Bantula
Jovelyn Bantula
2 months ago

What is the best option if I have to go to California not for forever but it might be longer than a year just to take care of someone while they wait for a relative. I have a son that is covered in Texas Medicaid and on that part I’m kind of worried because I’m in low income family and Medicaid really helps me for my son. I am also being offered to stay for good, but what could be the best option? I’m a single mother, fairly new in America and I honestly still have so much to learn which I am still struggling to do at this time.

Louise Norris
Editor
2 months ago

You’ll want to reach out to Medi-Cal with specific questions: https://files.medi-cal.ca.gov/pubsdoco/contact.aspx But in general, the Medicaid eligibility guidelines for kids are more generous in California than they are in Texas: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html So if your son is eligible for Medicaid in Texas, he should also be eligible for Medicaid in California for the time while you’re living there.

Kate
Kate
2 months ago

Hi recently moved in and living with family in Florida from a different state. I am currently 31 weeks pregnant and plan on seeing a specialist here for my babies condition. Am I able to get FL Medicaid? Do I need to get a FL license?

Louise Norris
Editor
2 months ago
Reply to  Kate

Congratulations on your little one! Medicaid is available to pregnant women in Florida with household income up to 191% of the poverty level: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html You can contact Florida Medicaid to see what they need in terms of proof of residency and to verify your eligibility: https://www.myflfamilies.com/service-programs/access/medicaid.shtml#pw

Chris
Chris
2 months ago

My mother moved back to California from Nevada before the end of February this year. She went to the DWSS office in Nevada to cancel her Medicaid coverage at the beginning of the same month. She completed a Termination of Assistance form, which has a stamp on it reading “Received: Southern Administration Office”. Fast forward to today, where she contacted a Medical office to enroll for benefits, but was told she was still enrolled in Nevada’s Medicaid program. If the state of Nevada received her form at the beginning of February, how long would it take for her to be unenrolled from it? She tried calling various Nevada DWSS offices, but could not connect to anyone

Louise Norris
Editor
2 months ago
Reply to  Chris

This is a very state-specific question. I’m sorry she’s had trouble getting in touch with someone at Nevada Medicaid, but they’re the ones who are going to have to address this issue for her.

Belinda Cross
Belinda Cross
2 months ago

Mother is in a nursing home in GA and would like her to be closer to family in NM, especially due to the COVID-19 concerns. She has been told that she makes too much money for NM to be eligible for Medicaid in NM and can not afford nursing home care out of pocket and family can not help much either. Does she have any other options?

Louise Norris
Editor
2 months ago
Reply to  Belinda Cross

Is she eligible for both Medicare and Medicaid? If so, the eligibility rules for Medicaid assistance do vary a bit from one state to another, but not dramatically so. You can click on a state on this map to see more details about the income/asset limits for Medicaid eligibility for people over the age of 64: https://www.medicareresources.org/financial-help-by-state/
Have you reached out to NM Medicaid directly? They would be able to give you some concrete information in terms of what it would take to qualify for coverage in NM. https://nmmedicaid.portal.conduent.com/static/index.htm

Frances Quidachay Camacho
Frances Quidachay Camacho
1 month ago

I have medicaid in Guam and it is a US TERRITORY so i just want to know where i am eligible to use my medicaid off island to the US

Louise Norris
Editor
1 month ago

We advise that you contact the Guam Department of Public Health and Social Services with questions about your specific Medicaid benefits: https://www.cms.gov/CCIIO/Resources/Consumer-Assistance-Grants/GU

Shewanna Marie Johnson
Shewanna Marie Johnson
1 month ago

I have a rare condition called Postural Orthostotic tachycardia syndrome & vasovagel syncope. I previously had cigna. When my care started with my specialist (in Raleigh NC) I had to go out of state because there’s no doctors in SC that treats my condition. I was on LTD for a year with my job and my doctor declared that I couldn’t work. With that I lost my job and health insurance. I now have SC medicaid. Is there a way I can continue to see my out of state specialist with my SC medicaid since there are NO Doctors that treat my disorder in SC? If no what am I to do? This is the closest doctor to me. I drive 5 hours one way and 5 hours home. My SC doctor referred me to the specialist because there is no one here. Help????

Louise Norris
Editor
1 month ago

I’m sorry you’re having to go through this. You’ll have to contact South Carolina Medicaid directly in order to see if they can make this work for you. Your specialist in Raleigh may be able to help, or may be able to connect you with a billing specialist or patient advocate who can help. Best of luck, and I hope you’re able to continue to receive the care you need.

Last edited 1 month ago by Louise Norris
Darrell Moody
Darrell Moody
1 month ago

Relocating Mom to Florida from South Carolina, she has been approved for Medicaid for Nursing Home but has not yet moved to Nursing Home. She is still in an Assisted Living Home, but money has run out and needs to be relocated. My brother is in Florida and this is where we are looking at the Nursing Home.
What do I have to do to get her Medicaid changed from SC to Fla?

Louise Norris
Editor
1 month ago
Reply to  Darrell Moody

You’ll need to contact the Medicaid agencies in each state directly to see what information they need. A person cannot have Medicaid coverage in multiple states simultaneously, so SC will need to terminate her coverage before her FL coverage can start. But they should be able to make this happen seamlessly.

Patricia Havens
Patricia Havens
19 days ago

My brother is visiting from IL to CT for a week and has health issues. He’s on IL Medicaid. If he has a health emergency, and i have travel insurance for him, I believe he would be covered for either handling the emergency or getting him home. Do you agree?

Louise Norris
Editor
19 days ago

In general, yes. But I’d advise that you contact IL Medicaid directly to see what their out-of-state emergency care provisions are. Some states have more limited coverage in those situations than others (for example, only stabilization care during an emergency, with the patient having to return to their home state as soon as it’s safe for them to do so, in order to continue to receive coverage). It sounds like the travel insurance policy you’ve purchased is designed to help get him back home if a medical situation arises? If so, he should be well covered, but you’ll want to make sure you understand what rules IL Medicaid has in place, just to cover all your bases. Best wishes, and enjoy your visit with your brother!

Leah Myers
Leah Myers
18 days ago

I am moving from Indiana to Texas. I am still on my grandparents insurance until I am 26, so what does this mean for me moving and what do I have to do?

Louise Norris
Editor
18 days ago
Reply to  Leah Myers

If your grandparents’ health plan has network coverage in Texas, you might be able to keep using it without a problem. But if it’s a local plan that only includes Indiana providers in its network, you’re likely only going to have coverage for emergencies when you’re in another state. You’ll need to contact the insurer directly and ask them about your specific situation.
If it turns out that you need to get new coverage in Texas, you can enroll in a plan through the Texas marketplace. But be aware that Texas has not expanded Medicaid under the ACA, while Indiana has. So there’s a coverage gap in Texas: Non-disabled childless adults earning less than the poverty level ($12,760 in 2021) are not eligible for Medicaid in Texas, nor are they eligible for premium subsidies. But as long as you’re earning at least $12,760 this year, you’d be able to get health coverage in the Texas marketplace. And depending on your income, you might find that the coverage is free, thanks to the ACA and the American Rescue Plan: https://www.healthinsurance.org/blog/american-rescue-plan-drives-health-insurance-costs-down-for-young-invincibles/

Shawn Stokes
Shawn Stokes
9 days ago

Question:

We have a client who is a Medicaid member in Alabama. That member briefly lived in Oklahoma, where she also received Medicaid. Now she has moved BACK to Alabama… Will she keep her original Alabama Medicaid number, or will a new one be assigned??

Thanks

Louise Norris
Editor
9 days ago
Reply to  Shawn Stokes

You’ll need to contact Alabama Medicaid to see how they handle this. Her Alabama Medicaid coverage would have been terminated when she moved out of state and transitioned to Oklahoma Medicaid. So it’s likely that she’ll be starting over with a new Medicaid number when her Alabama Medicaid takes effect again.

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