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.
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.