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Definition of Medicaid State to State Transfer Rules

Medicaid State to State transfer rules are laws and regulations that provide guidance for transferring one’s 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 you’d be wrong. It can be incredibly frustrating for a senior or their family to discover that Medicaid benefits don’t just transfer when you relocate to another state. There’s 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 they’re relocating to.

While each state administers its own Medicaid benefits, the Federal government sets overall rules for the program. One of the most important rules that benefits Medicaid recipients is that there is no minimum residency eligibility. This means that you can apply for benefits the same day you move to your new state.

How to Transfer Medicaid Benefits Between States

If you or a loved one is planning a move in the near future and wish to transfer Medicaid benefits, you can get in touch with the Medicaid office in the state to which you’re planning to relocate for information and assistance on transferring your benefits.

Each local office should be able to explain eligibility criteria and guidelines, which are based off of family size, income, and assets. Most states have similar eligibility criteria, which means that in most cases, you’ll still be eligible to receive benefits, and there’s often no need to restructure finances in order to qualify. Filling out an application on the Health Insurance Marketplace website should be able to give you an idea of whether you would qualify. It is important to also look at “level of care” requirements when determining Medicaid eligibility. Just because a person is medically-eligible in one state does not necessarily mean they will be in another state, and this could affect coverage.

In order to transfer your Medicaid benefits from one state to another, you must first close out your benefits in the state you reside and receive benefits in currently. After a caseworker in your new state of residency determines that your benefits have been closed, your application can then be considered to receive Medicaid benefits in your new state of residence. Timing a move towards the end of the month can help ensure any gaps in coverage are kept to a minimum, as some states won’t close out coverage until the end of the month in which the request is made. It is important to apply for benefits as soon as the move is completed to lessen any gaps in coverage.

In most instances, you can apply for Medicaid benefits either in person at your local office, or online. Be sure that you have all required documentation before beginning your application in order to make the process as smooth as possible. It usually takes 15-90 days to receive a letter of approval once you apply for benefits, depending on the state.

In most cases, if you meet all of the state’s eligibility requirements, the date you requalify for Medicaid benefits will usually be the date on which you applied, and your coverage should be retroactive. Some states use the date the application was received to determine payment eligibility.

While you are waiting for your application to be determined, you may have to pay for any medical services you receive out of pocket. Many states do offer retroactive coverage though, so hang on to any receipts until your application is approved. It is a good idea to secure affordable medical care providers to keep any out-of-pocket expenses to a minimum during this transition period. Depending on which state you are moving from, services received in your new state before you officially move may still be covered by your former state, if certain conditions are met. It’s best to consult with your Medicaid caseworker to determine specifics.

The process of transferring Medicaid benefits from one state to another can be very confusing, so it’s best to speak with a professional for assistance to ensure a transfer goes as smooth as possible.