Medicaid is a federal program, but each state operates its own Medicaid program and can have different rules. This means you cannot transfer your Medicaid coverage from one state to another, and you cannot have Medicaid coverage in two states at the same time. But if you plan ahead, you may be able to get Medicaid in a new state in time to avoid a gap in your coverage. It is important to talk to your health care team to let them know you are considering moving, as they may be able to help with the transfer of your medical care and your Medicaid coverage.
Research the Medicaid Rules in your New State
In all states, you qualify for Medicaid if you meet the income and resource (asset) requirements and you meet another category of eligibility, such as having a disability. But details vary by state. So, it is important to learn about the eligibility rules in your new state, because they may be different from where you live now.
Some states offer “expanded Medicaid,” which may make it easier to qualify for Medicaid, because it is available to adults under 65, with a household income up to 138% of the Federal Poverty Level (FPL). Find out if your state offers expanded Medicaid at TriageCancer.org/Medicaid-Expansion. Minnesota and New York also give individuals with a household income between 138-200% FPL access to Medicaid through the Basic Health Program. For expanded Medicaid, there is no asset requirement and you don’t have to meet another category of eligibility.
You should also look to see how Medicaid benefits in your new state compare to your current benefits. For example, your new state may offer more or less optional benefits, such as dental coverage.
Consider the Timing of Your Move
To avoid a lapse in your coverage, you should also consider the timing of your move. Because most states end existing Medicaid coverage at the end of the month, the best way to prevent a lapse is to move close to the end of the month, cancel your coverage in your original state, and immediately apply for coverage in your new state. On average, it takes 7 to 90 days for Medicaid applications to be processed by a state.
If you cannot avoid a gap in coverage, you may still benefit from Medicaid. Once you’ve been approved for coverage, you can apply for retroactive Medicaid coverage to help pay for certain health care expenses accrued up to three months before your application date. To qualify, you must have been eligible for Medicaid during those three months, and your state may require additional qualifications for retroactive eligibility. Note: Some states have dropped retroactive coverage (e.g., Arkansas, Arizona, Florida, Iowa, Indiana, Kentucky, New Hampshire).
Apply for Medicaid in Your New State
Once you are ready to apply for Medicaid, you can do so by:
- Applying directly through the state Medicaid agency, or
- Applying through the Marketplace. If anyone in your household is eligible for Medicaid, your information will automatically be sent to your state Medicaid agency. This is the best option if you are unsure of your eligibility or want to learn more about income-based insurance options that you may qualify for.
Moving with Medicaid Example:
- Let’s say you’re moving from California to Texas, and you want to know if you qualify for Medicaid in Texas. You are 45 years old and earn $16,200 a year. You have $1,700 in savings. You qualify for expanded Medicaid in California, because your income is under 138% of the FPL (or $20,120.40). Now you need to figure out if you qualify for Medicaid in Texas, which does not have expanded Medicaid. But, you have a disability, so you might be able to get Medicaid. Your assets are under the $2,000 limit. Unfortunately, the income limits for that Medicaid program in Texas are $9,528 a year. So, you make too much to qualify for Medicaid in Texas. You could look at your health insurance options in the State Health Insurance Marketplace at HealthCare.gov.
- If, instead, you were moving from Texas to California, you would be eligible for expanded Medicaid in California. In that case, you should close out your Medicaid coverage in Texas at the end of the month, and file immediately in California after you move. Remember, you can file for retroactive Medicaid for care you receive up to three months before your Medicaid coverage begins, so that you don’t have to pause treatment due to a temporary lapse in Medicaid coverage.
Considerations for Picking a Health Insurance Plan
If you are in a position where you need to compare new health insurance options, there are a few key things to consider when picking a health insurance plan:
- What will the plan actually cost me?
- Are my health care providers and facilities included in the plan’s network?
- Does the plan cover my prescription drugs and any pharmacies I use?
When comparing plans, it can be tempting to just choose the one with the lowest monthly premium. But, to figure out the total cost for the year, including your out-of-pocket expenses, you have to do some math:
(Plan’s monthly premium x 12 months) + Plan’s out-of-pocket maximum = Total annual cost