This chart highlights the state laws related to Medicaid retroactive coverage. When you apply for Medicaid, if approved, your state Medicaid program may cover any medical expenses that you have had depending on the state in which you live, up to 90 days in the past. Check back often, as this chart is updated frequently.
For more information, visit our Medicaid Topics Page.
| State | States That Eliminated 90-day Retroactive Medicaid Coverage | |
|---|---|---|
| ALABAMA | NOT ELIMINATED: "Individuals who have incurred medical expenses for the three months immediately preceding the month of application for Medicaid or the three months prior to the receipt of the first SSI check (for SSI cases), may become eligible for Medicaid benefits during that time provided all eligibility requirements are met for each month." | https://admincode.legislature.state.al.us/administrative-code/560-X-25-.12 |
| ALASKA | NOT ELIMINATED: " At the time of application or interview, an applicant may request Medicaid coverage for a maximum of three months immediately preceding the month of application if the applicant has unpaid medical expenses for dates of service any time during that three-month period." | https://www.akleg.gov/basis/aac.asp#7.100.072 |
| ARIZONA | Coverage for most newly eligible members will be retroactive to the first day of the month in which the Medicaid application is received. Pregnant women and children up to age 19 exempt from this requirement. | https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/priorqtrcoverage.html |
| ARKANSAS | Shortened to 30 Days | https://humanservices.arkansas.gov/wp-content/uploads/Recent-Final-Rule-AR-Home-Integration.pdf |
| CALIFORNIA | NOT ELIMINATED: "An applicant shall be eligible for Medi-Cal in any of the three months immediately preceding the month of application or reapplication." | https://govt.westlaw.com/calregs/Document/I427238E35B6111EC9451000D3A7C4BC3?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default) |
| COLORADO | NOT ELIMINATED: "Those applicants who within the three (3) months period prior to the date of application or as of the date the person became eligible for medical assistance, whichever is later, have received medical services which would be a benefit of the Colorado Medicaid Program or the Colorado Modified Medical Program as applicable, can request retroactive coverage on the application form." | https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=2171#:~:text=An%20applicant%20does%20not%20have,program%2C%20as%20defined%20at%208.105. |
| CONNECTICUT | NOT ELIMINATED: "HUSKY [Connecticut's Medicaid program] can cover you retroactively from the date you apply, up to 90 days earlier, depending on when you became eligible." | https://portal.ct.gov/OHA/Loss-of-Coverage-Options/Loss-of-Coverage---Comprehensive |
| DELAWARE | Eliminated except for instituionalized individuals in nursing facilities, qualified disabled working individuals, pregnant women, and children under age 19. | https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/de/de-dshp-ca.pdf |
| *DISTRICT OF COLUMBIA | NOT ELIMINATED | https://dhs.dc.gov/service/medical-assistance |
| FLORIDA | Eliminated except for pregnant women and children under age 21. Eligibility begins on the first day of the month that the application is received. | https://ahca.myflorida.com/medicaid/Policy_and_Quality/Policy/program_policy/eligibility/retro_elig.shtml |
| GEORGIA | Eliminated except "[a] woman may be eligible for up to three months of retroactive coverage before the date of application as long as she was financially eligible and pregnant in those retroactive months." | https://medicaid.georgia.gov/eligibility-faqs#:~:text=A%20woman%20may%20be%20eligible,pregnant%20in%20those%20retroactive%20months. |
| HAWAII | Shortened to 10 days, except for "individuals requesting long-term care services." | https://medquest.hawaii.gov/en/faq.html |
| IDAHO | NOT ELIMINATED: "Title XIX and Title XXI can begin up to three (3) calendar months before the application month if the participant is eligible during the prior period. Coverage is provided if services that can be paid by Medicaid were received in the prior period." | https://adminrules.idaho.gov/rules/current/16/160301.pdf |
| ILLINOIS | NOT ELIMINATED: "Eligible persons may receive retroactive medical coverage beginning three months prior to the month of application per PM 17-02-05-a." | https://www.dhs.state.il.us/page.aspx?item=61290 |
| INDIANA | Eliminated except for children and pregnant women | https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/in-healthy-indiana-plan-support-20-ca-01012021.pdf |
| IOWA | Eliminated except for pregnant women, children under the age of 19, nursing home residents | https://www.medicaid.gov/sites/default/files/2021-09/iwp-stcs-retroactive-eligi-imp-plan-ca-08042021.pdf |
| KANSAS | NOT ELIMINATED: " If needed, eligibility may also be determined for three months prior to the month of request." | https://khap2.kdhe.state.ks.us/kfmam/main.asp?tier1=02000&tier2=02340&tier3=2340&tier4=02 |
| KENTUCKY | NOT ELIMINATED: "if an enrollee is retroactively determined eligible for Medicaid, the retroactive eligibility shall be for a period up to three (3) months prior to the month that the enrollee applied for Medicaid." | https://apps.legislature.ky.gov/law/kar/titles/907/017/010/ |
| LOUISIANA | NOT ELIMINATED: "Applicants for Medicaid assistance can be considered for Retroactive Medical Eligibility (RME) in each of the three months prior to application as a part of the initial eligibility determination process" | https://ldh.la.gov/assets/medicaid/MedicaidEligibilityPolicy/H-1800.PDF |
| MAINE | NOT ELIMINATED: "An applicant for Medicaid may receive retroactive coverage of up to three months prior to the application month." | https://www.law.cornell.edu/regulations/maine/10-144-C-M-R-ch-332-SS-2-13 |
| MARYLAND | NOT ELIMINATED: "Medicaid will pay for unpaid medical expenses for certain medical services that were incurred up to three calendar months prior to the month of the initial application, if the applicant was eligible for Medicaid during this retroactive period and their provider accepts Medicaid as payment for services they received." | https://www.marylandhealthconnection.gov/glossaryslug/retroactive-medicaid/ |
| MASSACHUSETTS | Shortened to 10 days except for children under age 19 and pregnant women. | https://www.mass.gov/doc/eom-22-18-three-month-retroactive-eligibility-for-certain-masshealth-applicants-0/download |
| MICHIGAN | NOT ELIMINATED: "Individuals are entitled to Medicaid services under the plan during the three months preceding the month of application, if they were, or on application would have been, eligible" | https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Doing-Business-with-MDHHS/Forms-and-Applications/FIA-3243_85431_7.pdf?rev=653fd1e5f992476a9797c7ab77e868d8&hash=D75A932A621F603849E3A081956519A0 |
| MINNESOTA | NOT ELIMINATED: "MA can retroactively pay for the cost of health care services provided to an individual up to three months before the month of application" | https://www.house.leg.state.mn.us/hrd/pubs/medastib.pdf |
| MISSISSIPPI | NOT ELIMINATED: "Retroactive Medicaid eligibility may be available to any Medicaid applicant who received medical care prior to applying for Medicaid. Applicants may qualify for coverage for a 3-month period prior to the month of the application." | https://medicaid.ms.gov/wp-content/uploads/2016/12/Section-101.10.04.pdf |
| MISSOURI | NOT ELIMINATED: "The effective dates of PQ benefits can be no earlier than the first day of the third month prior to the month of application" | https://dssmanuals.mo.gov/family-mo-healthnet-magi/1830-000-00/1830-020-00/ |
| MONTANA | NOT ELIMINATED: "Three month retroactive coverage will be provided to individuals...[who are deemed eligible]" | https://rules.mt.gov/gateway/RuleNo.asp?RN=37%2E82%2E904 |
| NEBRASKA | NOT ELIMINATED: "The effective date of Medicaid can be determined up to three months prior to the month of application." | https://www.law.cornell.edu/regulations/nebraska/477-Neb-Admin-Code-ch-4-SS-003 |
| NEVADA | NOT ELIMINATED: "Nevada Medicaid offers up to three months of retroactive eligibility from the date in which the individual filed their application for assistance." | https://www.medicaid.nv.gov/downloads/provider/nv_billing_general.pdf |
| NEW HAMPSHIRE | Eliminated except for "pregnant women (including women during the 60-day period beginning on the last day of a pregnancy), infants under age 1 and children under age 19 (described in section 1902(l)(4) of the Act), parents and caretaker relatives, and individuals eligible in aged, blind, or disabled eligibility groups (including those who are applying for a long-term care determination)." | https://www.medicaid.gov/sites/default/files/2021-03/nh-granite-advantage-health-care-program-ca.pdf |
| NEW JERSEY | NOT ELIMINATED: "Persons may be eligible under the provisions of this chapter for retroactive Medicaid eligibility for the three months preceding the month of application" | https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-10-72-2-7 |
| NEW MEXICO | NOT ELIMINATED: "Up to three months of retroactive medicaid coverage can be furnished to applicants who have received medicaid-covered services during the retroactive period and would have met applicable eligibility criteria had they applied during the three months prior to the month of application." | https://www.law.cornell.edu/regulations/new-mexico/N-M-Admin-Code-SS-8.206.600.13 |
| NEW YORK | NOT ELIMINATED: "Medicaid is free health insurance for children and adults who meet income and other eligibility requirements. It may also provide up to 90 days of retroactive coverage for unpaid medical bills. You must request this coverage when you apply for Medicaid. Medicaid will pay those bills if you are determined eligible for Medicaid during those 90 days." | https://www1.nyc.gov/site/ochia/coverage-care/medicaid.page#:~:text=What%20is%20Medicaid%3F,eligible%20during%20those%2090%20days. |
| NORTH CAROLINA | NOT ELIMINATED: "You can request your Medicaid coverage be retroactive for up to three months from the application date." | https://medicaid.ncdhhs.gov/questions-and-answers-about-medicaid-expansion#WhendoesmyMedicaidhealthcoveragebegin-2653 |
| NORTH DAKOTA | NOT ELIMINATED: "Retroactive eligibility may be established for as many as three calendar months prior to the month in which the application was received." | https://ndlegis.gov/information/acdata/pdf/75-02-02.1.pdf |
| OHIO | NOT ELIMINATED: "The administrative agency shall approve retroactive eligibility for medical assistance effective no later than the first day of the third month before the month of application" | https://codes.ohio.gov/ohio-administrative-code/rule-5160:1-2-01 |
| OKLAHOMA | Eliminated except for pregnant women, children under age 19, Tax Equity and Fiscal Responsibility enrollees, and the Aged, Blind, or Disabled (ABD). | https://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/1115/downloads/ok/ok-soonercare-ca.pdf |
| OREGON | NOT ELIMINATED: "The Authority may evaluate for retroactive medical eligibility for the three calendar months preceding the month in which the Date of Request was established." | https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=270057 |
| PENNSYLVANIA | NOT ELIMINATED: "The earliest possible date for retroactive MA benefits to begin is the first day of the third month preceding the month of application." | https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter181/s181.12.html&d=reduce |
| *PUERTO RICO | NOT ELIMINATED: See 1902(A)(34) "THREE-MONTH RETROACTIVE ELIGIBILITY." | https://www.govinfo.gov/content/pkg/CFR-2018-title42-vol4/xml/CFR-2018-title42-vol4-part436.xml |
| RHODE ISLAND | NOT ELIMINATED: "Medicaid beneficiaries who meet the SSI-related eligibility criteria may request retroactive eligibility for UP TO THREE (3) MONTHS PRIOR TO THE MONTH OF APPLICATION." | https://eohhs.ri.gov/media/31436/download |
| SOUTH CAROLINA | NOT ELIMINATED: "Retroactive coverage means that Medicaid may cover your medical bills dating back to three months before your application date." | https://img1.scdhhs.gov/forms/FM3400-C.pdf |
| SOUTH DAKOTA | NOT ELIMINATED: "An individual may request retroactive coverage for the three months immediately preceding the application month if the individual had health care expenses in those months and met the South Dakota Medicaid eligibility criteria in those months." | https://dss.sd.gov/docs/medicaid/providers/billingmanuals/General/Recipient_Eligibility.pdf |
| TENNESSEE | Eliminated except for pregnant women and infants and children under age 19. | https://www.tn.gov/content/dam/tn/tenncare/documents/tenncarewaiver.pdf |
| TEXAS | NOT ELIMINATED: "A person may be eligible for Medicaid coverage for up to three months prior to the month of application" | https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/g-7000-prior-coverage |
| UTAH | Eliminated for most adults above age 19 | https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/ut-primary-care-network-state-ltr-08102021.pdf |
| VERMONT | NOT ELIMINATED: "Medicaid may be granted retroactively for up to three calendar months before the month of application provided all eligibility criteria were met during the retroactive period and any premiums required for those months have been received by the department. " | https://regulations.justia.com/states/vermont/agency-13/sub-agency-170/chapter-410/section-13-170-410/ |
| VIRGINIA | NOT ELIMINATED: "individuals are entitled to Medicaid services under the plan during the three months preceding the month of application, if they were, or on application would have been, eligible." | https://law.lis.virginia.gov/admincode/title12/agency30/chapter10/section60/ |
| WASHINGTON | NOT ELIMINATED: "The medicaid agency approves a retroactive Washington apple health (WAH) certification period for the three months immediately before the month of application" | https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-504-0005-washington-apple-health-retroactive-certification-period |
| WEST VIRGINIA | NOT ELIMINATED: "Medicaid coverage may be backdated for up to three months prior to the month of application, provided all eligibility requirements were met at that time, and provided the client has accrued medical expenses." | https://dhhr.wv.gov/bfa/policyplans/Documents/Binder4.pdf |
| WISCONSIN | NOT ELIMINATED: "The retroactive enrollment period may be backdated up to three months prior to the month of application if all enrollment requirements were met during the period." | https://www.forwardhealth.wi.gov/WIPortal/Subsystem/KW/Print.aspx?ia=1&p=1&sa=50&s=6&c=38&nt=Retroactive+Enrollment#:~:text=A%20member's%20enrollment%20may%20be,were%20met%20during%20the%20period. |
| WYOMING | NOT ELIMINATED: "Applicants shall be allowed to receive retroactive Medicaid benefits not to exceed three (3) calendar months prior to the application if the individual received Medicaid covered services at any time during that period, and would have been eligible for Medicaid had they applied, unless restricted by other federal and state laws and regulations." | https://rules.wyo.gov/DownloadFile.aspx?source_id=19435&source_type_id=81&doc_type_id=110&include_meta_data=Y&file_type=pdf&filename=19435.pdf&token=214029044056135149079127072220241155234068006180 |
| GUAM | NOT ELIMINATED: See 1902(A)(34) "THREE-MONTH RETROACTIVE ELIGIBILITY." | https://www.govinfo.gov/content/pkg/CFR-2018-title42-vol4/xml/CFR-2018-title42-vol4-part436.xml |
| LAST UPDATE | 08/25 |