Enhance Health

Medicaid Migration: What To Expect When Moving And Transferring Benefits

Are you planning a move to another state? If you rely on Medicaid for your healthcare coverage, you might wonder, “How long does it take to transfer Medicaid to another state?” Moving can be an exciting experience but can also come with challenges, especially regarding your healthcare benefits.

Medicaid, the government program that provides healthcare coverage to eligible low-income individuals and families, is administered at the state level. This means that when you relocate to a different state, you’ll need to navigate the process of transferring your Medicaid benefits to your new place of residence. 

If you’re concerned about your Medicaid migration, keep reading. We’ve outlined what you can expect when moving and transferring benefits. 

Can Medicaid Benefits Be Transferred From One State To Another?

You cannot transfer existing Medicaid benefits to another state for two reasons. 

Firstly, although Medicaid is available in every US state, the expanded form of Medicaid under the Affordable Care Act (ACA) is not available everywhere. (We’ll go into more detail about that later in this article). 

Secondly, every state has its own set of Medicaid eligibility criteria. Some of them may have great similarities, but they are not the same. You may be entitled to coverage in one state but not in another.

This doesn’t mean that you can’t enjoy Medicaid coverage in another state. But you’ll have to terminate your Medicaid coverage in your home state and reapply for coverage in the new one. You will be without Medicaid coverage if you don’t meet the requirements in your new state of residence.

Do All States Have The Same Medicaid Benefits?

The various US states establish and administer their own Medicaid programs. They determine the type, amount, and scope of medical services offered under Medicaid in line with broad federal guidelines. As long as these federally mandated benefits are offered, states may also cover other optional benefits.

These mandatory benefits include:

  • Inpatient and outpatient hospital services
  • Home health services
  • Physician services
  • Family planning services
  • Transportation to medical care
  • Lab testing and X-ray services
  • Prenatal care
  • Pediatric care

State-specific optional benefits often include prescription drugs, physical therapy, and occupational therapy services.

Qualifications For Medicaid Transfer: Meeting Eligibility Criteria

You must be very sure of your eligibility before canceling your Medicaid and reapplying in your new location. You can’t use your existing Medicaid in your new state, even if you only visit temporarily. (The exception to this rule is emergency care.)

In addition, you can’t receive Medicaid benefits in two states, so you need to cancel your existing membership when you move. 

So, how can you know if you meet the eligibility requirements in the new location? Contact the local Medicaid offices in the state that you are moving to ahead of the move. Speak to one of the Medicaid Planning Professionals. They will be able to provide you with all the details. 

However, Medicaid’s eligibility criteria across all US states generally include:

  • US citizenship or legal immigrant status
  • Residency in the state you’re applying for Medicaid in
  • Low-income status (this is calculated based on your entire household’s net income

Other requirements may be based on your age or pregnancy/parenting status.

Initiating Your Medicaid Transfer: Step-by-Step Guide

Initiating a Medicaid transfer can involve several steps. It may vary depending on your specific circumstances and the rules of your state’s Medicaid program. However, here is a general outline of what you can do to initiate a Medicaid transfer:

Step One:

Cancel your Medicaid membership in the state where you have been receiving your benefits. Do so as close to the moving time as possible to enjoy the benefits until you move. You may only apply in the new state once you have canceled your existing membership.

Step Two:

Apply for Medicaid membership when you arrive in your new state after the move. There’s no need to have lived at your new residence for any specified time before applying. However, some states have a minimum nursing home length of stay requirement (30 days) before you can apply for Nursing Home Medicaid.

Step Three:

Get signed up for Medicaid in your new state. You don’t have to visit the Medicaid offices; you can complete your application online. Your health coverage benefits will begin on the date your Medicaid application was filed or at the beginning of the month in which the application was filed. 

What If Your New Application Is Unavoidably Delayed?

Of course, it may not always be possible for you to sign up right away. Life can be busy and complicated immediately after a long-distance move. That’s why Retroactive Medicaid was created. 

Most states have Retroactive Medicaid coverage, which allows qualifying applicants to receive coverage for up to 3 months before the date of one’s application. Your Medicaid-covered expenses will be covered if you’re approved and meet Medicaid’s eligibility requirements in the three months preceding your application. 

Retroactive Medicaid coverage is only available to applicants who have been approved for Medicaid in their new state. It addresses a gap in coverage between canceling their previous membership and applying for a new one.

So, for example, if you cancel your membership and move out of state but only reapply in your new state three months later, they’ll retroactively cover your medical expenses for that timeframe. Retroactive Medicaid coverage is only available for up to three months before the new application.

Gathering The Necessary Paperwork For Your Medicaid Transfer

Although you can apply online, you’ll need to have some paperwork available for your Medicaid transfer. This may be identical to the paperwork you needed before, but it could differ slightly. It all depends on the qualifying criteria in the state that you have moved to.

Also, remember that some time has elapsed since you last applied for Medicaid. Therefore, some of your old documents will not suffice because they are outdated. 

Medicaid Transfer Timelines: How Long Does It Take?

Once you’ve applied and sent through any required documents, you must wait for approval confirmation. Federal rules require that US states take no more than 90 days to process a Medicaid application based on disability. 

For all other Medicaid applications, the law states that it should take no more than 45 days. It rarely takes that long. When the process is delayed, it is usually due to one of the following common hurdles.

Common Hurdles In The Medicaid Transfer Process 

These common hurdles are the main reasons behind an extended wait for your new Medicaid benefits to be approved.

Complex Eligibility Determination

Because every state has its eligibility criteria, it could take some time to establish your eligibility in your new state. You don’t necessarily have to be a US citizen to apply. Many other lawfully resident immigrants may apply, too. 

Permanent resident immigrants (green card holders) are usually eligible for Medicaid after five years of US residence. Issues like establishing proof of legal residency, pending citizenship, or changes to your legal immigrant status may delay things slightly. 

Income Changes And Documentation Requirements 

A change of state generally means a change in your employment status or place of work. This could mean a change in your income. Because income is one of the main Medicaid criteria, a rise in your income may disqualify you from Medicaid benefits in your new state.

Getting all the documents needed will delay the approval process even further if it takes you some time. Avoid this issue by finding out which documents you’ll need and getting them together before you move and apply for Medicaid.

Technical Or Communication Challenges

Sometimes, unavoidable technical issues with the Medicaid applications system or communication difficulties deal with the process. This is possible with any federal program application, and although rare, it can happen on occasion. 

You may also be experiencing difficulty reaching your local Medicaid offices. You’ll save a lot of time and stress by applying online. Be aware that this will not necessarily speed up the approval process, but it will make applying quicker and easier. 

Pending Appeals/Disputes

Do you have any ongoing appeals or disputes with Medicaid in the state that you’re moving from? This may delay canceling your membership and applying for a new membership in another state. Similarly, if your new membership has been denied, you may appeal this, but it could cause significant delays. 

You will be informed in the written notice of denial letter what the reasons for the denial are. Should you wish to appeal this decision, contact the Medicaid offices to enquire about steps for appealing. 

Absence Of Medicaid Expansion 

The federal government and the various state governments jointly fund Medicaid. The Affordable Care Act, a health reform law passed in 2010 and better known as Obamacare, made provision for Medicaid expansion. 

States don’t have to participate, so although they all offer Medicaid, not all choose this expansion. 

Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming have not adopted the Medicare expansion. If you enjoyed the benefits of Medicaid expansion and are moving to one of these states, there’s no guarantee you’ll be approved.

Delayed Application Processing Time 

Every day you wait after applying is another day of uncertainty about your health coverage status. Every effort is made to ensure that you don’t have to wait too long to hear if you’ve been approved. There are federal guidelines (see above) for the maximum waiting time after an application. 

But you could wait longer if any of the above hurdles are present. It’s possible to wait anywhere from 15 to 90 days to receive a letter of approval. This is why you must try to avoid as many of these hurdles as possible by being proactive. Check the facts before you move so that you can get everything ready in time.

Conclusion

Enhance Health is a licensed broker for ACA-compliant health insurance. If you find that you no longer qualify for Medicaid after moving to another state, give us a call. Our team of licensed insurance representatives will help you choose an affordable health plan in your new state. 

If you are over 65 and qualify for the Medicare program, we can also assist with the Medicare application process. Contact us today for more information on your health insurance options.

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