What happens if you decide to move to another state while you are receiving Medicaid for healthcare needs? Or what about those Medicaid recipients who move to Florida from another state? Does Medicaid move with you from state to state?
Thank you for reading this post, don't forget to subscribe!Medicaid Basics
Remember that Medicaid is a joint federal-state program that provides health insurance to low-income individuals and families, including seniors who require long-term care services. In Florida, to be eligible for Medicaid, you must meet certain income and asset limits.
Many seniors have asset protection strategies in place to help them qualify for Medicaid long-term care benefits while preserving their hard-earned assets for their loved ones. These strategies may include creating trusts, gifting assets to family members, or using other legal tools to shield assets from Medicaid’s spend-down requirements.
Why Medicaid Doesn’t Transfer Between States
Many seniors are surprised to learn that Medicaid coverage does not automatically transfer from one state to another. While Medicaid is a federal program, it is administered by each state individually. This means that each state has the authority to set its own rules and regulations for Medicaid eligibility and coverage.
There are several key reasons why Medicaid does not seamlessly transfer between states:
- State-specific eligibility criteria: Each state has its own income and asset limits for Medicaid eligibility, which can vary significantly from one state to another.
- Different covered services: While all states must provide certain mandatory Medicaid benefits, they have the flexibility to offer different optional services. This means that the specific services covered by Medicaid can vary from state to state.
- Unique state-run programs: Some states have their own unique Medicaid programs or waivers that provide additional benefits or target specific populations, such as seniors or individuals with disabilities. These programs are not portable across state lines.
- Budgetary considerations: Medicaid is funded jointly by the federal government and each state. States have different budgetary constraints and priorities, which can influence the scope and coverage of their Medicaid programs.
- Residency requirements: To be eligible for Medicaid in a particular state, you must be a resident of that state. When you move to a new state, you must establish residency and meet that state’s specific Medicaid eligibility requirements.
As a result of these factors, when you move from one state to another, you cannot simply transfer your Medicaid coverage. Instead, you must close your Medicaid case in your previous state and apply for Medicaid in your new state as if you were a new applicant. This process can be complex and time-consuming, which is why it is essential to plan ahead and seek the guidance of a knowledgeable Medicaid planning attorney in each state (the one you are leaving and the one you are going to) to ensure a smooth transition and continuity of care.
Relocating with Medicaid: Closing Your Case and Reapplying
There are some steps you should consider when moving from one state to another while on Medicaid
- Research the Medicaid eligibility requirements in your new state
- Plan your move towards the end of the month to align with Medicaid coverage periods
- Cancel your Medicaid coverage in your original state at the end of the month
- Apply for Medicaid in your new state as soon as possible after relocating
- Take advantage of Retroactive Medicaid coverage, if available (as it is in Florida), to cover unpaid medical expenses from the previous there months
Considerations for Home and Community Based Services (HCBS) Waivers
If you receive services through a Medicaid HCBS Waiver, relocating can be more complex. Waivers are not entitlement programs and have limited slots available. When moving, consider the following:
- Research whether your new state offers a comparable HCBS Waiver
- Check if there is a waiting list for the Waiver in your new state and how long the wait times are
- If there’s no comparable Waiver or the waiting list is extensive, you may need to apply for State Plan Medicaid and receive care in a nursing home until Waiver services become available to you.
How a Medicaid Planning Attorney Can Help
Navigating the complexities of Medicaid can be challenging, especially when moving between states. A Medicaid planning attorney can provide invaluable assistance and guidance throughout the process, ensuring that your transition is as smooth as possible and that your long-term care needs are met. Here’s how they can help:
1. Assessing Eligibility Requirements
A Medicaid planning attorney can help you understand the specific eligibility requirements for Medicaid in your current state and your new state, including the income and asset limits, level of care requirements, and any state-specific rules or regulations They can asses your current financial situation and advise you on any necessary changes to ensure you qualify for Medicaid in your new state.
2. Developing an Asset Protection Plan
If you have assets that may disqualify you from Medicaid eligibility in your new state, a Medicaid planning attorney can help you develop a plan to protect those assets while still qualifying for benefits. This may involve strategies such as creating trusts, investing funds in income-producing assets, or spending down excess assets in a Medicaid-compliant manner.
3. Coordinating the Transition Process
A Medicaid planning attorney can help you navigate the process of closing your Medicaid case in your current state and applying for benefits in your new state. They can assist with gathering necessary documents, completing applications, and communicating with Medicaid offices in both states to ensure a seamless transition of your coverage.
4. Maximizing Retroactive Coverage
If your new state offers Retroactive Medicaid coverage, a Medicaid planning attorney can help you identify and document any unpaid medical expenses from the three months prior to your Medicaid application. They can assist you in submitting these expenses to your new state’s Medicaid office, potentially saving you significant out-of-pocket costs.
5. Appealing Denials or Adverse Decisions
If your Medicaid application is denied or you receive an adverse decision regarding your coverage, a Medicaid planning attorney can help you navigate the appeals process. They can represent you in hearings, present evidence to support your case, and work to ensure that you receive the benefits you are entitled to.
6. Planning for Long-Term Care
A Medicaid planning attorney can help you explore your options for long-term care in your new state, including nursing home care, assisted living, memory care, and home and community-based services. They can assist you in understanding the differences between Medicaid waiver programs and state plan benefits, and help you determine the best course of action based on your individual needs and preferences.
By working with a Medicaid planning attorney, you can have peace of mind knowing that you have an experienced professional guiding you through the complex process of transferring your Medicaid benefits from one state to another. They can help you avoid common pitfalls, protect your assets, and ensure that you receive the long-term care services you need to maintain your quality of life.
If your family is facing a possible nursing home stay, you should contact Burzynski Elder Law at 239-434-8557. We have the experienced team in place to advise you through the complex Medicaid application process. Call to get your appointment today!