While Medicaid is a federal program available nationwide, each state has the ability to establish its own eligibility policies. If a move is in your future, it’s important to understand what factors should be evaluated to help you determine if you will be eligible for Medicaid in a different state.
Unlike Medicare, Medicaid is a needs-based program that looks at a combination of income and assets for each applicant to determine their eligibility for services. Because states set their own limits for income and assets, your eligibility can change if you move. Although these differences in limits between each state may not be very much, these policies can also change throughout the year, which makes planning carefully all the more important.
Financial requirements for Medicaid eligibility are classified under the following categories:
- Income. Both earned and unearned income are considered when testing for eligibility. The limits for an individual are different from those of a married applicant, whose non-applicant spouse can receive a certain allocation of income for living expenses. Married applicants applying together are typically not eligible for spousal allocations and will be considered based on each individual’s income amount.
- Countable assets. This includes any savings or investment accounts that are not already exempt by allowances that each state determines on its own. Countable assets may also include a second vehicle or any vehicles worth more than a state-established limit. Although income guidelines consider limits on an individual basis, a married couple’s assets are considered jointly. However, married couples may have a higher asset limit than an individual does to account for this.
- Exempt assets. Common exemptions include a home and its furnishings, provided the home is the only one owned by the individual or married couple and is their primary residence rather than a rental property. Certain types of investment accounts for retirement or burial expenses may also be exempt. Each state determines which assets can be exempt.
Other factors that decide financial limits include age and disability status. People over the age of 65 may have different income and asset limits than those under the age of 65. Blind or disabled individuals can also have different eligibility requirements in each state.
Some states also conduct what’s called a look-back period, which checks to see if applicants have transferred their assets to non-applicants in order to be eligible. If these transfers are deemed inappropriately handled, there may be an additional waiting period before the applicant can become eligible.
Differences in Level of Care Requirements
Medicaid eligibility for seniors also takes into consideration the individual’s level of care needs in order for them to receive long-term care services. As with financial requirements, each state can define what qualifies an applicant for these services. Being eligible for long-term care in one state does not mean that the applicant will be eligible in another state.
If an applicant meets Medicaid’s financial requirements and a medical doctor certifies the need for nursing home care in the applicant’s resident state, that state is required to pay for nursing home care. If the recipient moves to another state, they will need to undergo a new evaluation for income, assets and level of care requirements before Medicaid can pay for services in the new location.
Waivers that allow applicants to stay in assisted living facilities or receive in-home care assistance follow the same state-specific guidelines, but applicants can be wait-listed for these services even if they are otherwise eligible to receive them.
Transferring Medicaid Between States
Even though you may be eligible for Medicaid in more than one state, you may not receive simultaneous coverage from more than one state. You will need to cancel your Medicaid coverage in your current state before applying to Medicaid in the new state. Coverage gaps are often retroactively paid by the new state’s Medicaid program. Check with your Medicaid providers for eligibility considerations so that you can plan your move as seamlessly as possible.
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