Moving to a New State Can Affect Medicaid Eligibility

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What happens if you or your family member must move from one state to another and then apply for Medicaid? What if you or your family member is already in the Medicaid program and then moves? Will you lose your eligibility?

First of all, it is a violation of the U.S. Constitution to impose a residency requirement on an individual who moves into a state and then needs to apply for Medicaid. So the day after an individual moves, he or she can apply for Medicaid.

That being said, the person who is moving will still need to meet the asset and income requirements of the new state's version of the Medicaid program. In addition to the federal requirements that apply to all states (no more than $2,000 in liquid assets, no more than a certain amount of income, etc.), there are other optional requirements and regulations that vary from state to state. If the requirements for eligibility are different in a person's new state of residence than they were in their previous state of residence, then they must meet the eligibility requirements of the new state before Medicaid will cover their expenses.

For example, there may be different requirements as what types of gifts are allowed, different calculations for penalty periods following gifts, or different rules governing Medicaid annuities or the exemption of the personal residence.

As you can see, even if a person was already on Medicaid in one state, there is no guarantee that they will qualify for Medicaid in another state. If your loved one must move, it would be advantageous to understand the rules of their new state of residence, so that they don't make any gifts or implement any planning techniques in the old state that may have negative consequences in the new state. By understanding the rules of both states, your family member may be able to adjust the timing of their gifts before the move, as well as the timing of their Medicaid application in the new state.

In addition, because many states operate under federal waiver programs, the relocated individual may have to go on a long waiting list to get Medicaid coverage, and indeed the coverage under the prior state's waiver program may simply not be available in the new state (for example, some states cover assisted living costs and some do not). Again, once a person moves, he or she is governed by the program rules and coverage of their new state.

Bottom Line: If an aging family member has the option to move or not, then he or she would be wise to check with an experienced elder law attorney in the state they are considering moving to. Be sure they understand how the rules of the new state would apply to their situation, so no one is faced with any nasty (and expensive) surprises!

K. Gabriel Heiser is an attorney with over 25 years of experience in elder law and estate planning. He is the author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets," an annually updated practical guide for the layperson.

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4 Comments

To give an example, in the case of my Mother. She has resided in NY all her life; there the qualifying requirement(s) -in part- states that for the 2014 she can have assets of $14,300. The state of MI, from what i have read, asset level follows the Fed.Govt. guideline of $2,000.
There are no direct, bloodline, family members still alive in NY; whereas in MI there two(2) sons and five(5) grandchildren. Mother has been placed in an AL facility, by advise (direction) of NY authority. I was told that 'unless you can prove your Mother will have 24/7 care at home, she will be placed.'
Mr. Heiser is a good resource and I for one sincerely appreciate the information he posts. I only wish that an Elder Law Attorney was close to consult with.
My very direct experience with the whole "moving" was with my MIL from LA to TX. MIL's old NH closed due to Hurricane Katrina with the residents, the NH director and many staff moved via vans the Friday after the storm to the Houston area. The area where we had a home & where MIL NH was did not flood but there was total absence of any infrastructure to stay in New Orleans. (we drove out on Thursday; NH left on Friday & this was lucky as that next Sunday the area was militarized; really chaos by midweek with everybody packing heat who could). State of TX was really good on accepting all those on Medicaid to basically fold into the TX program initially. But there was a federal edict that all states had to do whatever for evacuees from the LA & MS Katrina zone & without requiring any documentation nationwide. So in theory you could get into any public school district for the kids and any NH for the elderly. For MIL's NH group, they went & took over a hotel by IAH & were there maybe 2 mos for those that weren't needing truly higher level of care to get placement for residents or if family came & picked them up. MIL & 5 others got placed in a really nice & new NH in the area (btw she hated it but that was going to happen no matter if it was The Windsor Court). Federal FEMA funding paid TX for NH on emergency waiver - just like fed's paid for all Rx's at the major pharmacy chains for this period of time. Then at about 6 mos, all the Katrina NH evacuees got letters requiring them to qualify for TX Medicaid. They had to become a resident of the state, with state ID. For any of them who had any real property in LA - like home, land or car - they were declined TX Medicaid. Even if the home flooded, uninhabitable w/ no power/gas/water in the neighborhood where the house was OR even if the home was on the MS coast and had been vaporized by windstorm & storm surge. Home, car, land was considered real property and an asset that would disqualify them for Medicaid. It was on the tax rolls & showed up. MIL didn't have anything in her name so this was not an issue for her, but for others it was a total clusterF. NH billed residents & their families at full private pay rates too. Most walked on their bill and I'm sure the NH wrote it all off on taxes.

Couple of them became emergency wards of the state as their family were homeless (as they lost their home or could not get it habitable) and even if they wanted to get momma there was no home to take her to. We have friends who's NH parents were stuck in HS gym for weeks as the state they went to did not have emergency openings in NH that would take the waiver. They too would have to have their parent become a resident of the state in order to have them qualify for Medicaid. Many had their folks move up to the northern part of LA or MS to get them into any NH with an open bed - many of which were somewhat substandard compared to their old LA or MS NH - as there was flat just no way to get the real property dealt with within the time frame the new state required.

A lot of the Al & NH set died before their time as it all was just too much, too complicated to deal with. It is just so important to think ahead to what your backup plan would be if a natural disaster strikes or other worse case scenario. My experience has shown that if they own real property, you basically have to keep them in their state to have Medicaid work for them with the least amount of issues.
My mom and I had bought our condo in CA back in 1991 and lived together in it for 22 years. My then 93-year-old Mom had many health issues, including congestive heart failure, suffered several fall injuries and had to move to assisted living in 2013. She miserably lived in CA shared rooms from April 2013 until August 2013. Because she really needed a private room and our family could not afford it in CA, my sibling and his wife up in OR State moved her to an assisted living private room up there. Her funds were running out, so family helped her apply for Oregon Medicaid which started in December 2013. The legal agreement with our 50/50 CA condo ownership was that I was to occupy the property until at least Mom passed. Since I have a genetic condition disability and have been mostly unemployed from the clerical workforce because my limited skills finds no matching job, my OR family explained to OR Medicaid that the my/Mom’s property should be exempt from any Medicaid liens. Mom lived until November 2014, and I still occupy my only residence in CA: the condo. All legal work for Mom had been transferred from CA to OR, since Mom had spent her final months up in OR. I do not think Medicaid will place a lien on my property (after Mom's estate is transferred to me.) Mom left no assets other than the CA condo. I have been unemployed for most of the last three years and have Medi-Cal for my health care. Last year I had applied for disability for my condition that now leaves me unable to work because employers have laid off all of the clerical assistance type of work I am able to do, but Social Security denied my claim, telling me that I can do some work. Not only is no suitable work open, but I am not even able to land any work because I cannot even get through new and tougher interviewing standards called the STAR (Situation/Task/Action/Results) questioning methods. I am only 59 and have to wait at least 2 1/2 years to apply for Social Security at age 62. I have been going to a therapist for over one year because of my stress. Prayers are appreciated.