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Will the Medicaid coverage transfer out of state?

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php111

Member
What is the name of your state? Pennsylvania

Hi,

I have the Medicaid and HCBS funds through the Consolidated Waiver. Will it transfer across state lines? I know it will transfer from county to county in the same state but will it actually cross over the state line in any direction out of PA? I want to move to NYC and the local State Regional Office of DPW is saying NO it won't transfer. I will think it will cause even though it is funded through the Federal program it is half Federal and half State Waiver dollars. Federal goes nationwide. Please reply back ASAP with some info please. Thank you very much.
 


ecmst12

Senior Member
No of course not. Medicaid is a state program. If you move to NY, you will have to apply for NY Medicaid.
 

php111

Member
No of course not. Medicaid is a state program. If you move to NY, you will have to apply for NY Medicaid.

I can't move to NY without Medicaid nor I can move to any state.

The other day on the phone, I called the main NY Medicaid helpline and I asked them will my Medicaid transfer. The first question they asked me after the transfer was am I on SSI and I said no and then I said that I am on SSD and then she said it might transfer but I would need to call my Medicaid office in PA. Now what she told me is it or is it not true that the Medicaid might transfer out of state?
 

php111

Member
No of course not. Medicaid is a state program. If you move to NY, you will have to apply for NY Medicaid.
Please read carefully. The State is right it's half and half. State and Federal NOT State only.


The name Waiver comes from the fact that the federal government waives Medicaid rules for institutional care in order for the state to use the same funds to provide supports and services for people in the community. The state must make specific assurances to the federal government when requesting a Medicaid Waiver.

Federal and state funds are combined in Medicaid Waivers. The federal and state shares are not the same in each state and they are adjusted each year. In Pennsylvania it is generally a 50/50 split.


http://www.dpw.state.pa.us/ServicesPrograms/MentalRetardation/003670156.htm
 

ecmst12

Senior Member
Where the money comes from is not important. Medicaid is RUN by the state that it is offered through.
 

php111

Member
Where the money comes from is not important. Medicaid is RUN by the state that it is offered through.

Ok. I understand that. I am asking DPW staff that never even talked to me before and the same thing just keeps going around. Waivers can not transfer.
 

ecmst12

Senior Member
Then that must be the case. I don't even know what a Waiver is, in this sense. It's not a term I'm familiar with. I know each state has different qualifications for medicaid and you must apply with the state where you live - if you move, you will need to re-apply with your new state. If you work with the medicaid folks in NY, you can hopefully avoid any break in coverage due to the application process.
 

php111

Member
Then that must be the case. I don't even know what a Waiver is, in this sense. It's not a term I'm familiar with. I know each state has different qualifications for medicaid and you must apply with the state where you live - if you move, you will need to re-apply with your new state. If you work with the medicaid folks in NY, you can hopefully avoid any break in coverage due to the application process.

ecmst12,

A Waiver is part of Medicaid. I have the MR Waiver. Elder folks might qualify for the elder Waiver such as Waivers for nursing homes and so on.

As far as re-applying for Medicaid. My question is and always will be a question. Where am I going to live to establish residence? I have no family in NY and if I did they are ignorant and won't take me in. They live in North NJ. As far as I know I would need to be a legal resident of any state to apply for Medicaid.
 

ecmst12

Senior Member
How are you planning on moving to NY if you can't find a place to live there? Were you planning on moving there so you could be homeless? That doesn't make any sense. I did not figure you would be worrying about your Medicaid coverage if you haven't even gotten the housing situation squared away.
 

ecmst12

Senior Member
The link you posted did not really clear anything up, and it's a Maryland site. Are you saying that your "waiver" allows you to qualify for Medicaid because of your disability, even if your income may be above the maximum normally allowed for Medicaid recipients? If that is the case, you may or may not qualify in NY, since NY will have different criteria then PA. Do you receive SS income?
 

php111

Member
The link you posted did not really clear anything up, and it's a Maryland site. Are you saying that your "waiver" allows you to qualify for Medicaid because of your disability, even if your income may be above the maximum normally allowed for Medicaid recipients? If that is the case, you may or may not qualify in NY, since NY will have different criteria then PA. Do you receive SS income?

I do. I receive SSD and Survivor. Adult child disabled benefits. That what it sounds like I am qualified for the Medicaid program.
 

cbg

I'm a Northern Girl
I have no dog in this hunt and know nothing about Medicaid in PA, NY or MD.

That being said, reading this thread it sure sounds to me, php111, as if you've already decided what the answer is and are fighting hard to get someone here to agree with you, whether they do or not, whether the answer is correct or not.

Since you're not getting the answer you want here, why don't you call Medicaid and ask THEM if the benefits will transfer out of state?
 

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