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What to Expect When Moving a Medicaid Nursing Home Resident to Another State: Risks and Solutions
By Harry S. Margolis,
3 hours ago
By Harry Margolis
Question:
My sister receives long-term care Medicaid benefits in a nursing home in another state, about five hours driving from my current residence. Few relatives are still living near her to visit. What risks or potential problems might I encounter should I relocate her to my state in a nursing home and reapply for Medicaid? Since she only has less than $2,000 in resources (aside from an ABLE account and a third-party supplemental needs trust), she would be paying her nursing home expenses out-of-pocket until Medicaid is approved. Would the first Medicaid state be entitled to reimbursement from my sister once the first nursing home notifies the Medicaid authority of a planned change in residence?
That sounds like a difficult situation. Moving someone on Medicaid from one state to another can be problematic. But, on at least one point, you can rest easy. The Medicaid agency in your sister’s current state will have no claim for reimbursement when she leaves the state, just from her estate upon her death.
The biggest issues are logistics. You won’t be able to transfer your sister’s Medicaid eligibility automatically from one state to another. Instead, you will have to file a brand new application on her behalf in the new state. But to make matters more complicated, you probably won’t be able to do so until she has moved because state Medicaid programs won’t cover non-residents. This means that at first you won’t be able to use Medicaid to pay the new nursing home. Instead, you’ll have to use funds in your sister’s ABLE account or special needs trust. (Fortunately, she has those resources.)
The difficulty here has to do with what to tell the nursing home, since it would much rather your sister be private-pay than on Medicaid. The reality is that as soon as your sister moves to the nursing home, she will be eligible for Medicaid even though it may take months to get her application processed and approved. She can ask for retroactive coverage when she applies. But this can get complicated since it would mean the care facility reimbursing the special needs trust once the Medicaid application has been approved, in effect treating the payments as a loan. You may be able to work an arrangement with the new nursing home where you agree to pay privately for a period of time -- perhaps the first six months -- even if your sister could obtain Medicaid coverage earlier. This could help grease the wheels of the move.
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