What Happens to Medicaid When You Move to Another State

Medicaid doesn't transfer when you move: each state covers its own residents, so you apply in the new state once you live there.1 The new state can't make your parent wait a set period to qualify,1 and federal rules give it 45 days to decide (90 days for a disability-based application), barring unusual circumstances.2

In This Guide

• Why Medicaid Doesn't Transfer When You Move to Another State
• Moving to Another State on Medicaid, Step by Step
• If Your Parent Is in a Nursing Home
• If Your Parent Is on an HCBS Waiver
• Is There a Coverage Gap?
• Can You Have Medicaid in Two States at Once?
• Frequently Asked Questions

Why Medicaid Doesn't Transfer When You Move to Another State

Under 42 CFR 435.403, each state's Medicaid program covers its own residents. For an adult who doesn't live in an institution, the Medicaid state of residence is where the person is living and intends to stay, even without a fixed address, or where the person is living after arriving with a job commitment or to look for work. A state may not deny Medicaid because someone hasn't lived there for a specified period, or turn away a nursing-home resident who meets its residency rules because she didn't live in the state before entering the facility.1 So your parent applies for Medicaid in the new state once she lives there; start with our Medicaid by state hub.

The Medicaid residence rule has three exceptions. For a family moving a parent who needs nursing-home care, the one to check is a state placement: a state agency that arranges an out-of-state institutional placement remains the state of residence (more on that below). The other two are narrower. If your parent receives a State Supplementary Payment, a state's own add-on to federal SSI, the state paying it is her state of residence, so ask that state how the move affects her. And states can agree in writing to use other residency criteria between themselves, so ask both agencies whether one applies.1

Your parent generally isn't a Medicaid resident of the new state until she's there. Wisconsin's Medicaid eligibility handbook, for example, requires physical presence to apply, though that is one state's procedure, not a federal rule.1

Moving to Another State on Medicaid, Step by Step

A move between states has two halves: the old state closes its Medicaid case, and the new state opens one. Federal notice rules control how the old state ends coverage, and the residence rules decide which state is responsible if the two disagree.3

1. Decide which kind of move this is. A family-arranged move and a state agency's placement are treated differently (see the nursing home section).
2. Contact both Medicaid agencies. Our Medicaid by state hub lists each state's agency and application portal. Ask the old state how its coverage will end, and ask the new state when your parent can apply and what proof of residence it wants at the new address. The new state decides eligibility under its own rules, and the Medicaid income limit for older and disabled adults isn't the same in every state, so qualifying in the old state doesn't guarantee qualifying in the new one.4 Check the new state's figures in our guide to Medicaid income limits. See how to apply for Medicaid by state.
3. Watch for the old state's notice. Ordinarily the old state's Medicaid agency must send notice at least 10 days before it ends Medicaid coverage. The old state may give notice as late as the day it acts if it establishes that another state has accepted your parent for Medicaid, or if your parent's whereabouts are unknown and its mail comes back with no forwarding address.3 (See 42 CFR 431.211 and 431.213.) If a Medicaid notice looks wrong, you can request a fair hearing by the deadline printed on the notice.5
4. Keep dated records of the move, the application and medical bills. When your parent applies in the new state, list any medical bills from the months just before the application and ask about retroactive coverage for them (see the coverage gap section below).6

If your parent gets Supplemental Security Income (SSI), whether she needs a separate Medicaid application depends on the new state. In the 34 1634 States and the District of Columbia, the Social Security Administration makes the Medicaid eligibility decision as part of SSI, so an SSI recipient is generally enrolled in Medicaid with no separate application. The eight SSI criteria states (Alaska, Idaho, Kansas, Nebraska, Nevada, Oklahoma, Oregon and Utah) and the eight 209(b) States (Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota and Virginia) require a separate Medicaid application, and a 209(b) State applies at least one eligibility rule stricter than SSI's.7 Our guide to SSI and Medicaid eligibility explains the three groups.

If Your Parent Is in a Nursing Home

Two cases change which state is responsible for nursing home Medicaid.1

• A move your family arranges. If your parent can state her intent and you move her near you, her Medicaid state of residence is where she lives and intends to stay.1
• A placement a state agency arranges. If a state agency, or an entity under contract with the state, arranges the out-of-state placement, the placing state stays her Medicaid state of residence, even if it lacked enough suitable facilities.1

States can also set different residency criteria by written interstate agreement. Wisconsin, for example, has reciprocal agreements with a list of states in its eligibility handbook that make people placed in out-of-state institutions, other than through an interstate placement, residents of the state where the institution is.1 See nursing home Medicaid by state.

If Your Parent Is on an HCBS Waiver

Each state's 1915(c) Home and Community-Based Services (HCBS) waiver has its own enrollment limit. Under 42 CFR 441.303, the state names how many people it intends to serve each year, and that number caps the state's 1915(c) waiver unless a larger one is approved. A state with a waiver cap may keep a waiting list, and a place in one state's HCBS waiver is a place in that state's program.8 Because each waiver belongs to its own state, don't count on your parent's home care continuing until the new state has told you how a newcomer enrolls and whether there is a wait.

To enroll in the new state's waiver, your parent needs that state's level-of-care evaluation, which checks whether she would need the care a nursing facility provides if she didn't get waiver services.9

Before you set a move date, ask the new state which waiver fits, whether it has a waiting list, and how to schedule the evaluation; see HCBS waivers by state.

Is There a Coverage Gap?

The stretch families worry about is the one between the old state closing its coverage and the new state deciding the application, when medical bills can still arrive. There can be a gap, and federal rules limit how long the new state's decision on the application can take. Under 42 CFR 435.912, a state's decision on a Medicaid application may not take more than 45 days, or 90 days for a disability-based application, counted from the date of application to the date the agency notifies the applicant. Think of those limits as a ceiling, not a schedule. Unusual circumstances, such as a delay by the applicant or an examining doctor, or an emergency the agency can't control, can stretch them, but the Medicaid agency can't treat the time limits as a waiting period and simply hold the application until they run out.2

Medicaid retroactive coverage can fill part of the gap. Today, Medicaid must cover care received in or after the third month before the month of application, if your parent would have been eligible when she got it. The state plan sets the exact start date, and a Section 1115 demonstration can change what a state provides. For Medicaid applications made on or after January 1, 2027, the retroactive coverage window shrinks to two months before the application month for most people and one month for the Affordable Care Act (ACA) expansion adult group.6 See our retroactive eligibility guide.

Can You Have Medicaid in Two States at Once?

Not by design. Federal rules tie your parent's Medicaid to her state of residence, the state where she is living,1 and if two states can't agree, the state where she is physically located is her Medicaid state of residence.3 Enrollment in two states at once can still happen, and Congress has ordered a cross-state check, described below, to reduce it.10

A trip away is different from a move. Her home state can't end her Medicaid because of a temporary absence if she plans to come back, unless another state has decided she now lives there. And when states sign a written agreement for settling residency disputes, it has to include a way to provide Medicaid while a case is being sorted out.3

Under section 71103 of Public Law 119-21, the 2025 federal budget law, states must have a process to regularly obtain Medicaid enrollees' addresses beginning January 1, 2027. By October 1, 2029, the federal government must set up a system to prevent Medicaid enrollment in more than one state at once, and when that system shows someone is enrolled in another state, the state must check whether the person lives there and disenroll a person who doesn't, unless an exception applies.10 For your parent, that means planning on one state's Medicaid at a time and telling the old state about the move rather than trying to keep both.

If your parent also has Medicare, see what happens to Medicare when you move to another state.

Learn More

Find personalized help moving a parent's Medicaid to a new state at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.