FAQ: Can Medicaid Coverage Be Retroactive?

A fellow caregiver asked...

Can Medicaid coverage be retroactive?


Expert Answer

Yes, Medicaid (called Medi-Cal in California) medical, home care, and nursing home coverage can be retroactive. If someone is approved for Medicaid, coverage can go back not only to the date of application but also to three months prior to the application. But retroactive coverage is not automatic. It only applies to those months during which the person would have met Medicaid eligibility requirements. If he or she was not Medicaid eligible -- had too high an income or assets, or is determined not to have needed the level of care received (in a nursing home, for example) -- during any one of the three prior months, that month's medical or other care bills are not covered.

To find out the specifics about eligibility and the application process for Medicaid in your state, search the Internet by entering the word Medicaid and the name of the state, which will take you to the official website of your state's Medicaid program. This can help you begin the process, but to actually apply you'll have to make an appointment with your local Medicaid or Social Services office. You can also find the Medicaid office nearest you by going to the Benefits.gov website and clicking on the name of your state. Or you can call the Eldercare Locator toll-free at (800) 677-1116.