FAQ: Can Medicaid Coverage Be Retroactive?

2 answers | Last updated: Nov 13, 2016
A fellow caregiver asked...

Can Medicaid coverage be retroactive?


Expert Answers

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.

Community Answers

Ge mom answered...

Just to clarify, in many states you can actually apply by completing an online application or a paper application (and mailing it). If you do this, make sure you have all the necessary verifications included in the packet. In our state (Illinois) if the application is complete with all the verifications of income and assets and identity, you never have to go into the state office. Given the major staffing cuts that most states have sustained, it's far better if you do it this way.