Can you receive Medicaid if you live, primarily, out of the country?

A fellow caregiver asked...

Can an individual receive Medicaid benefits and live in another country and only return every year for medical? Prescriptions are filled and then sent to that overseas address. Is this legal for the state of Alabama?

Expert Answer

If you live outside the US but want to continue receiving Medicaid medical coverage, you may face several problems. First, there may be a problem qualifying for or keeping Medicaid coverage. Each state Medicaid program is available only to residents of that state. So, even if you are a US citizen, or are a legal resident of the US who manages to maintain US legal alien residence status ("green card") while living abroad, you also need to be a resident of a particular state (in this case, Alabama) to receive coverage from the state's Medicaid program. That means you are supposed to maintain a place of residence in the state, file a state tax return, and spend some substantial part of the year there. The state Medicaid program would regularly monitor your eligibility, and if it finds that you don't have substantial connections to the state, including a primary residence, Medicaid may determine that you're no longer a state resident and may refuse or drop you from Medicaid enrollment.

Also, Medicaid does not cover any medical treatment outside the US and its territories. So, to receive Medicaid coverage for any medical care, you would have to physically return to the US and get the treatment from a Medicaid-participating doctor or other provider in the state where you have Medicaid coverage. This may be possible for planned medical check-ups and regular review of your prescriptions, but won't work very well when you're sick or injured.