How do I manage insurance and Medicaid while moving Mom from state to state?

2 answers | Last updated: Oct 26, 2016
Emmarie asked...

I live in California, and my parents live in Florida by the Mayo Clinic. Father, 88, has cancer and end-stage heart failure; mother, 83, has increasing undiagnosed dementia and sits silently in her chair all day, no housework, no bathing or any hygiene. Dad's doctor recommends hospice care, which he's refused. Neither cooks, Dad gives Mom meds as she's mostly listless. I've a sister in NY and another in GA - both are willing to research extensively but can't help parents physically too much now. Both sisters report that Mom seemed OK when they visited in August, but was slipping by Thanksgiving and was shockingly worse by Christmas. My wife (who homeschools our kids) is willing to do in-home care of Mom after Dad dies until Mom no longer can walk.
My Questions: 1. What insurance difficulties might we find in moving Mom from FL (with Mayo Clinic Medigap-type insurance) to CA for in-home care, and then possibly moving her to a nursing home in GA (another out-of-state move)?
2. Is it too hard to change from FL Medicaid to CA Medi-Cal and then to GA Medicaid?
3. Are there long waiting periods without Medigap insurance after moving to another state?

Expert Answers

Mary Koffend is the president of Accountable Aging Care Management (AACM), an eldercare consulting and care management firm that works with elder clients and their families to find the best care providers and services to meet their needs.

Moving seniors from one state to another can be very complex because of health insurance issues. Original Medicare, Part A and B, are the only portable part of the insurance. Medicare Advantage and Medicare Supplement programs are generally for a specific area as contracts are with service providers in that area and/or licensed in a specific service area. Medicaid offers very different services and options in each state. There are open seasons for Medicare Advantage and Supplements with a move if the policies in the prior location are not options in the new location. Because of the complexities involved, a strong and knowledgeable advocate like a geriatric care manager could assist. This website has a list of care managers in each area. Not all are experts in health insurance, but many are and could assist when a move is necessary. A care manager could also be your family's onsite representative and advocate in Florida. Care managers are aware of the variety of resources in an area. If your father is really in need of hospice services, the recommendations and education by a professional third party with no vested interest can be very impactful in his willingness to accept this service. A care manager could advise you and your siblings about the best plan of action for the present for your mom and your dad as well as assist with a plan in the future.

Community Answers

Skyeblue answered...

Just wanted to let you know my recent experience with moving parents from one state to another. They had Medicare coverage and an Advantage supplement, which cost them very little. The Advantage supplemental coverage was state and location specific. This plan was not available at their new location (our home in Oklahoma). It was very scary wondering if their insurance would be unsatisfactory after the move. Most insurance companies will deny new applicants coverage on preexisting conditions.

However, after doing some research, I found out that legally they were entitled to new coverage without being required to answer any medical questions. Certain life events for medicare recipients fall into this category and one is a move to an area where previous coverage is not available, Thankfully, I worked with an insurance agent that went to bat to make this happen. He had to call 10 different people at the Insurance Company before he found the right person that understood this.

Now they have supplement insurance from a reputable company and there are no exclusions to their coverage (which would have been a disaster). they do pay considerably more than in their home state, but comparable to what they paid prior to their state going to the Advantage plan.

My advice is to contact insurance companies that are knowledgeable with Medicare Supplements several months before the move and begin the application process, to insure there is no coverage gap and make certain that none of their illnesses are excluded. I tried working with a so called government help line and it was no help at all, it will be wise to do your own homework. God bless and keep you