Can Medicaid still be used even if she lives outside the US?

A fellow caregiver asked...

My sister is disabled and receives her health insurance through Medicaid (PA). She is thinking of moving to her daughter's house which is outside the US. Can she still continue to receive Medicaid/Access health coverage even though she lives outside the US? I understand that she would have to return to the US for treatment.

Expert Answer

If your sister goes to live with her daughter outside the US, she will have two different types of problem with her Medicaid medical coverage. The first is that neither Medicaid nor Medicare covers any medical treatment outside the United States and its territories. So, for her to actually receive any Medicaid or Medicare-covered treatment, she will have to physically return to the US and get the treatment from a Medicaid-participating doctor or other provider in the country.

Also, in order for Medicaid to cover the treatment, it has to be provided in the specific state (Pennsylvania) whose Medicaid program she's enrolled in. (Medicare, if she's enrolled in it, can cover her treatment anywhere in the US.)

There may also be a problem for her even keeping her Medicaid coverage. Although the federal government oversees Medicaid in general, each state runs its own Medicaid program. And each state Medicaid program is available only to residents of that state. So, even if your sister maintains her US citizenship (or legal alien residence "green card") when she moves abroad, she would also need to continue being a resident of Pennsylvania in order to receive coverage from the Pennsylvania Medicaid program. That means maintaining a place of residence in the state, perhaps filing a state tax return, and spending some part of the year there. Medicaid regularly monitors the eligibility of its beneficiaries. If your sister doesn't keep substantial connections to the state -- including a residence -- Medicaid may determine that she's no longer a state resident and drop her from Medicaid enrollment. (No similar enrollment restriction exists for Medicare.)