Medicare and Medicaid follow completely different rules when you move to another state. Medicare is a federal program that travels with you, so the transfer is straightforward. Medicaid is state-run, which means you cannot transfer it at all. You have to close your case in your old state and apply fresh in your new one. Understanding both processes, and how to time them, is the key to avoiding gaps in coverage.
Medicare Moves With You
Original Medicare (Parts A and B) is a federal program, so your coverage stays active no matter which state you live in. There’s no re-enrollment, no new application, and no waiting period. The only step you need to take is updating your address with Social Security. Even if you don’t receive Social Security benefits, Medicare relies on Social Security to maintain your records, so you still go through them. The easiest way is to log into your my Social Security account online and change your address there.
Updating your address ensures your Medicare card, notices, and any premium billing reach you at the right place. It also keeps your records current so claims process smoothly with providers in your new state.
Medicare Advantage and Part D Plans
If you’re enrolled in a Medicare Advantage plan or a standalone Part D prescription drug plan, moving to a new state is a bigger deal. These plans operate within specific service areas, and your current plan likely won’t cover you once you leave its network.
A permanent move triggers a Special Enrollment Period that gives you time to join a new plan in your area. If you notify your plan before you move, your window to switch opens the month before your move and lasts two full months after. If you don’t notify them in advance, the window starts the month you move and still runs for two full months. During this period, you can enroll in any Medicare Advantage or Part D plan available where you now live without waiting for the annual open enrollment season.
If you don’t pick a new plan before your old one drops you, you’ll revert to Original Medicare. That keeps you covered for hospital and doctor visits, but you’ll lose the extra benefits (dental, vision, prescription drugs) that many Advantage plans include. Act within your two-month window to avoid that gap.
What Happens to Medigap Policies
If you have a Medigap (Medicare Supplement) policy, you can keep it no matter where you move. Your insurer is required to continue your coverage. However, there are a few reasons you might want to switch. Premiums for Medigap policies vary by state and by insurer, so you could find a better rate in your new location. The plan letter you currently have might also not be the best fit given the providers and costs in your new area.
The catch: if you try to switch to a new Medigap policy outside your original Medigap Open Enrollment Period (the six-month window that starts when you first enroll in Part B at age 65), the new insurer can require medical underwriting. That means answering health questions and potentially being charged more or denied based on pre-existing conditions. Some states offer additional protections that give you more flexibility. Contact your new state’s insurance department to check what options are available.
Medicaid Requires a New Application
You cannot transfer Medicaid from one state to another. There’s no mechanism for it. Instead, you close your Medicaid case in your current state and submit a brand-new application in the state you’re moving to. This is the step that catches most people off guard, because it means your eligibility resets entirely under your new state’s rules.
Eligibility thresholds differ significantly between states. States that expanded Medicaid under the Affordable Care Act cover adults with household incomes up to 138% of the federal poverty level. States that didn’t expand have much narrower criteria, and some adults with incomes below the poverty level fall into a gap where they qualify for neither Medicaid nor Marketplace subsidies. If you’re moving from an expansion state to a non-expansion state, you could lose coverage even if your income hasn’t changed.
The application itself requires proof of residency in your new state. Common documents include a lease or signed letter from a landlord, a utility bill, a paystub showing your new address, a mortgage statement, a postmarked envelope, or a driver’s license with your current address. You don’t necessarily need to have lived there long, but you do need to show you intend to remain.
Timing the Gap
Processing times for Medicaid applications vary by state, typically ranging from a few weeks to 45 days or more. During that window, you may have no Medicaid coverage. Some states offer retroactive coverage that can pay for medical services you received before your application was approved. Historically, retroactive coverage reached back up to three months before the application date. Some states are shortening that window, so don’t count on it covering a long gap. Apply as early as possible after you arrive, ideally the same week you move.
Long-Term Care and Nursing Home Moves
Transferring Medicaid-funded long-term care to another state is the most complicated scenario. The same rule applies: you must close your case and reapply. But for nursing home Medicaid, some states require a minimum stay of 30 continuous days in a facility before you can even submit an application. Texas and Nevada are examples. If you were already in a nursing home in your previous state, that prior stay may count toward the 30-day requirement, but this varies.
Each state also sets its own definition of what qualifies as a “nursing home level of care.” If your new state has stricter medical criteria than your old one, you could be found functionally ineligible even though you were approved before. This is especially important to research ahead of time, because discovering the problem after you’ve already moved and closed your old case leaves you without coverage.
Home and Community Based Services (HCBS) waivers add another layer of difficulty. Unlike standard Medicaid, these waivers cap the number of people who can participate. If all slots are filled in your new state, you’ll land on a waiting list, which in some states can stretch months or even years. There’s no way to transfer your spot from one state’s waiver to another’s. If you rely on HCBS services for home health aides, adult day care, or similar support, research the waiting list situation in your destination state before committing to the move.
If You Have Both Medicare and Medicaid
People who qualify for both programs, known as dual eligibles, need to handle each one separately. Update your address with Social Security for Medicare, and apply for Medicaid in your new state. If you’re enrolled in a Dual Eligible Special Needs Plan (D-SNP), which coordinates both Medicare and Medicaid benefits into a single plan, you’ll need to find a new D-SNP in your destination. Your permanent move triggers the same Special Enrollment Period that applies to any Medicare Advantage plan: two months after your move to pick a new option.
Some states now offer Integrated D-SNPs, which combine Medicare and Medicaid even more tightly. Members get a single ID card, one handbook, and a unified process for appeals and grievances. These plans are expanding but aren’t available everywhere. Check whether your new state and county offer an integrated option, because it can significantly simplify managing both programs.
A Step-by-Step Checklist
- Before you move: Notify your current Medicare Advantage or Part D plan if you have one. This opens your Special Enrollment Period a month early. Research Medicaid eligibility rules and any waiver waiting lists in your new state.
- As soon as you arrive: Update your address through your my Social Security account. Apply for Medicaid in your new state with proof of residency. Contact your old state’s Medicaid office to close your case (some states do this automatically when they learn of a new state application, but don’t assume).
- Within two months of moving: Enroll in a new Medicare Advantage, Part D, or D-SNP plan if applicable. Decide whether to keep or replace your Medigap policy.
- If you have long-term care needs: Coordinate with the new facility and your new state’s Medicaid office before moving if possible. Confirm residency requirements, level-of-care criteria, and any mandatory waiting periods.