As an individual with a documented disability, elderly or someone with medical issues it is always important to take into account how you will be medically covered when moving in the United States. Unfortunately, we do not have Medicare for all or any sort of full coverage for all citizens at this time. With that being said, we are forced to navigate a complicated and stressful system in finding the best medical plans for ourselves.
It is important to note that if you are already on Medicare Part A and B coverage, that follows you throughout the U.S. It’s Medicaid (state) and the Medicare Part D (prescription) plan (depending on which one you get) that you’d mainly have to focus on as it only gives you coverage in that specific state.
With this article I’m sharing what I did to make sure I was covered without lapse in care.
In my previous state I had full medical coverage (federal-Medicare and state-Medicaid) plus a great prescription plan (Medicare part D) that allowed me to pay no more than $2.30 a prescription tops (most times it was less) and most of the prescriptions were 90 day supplies. Having End Stage Renal Disease is considered a disability. Having a disability, in some cases, can get you resources a bit quicker, especially in the case of End Stage Renal Disease. (Check my original diagnosis story article here. Video here).
Essentially, when making this move, timing was of the essence so I had to keep that in mind while accomplishing the following:
- Set Move Date
- Let Clinic Know
- Cancel State Medicaid
- Go To Appointments
- Refill Medications
- Updating Address Medicare/Social Security
- Apply For New State Medicaid
- Schedule New Appointments
Set Move Date
This may seem like a big duh but the day you plan on moving should be done strategically as it can affect coverage.
- If receiving treatments MWF then take the plane on Saturday (in case there might be delays).
- If receiving treatments TTS then take the plane on Sunday.
Side Note: Remember to check TSA rules on storing your medicine if you are taking a carry-on or checked bag. You can do so HERE.
Let Clinic Know
This is important because when dealing with the Fresenius Kidney Care/Davita, etc. clinic, you must tell your social worker or front desk so they can find a clinic in the area in which you can get treatment as well as schedule the days and the shift. It can take time for communication between clinics. Although, interestingly in my case, they wanted a two week window. Check with your clinic for full details.
Cancel Old State Medicaid
From my understanding, you cannot have Medicaid in more than one state. So, it is important to contact your current Medicaid insurance to let them know you are moving and initiate canceling of state insurance at least one month prior to your move as in some cases they keep the benefits for that final month before they cut it off. I say this because I didn’t know about the month of Medicaid close out from the old state despite speaking with 2 separate social workers so I waited until I got the letter confirming the closing. You may/may not have to do this depending on the states you are traveling from and to. I say this to keep in mind this might be the case for you. So yes, let your state Medicaid know asap and they should be able to give you the best guidance.
Go To Appointments
While you are in your old state, make sure to go to as many appointments as needed. For me I was due or close to being due with my yearly physical with my PCP (primary care physician). I also had some dental issues that needed addressing so I made sure to do that. For example, one of my wisdom teeth were acting up so I had to let it go. I also got my dental cleaning done amongst other things.
I also made sure that all my medicines that were due for refill were refilled by the pharmacy towards the end of the month prior to moving. As I previously mentioned, the prescription drug plan I had usually given me medicine for 3 months out. So in case anything was delayed, such as getting Medicaid in the new state, I didn’t have to worry about medicine.
Make sure to update addresses on file with Medicare/Social security if you get those benefits as well.
Apply For New State Medicaid
After I moved, I was able to apply for Medicaid benefits when I received the letter from the previous state that the intent was to end those benefits at the end of the month. If you are applying for nutrition/cash assistance as well most times you can apply for it at the same time as the Medicaid. Get what you need.
Schedule New Appointments
As soon as I got the letters of acceptance in the new state, new card and all, I was automatically given a PCP (Primary Care Provider). I scheduled an appointment ASAP so I can get referrals to other doctors such as a rheumatologist because of the lupus that caused ESRD (check my story here. Many thanks to the Neteru I have been in remission for 9 years now !) so I can get the appropriate labs to continue monitoring.
Now, considering that I had to continue getting treatment at the clinic prior the Medicaid coverage kicking in (due to me not knowing about the prior month close-out), Medicare was covering the treatments I was getting in the clinic, yet I didn’t have the medical rides to go. Therefore, I was forced to take public transportation to the clinic and took a ride sharing back (I don’t like to drive to and from those treatments although I handle them well, sometimes it can take a while to feel your full self again. Also, from watching other patients leave after kidney treatment I can tell cognition can be affected immediately after as well and didn’t want to risk it!). I was doing this for about 3 weeks.
When I got Medicaid acceptance in the new state I was eligible for a deductible on prior costs of going to treatments since my move date. Plus, the care coverage became retroactive to when I first got treatment for the new month. So I never saw one bill. Now, once again, I am fully covered with very little costs.
Overall, it is important to go over everything in regards to your insurance and care prior to your move. Making sure to cancel your old state Medicaid in time prior to your move and applying for you new Medicaid when you move is key. Keeping your address updated with insurances, refilling medicines and going to all your appointments will add to your peace of mind.
This is my story and although the overall move was pretty smooth for the most part, I do encourage you to DO YOUR RESEARCH before moving. The state you are moving to may or may not have this type of coverage. I only know what worked for me. I hope you or someone you know has found this information on navigating the system with a chronic condition helpful.