Medicaid Gap: Moving States Can Cost You Coverage

Individuals moving between states, such as from California to South Carolina, risk losing essential Medicaid coverage despite consistent income. This situation arises because each state administers its own Medicaid program with unique eligibility rules.

For instance, a 25-year-old earning $15,000 annually qualified for Medi-Cal in California, which expanded Medicaid under the ACA. However, South Carolina, one of ten states that has not expanded Medicaid, does not offer a full coverage category for childless adults without a qualifying disability.

This creates a coverage gap, leaving many residents without comprehensive health insurance. To qualify for subsidized marketplace coverage in South Carolina, an individual's income typically needs to be at least $15,960. Without this, essential medical needs and prescriptions could become unmanageable.

Smart movers should verify eligibility in their new state before relocating. This includes understanding specific categories, pricing alternative coverage, and refilling prescriptions. Some may also qualify for limited benefits or remain on a parent's employer plan until age 26.