Medicaid Benefits

A frequent question asked by new Florida Medicaid Benefits recipients is: Can I use my Medicaid benefits if I am traveling out of state and something happens? The answer is: It depends. Florida Medicaid never covers healthcare services in another country or for any assisted living facilities located out-of-state.

Emergency Services Healthcare

If you have an injury or illness when traveling in another state, the hospital cannot legally deny you emergency medical services. The law provides you with these protections under the Federal Emergency Medical Treatment and Active Labor Act (EMTALA). Florida Medicaid reimburses the hospital so long as care meets one of the two following criteria:

  1. The emergency treatment is the result of an accident or illness while the recipient is out-of-state;
  2. Postponing services until returning to Florida will endanger the recipient’s health.

If a recipient needs emergency treatment, he or she must give the medical provider his or her Medicaid Benefits member card to verify eligibility. Generally speaking, a provider cannot charge a Medicaid recipient more than the required copayments unless informed otherwise.

Non-Emergency Care

For non-emergency out-of-state services, Medicaid benefits will cover services if a physician makes a referral to an out-of-state provider and there is not an available provider in Florida to perform the services. There should also be preapproval by Medicaid’s Quality Improvement Organization.

One caveat is that the provider must accept Florida Medicaid payments. As such, you should obtain preauthorization from the facility before making formal arrangements.

Out-of-State Services Not Covered

Florida Medicaid will not cover long-term care or routine healthcare services outside of the United States.

Free Call with A Florida Elder Law Firm

If you have questions regarding Medicaid Benefits when traveling, schedule a free consultation with The Law Office Of Michelangelo Mortellaro, P.A. by calling 813-367-1500 or sending us a message here.