Massachusetts domicile for health care

[Watch_Cowspiracy]

TX, FL, SD, and NV are all quite RV friendly states to choose for a domicile. But what about Massachusetts? They have a pretty good state healthcare program called Mass Health. It covers out of state emergencies and it seems that many of us would qualify based on the low income level's I'm seeing reported on this forum. A low income (less than $8,000 a year) also means one wouldn't have to pay state income tax. And even if I did have to pay taxes, I think it would be worth it for health insurance.  In MA, you do have to do yearly vehicle safety and smog inspections, but those can be waived sometimes if you're going to be out of state.

 

[perj28]

I don't know if anything has changed, but as far as I know, all state Medicaid should cover ER visits in another state. It's not "contracted" which means you might have to forward bills to Medicaid. The hospital I worked at sent the bills directly to Medicaid, they just did it all by hand instead of electronically like in-state. However, I don't think it'd cover seeing a Dr or getting medications out of state unless there were extenuating circumstances.

The savings on healthcare can definitely outweigh the income tax. We're looking at NM. I should be able to get Medicaid (I do now, one of my meds is $700/mo) but our income taxes will be under $100/yr. There's also no sales tax, which is a tax that generally affects low income ppl more because we spend more of the money we earn.

 

[Zil]

Mass Health is a different program. It is not Medicaid.

 

[John61CT]

The more generous the state the more likely they will enforce residency requirements.

And don't get caught lying, AKA fraud.

 

[Anhedonic]

Mass Health is partially funded through Medicaid but is its own thing. I have it at the moment and it is a life saver.

I'm not sure how strongly they enforce residency requirements, but in-state coverage is excellent, better than many paid programs. Also, having zero or very low copays makes is especially useful to those of us who make very little money.

 

[John61CT]

Find out about enforcement before endangering you coverage.

Have a credible spiel ready about why you're away if asked so not caught flatfooted

 

[Anhedonic]

Excellent advice, especially for those of us who die without health insurance.

 

[Anhedonic]

Here is the relevant section of the Masshealth page:

https://www.mass.gov/service-details/covered-services

"Out-of-state emergency treatment
MassHealth is a health-care program for people living in Massachusetts who get medical care in Massachusetts. In certain situations, MassHealth may pay for emergency treatment for a medical condition when a MassHealth member is out of state. If an emergency occurs while you are out of state, show your MassHealth card and any other health-insurance cards you have, if possible. Also if possible, tell your primary care provider or health plan within 24 hours of the emergency treatment. If you are not enrolled in a health plan through MassHealth, but instead get premium assistance, your private health insurance may also pay for emergency care you get out of state."

 

[John61CT]

Question is if you want to take an extended trip e.g. "sabbatical touring other NE states"

how many days at a time, or

how many days per year total, whatever the formula

are you allowed to be outside MA

and still keep your coverage?

 

[Anhedonic]

I've not seen any information on that at all. I don't know if there are specific rules for that if you are officially a resident.

Of course if you're just touring NE, you could always just drive a couple of hours back. The Eastern states are much smaller. You can drive across all of New England in less than a full day.

 

[John61CT]

I meant that's the story in discussing the issue with CSRs / caseworkers / lawyers etc.

Your job to Be Prepared, knowing the rules gives you more freedom and security.

And of course they have rules, even if just the same as "when do you lose MA domicile status?" for tax, voting etc issues

Physical presence in a jurisdiction is not the only criterion, but it is usually the most critical