Reciprocity

Medicaid Extended Coverage is available through the New York State Medicaid program as well as the Medicaid programs of states participating in federal reciprocity standards (reciprocal states). Although the benefits payable under a Partnership policy/certificate may be used outside New York State or reciprocal states, at the time your eligibility for Medicaid Extended Coverage is determined, you must be a resident of New York State or a reciprocal state pursuant to the rules and regulations of the respective state's Medicaid program. It is permissible for a Participating Consumer to reside outside New York State or a reciprocal state while receiving benefits under a Partnership policy/certificate, and to reside in New York State or a reciprocal state when it is time to apply for Medicaid Extended Coverage.

In reciprocal states, Total Asset Plans will be considered Dollar for Dollar Plans, or plans that allow for the disregard of assets under Medicaid up to the total amount of benefits paid out by the insurer on behalf of the covered person.

NOTE: The Compact has two main standards that states must adhere to.  The first is that any state participating in the Compact agrees to recognize Medicaid Asset Protection earned by a Partnership policyholder from any other state who is a member of the Compact and that, second, Medicaid Asset Protection is recognized regardless of when the Partnership policy was purchased.  This second standard regarding the purchase date is important since the new Partnership states started their Partnership programs well after the original four Partnership states (CA, CT, IN & NY) developed their programs. 

UPDATE ON RECIPROCITY : It has come to our attention that New Hampshire has instituted its own state specific reciprocity criteria that could limit the amount of Medicaid Asset Protection a Partnership policyholder from another state, such as New York, could have recognized in New Hampshire.  New Hampshire's current rules require that the effective date of the Partnership policy from another state be on or after the date New Hampshire received approval from the federal government for their Partnership program, which is April 1, 2007.  In addition, New Hampshire's rules require that the Partnership policy from another state be approved by the New Hampshire Insurance Department.  This means that the only way a Partnership policyholder from another state will be able to have their Medicaid Asset Protection recognized in New Hampshire is if they are able to convert their policy to a Partnership policy approved in New Hampshire with an effective date of April 1, 2007 or after.  For most policyholders this will not be possible.

Please be aware this in no way affects the payments of benefits made from New York State Partnership-approved policies.

If you would like additional information on this matter directly from New Hampshire, please contact the New Hampshire Insurance Department at 603-271-2261 or toll-free in New Hampshire at 800-852-3416 or email at consumerservices@ins.nh.gov .

To see a map of states that participate in reciprocity, click here: Map link

NOTE: If New York State elects to withdraw from the Partnership, all new sales of policies/certificates will be halted. However, the State will continue to honor its obligations under Consumer Participation Agreements in effect at that time, provided that the Participating Consumer maintains his or her in-force Partnership policy/certificate and complies with his or her responsibilities under the Consumer Participation Agreement.

Reciprocal states can choose to opt out of Partnership and/or federal reciprocity standards at will. This means that NYS Partnership insureds may not be eligible for Medicaid asset disregard in other states, due to the state's withdrawal and/or state-specific standards on reciprocity. Current insureds should always contact the intended state of residency before relocating. However, once a person is determined to be eligible for a reciprocal state's Medicaid coverage with Partnership asset protection, the Partnership asset protection cannot be revoked upon eligibility redetermination should the reciprocal state subsequently decide to opt out of reciprocity.