2.8 Begin Dates

2.8.1 Begin Dates Introduction
2.8.2 Backdated Eligibility
1. 2.8.2.1 Backdated Eligibility Timeframe
1. 2.8.2.2 Determining Backdated Eligibility
1. 2.8.2.3 Medical Bills During Backdated Eligibility Period

2.8.1 Begin Dates Introduction

Medicaid eligibility begins the first day of the month in which the valid application is submitted and all program requirements are met with the following exceptions. For these exceptions, begin dates are the date a valid application is submitted, all program requirements are met, and:

Deductible – The date the deductible was met.
Foster Care Medicaid – The date the person entered into foster care. These dates are established by child welfare agencies.
Home and Community-Based Waiver Medicaid – The program start date provided by the Aging and Disability Resource Center (ADRC) or IRIS Consultant Agency (ICA).
Institutional Medicaid – The date the person entered into the nursing home or hospital.
QMBQualified Medicare Beneficiary – For applications, the first of the month following the eligibility confirmation. (For renewals, see MEH 32.10.1 QMB Renewals).
SeniorCare – The first of the month following the month in which all program requirements have been met.
Inmates – The restriction on covered services will end the date the member is no longer an inmate of a public institution. See Section 13.4 Suspension End Date.

2.8.2 Backdated Eligibility

Most types of Medicaid eligibility can be backdated up to three months prior to the month of application.

A backdate request can be made at any time except when the member is already enrolled and backdating the member’s eligibility would result in a deductible for the backdated period.

Home and Community-Based Waiver (HCBW) Medicaid cannot be backdated, as the start date is provided by the ADRC or ICA.

For backdating rules for Medicare beneficiaries, see Section 32.8 Medicare Savings Programs Backdating.

Note

Applicants are not eligible for backdated health care benefits while pending for citizenship and/or identity. Applicants who are otherwise eligible must be certified for health care benefits for the 95-day good-faith period within the normal application processing timeframe. Once verification is provided, the applicant’s eligibility must then be determined for backdated health care benefits if they have been requested. See Section 7.2 Verifying U.S. Citizenship for more information.

2.8.2.1 Backdated Eligibility Timeframe

The backdated eligibility cannot go back further than the first of the month, three months prior to the application month. The member may be certified for any backdate month in which they would have been eligible had they applied in that month.

2.8.2.2 Determining Backdated Eligibility

Actual nonfinancial information (for example, household composition) and actual income is used to determine eligibility in the backdated months.

A person’s asset eligibility in a backdate month is determined by whether they had excess assets on the last day of the month. If they had excess assets on the last day of the month, they are ineligible for the entire month. If they were asset eligible on the last day of the month, they are eligible for the whole month.

The reasonable compatibility test is used when determining backdated eligibility (see Section 20.3.5.2 Reasonable Compatibility for Assets and 20.3.8.1 Reasonable Compatibility for Income for Health Care). If the reasonable compatibility test is passed, further verification of income or assets may not be requested or required. If the reasonable compatibility test is not passed, further verification of income or assets is required.

See Section 15.6.8 Backdated Months for information on counting self-employment income for backdated months.

2.8.2.3 Medical Bills During Backdated Eligibility Period

If a member has incurred a bill from a Medicaid-certified provider during a backdate period, the member should contact the provider to inform them to bill Medicaid. The member may be eligible to receive a refund, up to the amount the member already paid to the provider.

Example 1

Mary who is 66 years old, applied for Medicaid on April 6, and was found eligible. At the time of application, Mary did not request a backdate.

In September Mary is billed for a doctor’s appointment she had at the end of February. Mary can ask to have her eligibility backdated through February. She meets all non-financial and financial eligibility criteria in the months of February and March. She is enrolled in Medicaid for both months.

This page last updated in Release Number: 26-02
Release Date: 04/15/2026
Effective Date: 04/15/2026