Medicaid Buy-in helps People Who Work

Many individuals with disabilities want to go to work and are able to work at a job.  This is a very positive thing in many ways.  It helps the individual to build their self-esteem and pride, helps them become a more integrated part of the community, it helps the individual become more self-sufficient and it helps the economy.

There is a drawback for many people with disabilities who want to work.  The drawback is simply that individuals are worried that they will lose their benefits – especially their medical benefits – if they go to work.  It can feel devastating to be willing and ready to work but have to choose between work and medical care.

The truth is, however, that an individual with a disability can begin – and continue – working and still maintain their benefits.  States can extend Medicaid to people who are working but who are earning too much money to qualify for Medicaid under the current rules.

A person can qualify if their income is less that 250 times the national poverty level or if they meet the definition of “disabled” under the Social Security Act and would be eligible for Social Security Disability Insurance (SSDI) if they were not working and bringing in an income.  An individual can qualify for the buy-in without receiving SSI, and the state would then have to determine whether or not the individual has a disability.  The fact that an individual is working will not have a bearing as to whether they are disabled or not.

Another important piece of this equation is the Ticket to Work and Self-Sufficiency Program.  In fact, this program is the foundation through which many of these benefits are protected when a person goes to work.  The Ticket to Work program allows for and encourages states to cover individuals between age 16 and 65 years old who decide to go back to work and the states can provide Medicaid to individuals who are working who have improved enough to lose their coverage, but still qualify as being disabled.

So, if you are considering trying to work, find out about the Ticket to Work and find out about whether your state will continue your Medicaid benefits.  Take the first step toward working by finding out how you can continue receiving your benefits.  You can do this by contacting your State Medicaid Office or go online for information at www.cms.hhs.gov and look up Ticket to Work.

The information you discover may make the difference between you being able to work or not.

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They Want Your Buy-in

One of the biggest worries that individuals with disabilities have when they attempt to work is the loss of benefits – especially health care coverage.  They are worried that they will have no coverage at all or be forced into an employer’s plan that they cannot afford or that won’t cover their disability.

There are solutions to this dilemma, however.  The solutions are found as part of the Social Security Act- especially part 1619b and Medicare.  One of the most important provisions is the Medicaid Buy-in program.  This program was designed to provide access to comprehensive health care for working people with disabilities.  This is essential for many people with disabilities who find it difficult to find affordable and comprehensive coverage privately. 

The Medicaid Buy-in program allows people with disability to pay a premium for coverage through their state’s Medicaid program, just as they would if they were buying private health coverage.  The concept behind the buy-in was originally put forth in the Balanced Budget Act of 1997 to allow for individuals who lost SSI or SSDI benefits because they were making more money working.  These individuals were able to support themselves without receiving SSI or SSDI checks because they were making enough money through their paychecks from work.  However, they still needed health coverage, and Medicaid was the best choice for many situations.  As long as the individuals continued to meet the Social Security definition of disability, they would be eligible for the buy-in program.

If you find yourself in this type of situation, there are several steps you can take.  You can contact your county health department to determine what local programs are available; you can check with your state Medicaid office to see whether you qualify for the Medicaid Buy-in or other benefits; and you can check the Social Security Administration, Medicaid or Medicare websites for further information.

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