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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Where Do My Benefits Go, If I Go To Work?

This is an important question, because there are a lot of recipients that want to work.  There are provisions called “work incentives” for those individuals. 

One provision is the Ticket to Work- Work Incentives.  These include being able to work during a “Trial Work Period” which allows you to work and see how things turn out.  You will NOT lose your benefits automatically during the Trial Work Period; you will receive full benefits no matter how much you earn.  You only need to report your work activity.

The Trial Work Period lasts until you accumulate 9 months of work (not necessarily consecutive months) within a 60 month period of time.  Once you have accumulated 9 months of work, you can earn up to $900 per month without losing your benefits.  For additional 36 months after the Trial Work Period any time your income falls below $900 per month, your benefits will be automatically reinstated.

If you are disabled and working, your Medicare benefits continue for 4.5 years after you begin work, and there is no premium charge for Medicare Part A.  Because of the work incentives, the coverage for individuals with disabilities trying to work, is FREE during that period of time.

If you are trying to work and receiving Medicaid, there are provisions available for most states to be able to provide any Medicaid recipients with disabilities.  It is important that you check with your state Medicaid office to determine if you can maintain your Medicaid while working.

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