medicaid buy in program
What is the Medicaid Buy-In Program for Working People with Disabilities?
The Medicaid Buy-In Program for Working People with Disabilities is a program that allows people with disabilities who are working and earning more than the allowable limits for regular Medicaid to retain their health care coverage through Medicaid. This program enables people with disabilities to work and still keep their access to Medicaid community-based services that may not be available through other insurers.
In this article, we will explain what the Medicaid Buy-In Program is, who is eligible for it, how to apply for it, and what are the benefits of participating in it.
What is the Medicaid Buy-In Program?
The Medicaid Buy-In Program is the nickname used to collectively refer to the Medicaid eligibility groups that serve workers with disabilities who are earning income and against whom states may charge premiums as a condition of Medicaid eligibility. The program was authorized by federal law in the late 1990s and early 2000s to promote and support employment for people with disabilities. The program is available in most states.
The Medicaid Buy-In Program breaks down barriers to employment for people with disabilities by allowing them to earn more income without the risk of losing vital health care coverage. The program also helps people with disabilities transition from public benefits to work by providing a safety net of health care services if their income or health status changes.
Who is eligible for the Medicaid Buy-In Program?
To qualify for the Medicaid Buy-In Program for Working People with Disabilities, you must meet the following criteria:
- Be a resident of New York State;
- Be at least 16 years of age (coverage up to 65 years of age);
- Have a disability as defined by the Social Security Administration;
- Be engaged in paid work (includes partâtime and fullâtime work);
- Have a gross income that may be as high as $73,932 for an individual and $99,636 for a couple; and
- Have nonâexempt resources that do not exceed the Medicaid resource limit of $30,182 for a oneâperson household and $40,821 for a twoâperson household.
Note: Retirement accounts are disregarded in determining eligibility for this program. Retirement accounts are annuities or workârelated plans for providing income when employment ends. They include but are not limited to: pensions; Individual Retirement Accounts (IRAs); 401 (k) plans and Keogh plans.
How to apply for the Medicaid Buy-In Program?
If you are interested in applying for the Medicaid Buy-In Program for Working People with Disabilities, you can contact your local social services district worker (county social services worker) or visit this website for more information. You will need to provide proof of your disability, income, resources, and work status. If you have not been certified disabled by the Social Security Administration, you will need to have a disability review done by the New York State Disability Review Team. Your local social services district worker can advise you of the process.
What are the benefits of participating in the Medicaid Buy-In Program?
By participating in the Medicaid Buy-In Program for Working People with Disabilities, you can enjoy the following benefits:
- You can keep your Medicaid coverage even if your income exceeds the regular Medicaid limits;
- You can access a range of health care services that may not be covered by other insurers, such as personal care assistance, durable medical equipment, home health care, mental health services, prescription drugs, and more;
- You can avoid or reduce your monthly spenddown requirements if you are already on Medicaid;
- You can pay a modest premium based on your income instead of losing your Medicaid eligibility altogether; and
- You can have peace of mind knowing that you have a safety net of health care coverage if your income or health status changes.
The Medicaid Buy-In Program for Working People with Disabilities