More Details on New York's Medicaid Buy-In Program

April 2003

· The Medicaid Buy-In program for Working People with Disabilities will make Medicaid coverage available to employed people with disabilities who are at least sixteen years of age but under the age of sixty five and whose income from work previously would have disqualified them from coverage.

· Once the program starts, individuals with net incomes up to 250% of the Federal Poverty Level can be eligible, meaning Medicaid will be available for working individuals with a gross income of $46,170 for a household of one and $61,870 for a household of two. A premium (a payment back to the state to retain Medicaid coverage), based upon a percentage of earned and unearned income, may be required.

· To be eligible for the Basic Medicaid Buy-In program, a working individual between the ages of 16-64 must have a disability that meets the medical criteria for Supplemental Security Income (SSI) established by the federal Social Security Administration, but have too much income to qualify for SSI.

· Eligible individuals can have no more than $10,000 of resources (excluding house or car).

· Individuals with incomes under 150% of poverty pay no premiums; individuals with incomes of 150-250% of poverty will pay premiums calculated at 3% of earned income and 7.5% of unearned income.

· Medicaid Buy-In enrollees who are later determined to be medically improved on a Continuing Disability Review but who retain a severe medical impairment can still qualify if they are working 40 hours per month or more.