MEDICAID BUY-IN PROGRAM FOR WORKING PEOPLE WITH DISABILITIES

June 2003

The Medicaid Buy-In is a special work incentive now offered in 25 states. It will allow individuals with disabilities to retain Medicaid at significant earnings levels even if the individual would not be eligible under the 1619(b) program. New York State was to start its buy-in program on April 1, 2003, but that start-up had been delayed. However, the governor’s office has announced that the buy-in will now be available on July 1, 2003.

Below is information about the Medicaid Buy-In Program provided by the New York State Department of Health.

Are you currently working or would you like to work without losing your Medicaid benefits?

Would you like to save more money and keep your benefits?

Are you presently paying a spend-down and would rather pay a premium for healthcare coverage?

If you answered yes, the Medicaid Buy-In Program for Working People with Disabilities may be the choice for you!

Questions and Answers About the Medicaid Buy-In Program For Working People with Disabilities

What is the Medicaid Buy-In Program for Working People with Disabilities?

The program offers Medicaid coverage to people with disabilities who are working and earning more than the allowable limits for regular Medicaid.  If you are eligible, the program offers you the chance to keep your health care coverage through Medicaid while earning more income than was previously allowed. 

When does the program begin?

July 1, 2003

Who is eligible?

To be eligible for this coverage, a person must:

· Have a disability as defined by the Social Security Administration

· Be at least 16 but not yet 65 years of age

· Be engaged in paid work (includes part-time and full-time work)

· Have a gross income that may be as high as $46,170 for an individual and $61,870 for a couple (as of January 1, 2003)

· Have non-exempt resources that do not exceed $10,000

If I'm not working now, can I become eligible for the program?

Maybe.  If you meet all the other criteria, you can apply for the Medicaid Buy-In Program for Working People with Disabilities once you begin working.

Will my family be covered?

Single people or married couples (if both spouses have a disability and are working) are covered under this program. Spouses without a disability and children may be covered through other programs.

What if I already work, meet the Social Security Administration's definition of being disabled, and receive Medicaid coverage with a monthly spend down?

If you are already working and receive Medicaid coverage with a monthly spend down, you still have the option of participating in the Medicaid Buy-In Program for Working People with Disabilities.

Will I have to pay a premium for coverage?

Maybe.  It depends on how much income you have.  The method used to compute net earned and unearned income is complex.  There may be a premium based on your income.  This will be determined when you apply for the program.

Where can I apply for the program?

Application for the Medicaid Buy-In Program for Working People with Disabilities must be made at your Local Department of Social Services.

What are resources?

Resources are property of all kinds, such as bank accounts, stocks, bonds, and vacation homes.  All resources will be reviewed to determine their availability and value.  To be eligible for this program a person may not have more than $10,000 in resources.

Resources that are not counted include:

· Homestead

· Automobile

· Pre-need funeral agreements (irrevocable)

· Plan to Achieve Self-Support (PASS)

· Life Insurance Policies (whole life policies with a combined face value of $1,500 or less)

There are other resources that are not counted.  Your Local Department of Social Services can provide you with further information.

Who can tell me if I am eligible?

Your Local Department of Social Services will review your application and tell you if you are eligible for the program.  Please make sure you bring the information required to complete the application.

Who can I contact for help in getting more information about the Medicaid Buy-In Program for Working People with Disabilities?

For more information:

Call the Medicaid Help Line
1-800-541-2831
TDD:  1-800-662-1220

or

Contact your Local Department of Social Services Addresses and phone numbers may be found in the phone book or online at: www.health.state.ny.us/nysdoh/medicaid/ldss.htm or Contact a Benefits Counselor who is trained to help you make decisions about this program and others. 

Call the toll free Statewide Technical Assistance line at (888) 224-3272 or TDD (716) 847-1322

or see the Benefits Planning Assistance & Outreach (BPAO) Directory online at http://www.ssa.gov/work/Service Providers/BPAODirectory.html