Medicaid for Working People with Disabilities
 

 

Effective October 1, 2000, The Work Incentive Act of 1999 expands state options and funding for Medicaid. Your State has the option to provide Medicaid to working people with disabilities whose earnings are too high for them to qualify for Medicaid under the State's existing rules. They also allow the States to permit an employed individual with a disability to buy into Medicaid, even if the individual is no longer eligible for Social Security or SSI benefits because his or her medical condition has improved.
  How You Qualify

You may qualify if you:

Are in a family whose net income is less than 250 percent of the national poverty level for its size (i.e., the poverty level for a family of three is $15,670, so the limit for this program is $39,175)
Meet the definition of "disabled" under the Social Security Act and would be eligible for SSI payments if it were not for your earnings



For more information contact:
The State Medicaid office in your area.
The Centers for Medicare and Medicaid Services
http://www.cms.gov/medicaid/consumer.asp

 
 


Here's an example of how the provision could work.

The 2004 Federal poverty level for an individual is $9310.00 The net income test for help under the provision is income of less the 250 percent of the Federal poverty level, or $23,275. Joe Green's annual income (earnings) is $42,765. After the SSI earned income exclusions, he meets the net income test for Medicaid and is eligible under this provision, as follows:

$42,765.00 - annual earnings divided by 12 = $3,563.75

  
 

$3,563.75
-       85.00
= $3,478.75

-  1,729.37
$1,739.37

 Monthly earnings
General and earned income exclusion


exclusion of half remaining earned income
monthly countable income or $20, 872 a year
 
In this example, Mr. Green's net income of $20, 872 is below the $23,275 limit for an individual.

  







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Letter to Report Earnings to Social Security
 

 


When you start working, it is important to keep the Social Security Administration informed of your earnings. Keep a photocopy of the letter you send, and file it in case you need it in the future. The following is an outline of a letter that you could use.

Download the Letter to Report Earnings Social Security.

 
 





[Date]

Social Security Administration
[Street address]
[City, State, Zip Code]


Re:  Employment earnings


Dear [Name of Your Social Security Representative]:

I am writing to report to you that during the month of _______________, 200__. I was employed by [company name], which is located at [street address, city, state, zip code]. My gross monthly earnings were $_____.  I have attached copies of these earnings.

Based on this earnings level, I [am/I am not (choose one)] eligible for an adjusted SSI cash benefit.

Please notify me if you disagree with any of this information.
Sincerely,




[Your Name]
[Your Address]
[Your Telephone Number]

[Your Claim Number]

  

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