Medicaid Works is a program for people with disabilities who work. Under this program, workers with disabilities who earn less than 200 percent of the federal poverty level can pay a monthly premium to buy into the Medicaid program.
Anyone between the ages of 16 and 64 with a disability who is working can apply for the program. Applicants also must meet the Social Security definition of disabled and earn less than 200 percent of the federal poverty level. See the chart listed below. A person cannot have more than $4,000 in personal assets.
|Family Size||200 percent|
Note: These income limits change in April of each year.
Except for earnings, all applicants must continue to meet the Social Security definition of disability and meet all other requirements of the program. Earnings from work are not considered in determining whether a disability exists.
Can I qualify for the program if I am not a citizen?
Disabled aliens may be eligible for this program if they meet the qualification to be considered a qualified alien. These qualifications can be found in 907 KAR 20:005.
Whose income is counted?
In the Medicaid Works Program, the income of the working disabled individual is counted. Participants may have up to $773 in unearned income to qualify. Unearned income includes Social Security benefits, workers or veterans compensation or interest. This limit changes each year.
Can I have a retirement fund?
Yes. Any employer or individual retirement plan approved by the Internal Revenue Code is permissible under the program (for example, an individual retirement account).
How do I prove I am working?
A person applying for the Medicaid Works Program must provide proof of employment (for example, pay stubs or written verification from the employer that verifies employment.)
If you are self-employed, you will have to provide records (for example, Schedule C forms) to demonstrate employment. Also, for the independent contractor, verification may be provided with a 1099 IRS form as proof of income and employment.
If I am in the program, do I have to let you know when my income or address changes?
Yes. You are required to report all changes in income, name or address to your case worker within 10 days of the change.
Are there other costs for the program?
Yes, the usual Medicaid co-payments for services apply to the Medicaid Works Program. Please refer to the Member Handbook for co-pay and benefit information.
Can I apply for the program if I already receive SSDI and Medicare?
Yes. As long as you are working and meet all other eligibility criteria, you can buy into Medicaid with an affordable premium payment under the Medicaid Works program.
Can I apply if I have other health insurance?
If you have other health insurance, you would continue to use that insurance as the primary payer for your medical care. Your other insurance may not cover all the services you need. You can have private or employer health insurance and receive services through Medicaid Works.
What if I stop working after I get into the program?
If you quit your job or lose it for some reason but plan on returning to work, you can continue to receive benefits under the program for six months. If you have not returned to work within six months, you no longer will be in the program. When you get another job you can apply for the program again
Where do I go to apply for the program or if I have more questions?
To apply for the program, you should visit your local Department for Community Based Services (DCBS) office. If you do not know where your local office is visit the website to obtain that information. You may also call the statewide call services number at 1- (855) 306-8959 to apply.