Medicaid For Workers With Disabilities

An individual is eligible to participate in the Medicaid for Workers with Disabilities coverage group if the individual meets the requirements below. (7-1-24) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.05 – Eligibility for Aid to Department of Health and Welfare the Aged, Blind, & Disabled (AABD) Section 802 Page 60 01. Non-Financial Requirements. An individual must: (7-1-24) a. Be at least sixteen (16) but less than sixty-five (65) years of age; (7-1-24) b. Meet the Medicaid residency requirement under Section 100 of these rules; (7-1-24) c. Meet the citizenship requirements under 42 CFR 435.406, Citizenship and Non-citizen Eligibility; (7-1-24) d. Meet the SSN requirements under Section 10 3of these rules; and (7-1-24) e. Meet the child support cooperation requirements under Sections 703 through 706 of these rules. (7-1-24) 02. Disability. An individual must meet the medical definition for having a disability or blindness used by the SSA for Social Security Disability Insurance (SSDI) and SSI benefits. (7-1-24) 03. Employment. An individual must be employed which may include self-employment. Proof of employment must be provided to the Department. Hourly wage or hours worked will not be used to determine employment. (7-1-24) 04. Countable Resources. Cannot exceed ten thousand dollars ($10,000) for an individual or fifteen thousand dollars ($15,000) for a couple. When calculating resources, the following items will be excluded: (7-1-24) a. Any resources excluded under Section 210 and Sections 222 through 299 of these rules; (7-1-24) b. A second vehicle as described in Section 222 of these rules; (7-1-24) c. Life insurance policies; (7-1-24) d. Retirement accounts; and (7-1-24) e. Exempt trusts as described in Section 872 of these rules. (7-1-24) 05. Countable Income. Is calculated using exclusions and disregards as described in Sections 300 through 547 of these rules. The countable income for: (7-1-24) a. An individual cannot exceed five hundred percent (500%) of the current federal poverty guideline for a household of one (1). (7-1-24) b. A couple cannot exceed five hundred percent (500%) of the current federal poverty guideline for a household of two (2). (7-1-24) 06. Earned Income Test. Gross income is the total of earned and unearned income before exclusions or disregards. Each individual’s gross earned income must be at least fifteen percent (15%) of their total gross income to qualify. (7-1-24) 07. Cost-Sharing. A participant in the Medicaid for Workers with Disabilities coverage group may be required to cost-share; the costs are determined under the provisions of the Idaho Medicaid State Plan. (7-1-24) 800. – 801. (RESERVED)