Working Disabled Coverage

Working Disabled Coverage A. Working Disabled is a category of eligibility for working disabled individuals offered by the Division of Medicaid as a work incentive program allowing disabled individuals with relatively high earnings and resources to qualify for Medicaid provided the individual engages in a paid work activity for a minimum of forty (40) hours per month. B. There is no requirement for the working individual to apply for disability benefits with the Social Security Administration until their full retirement age based on their date of birth. All other pensions and retirement benefits must be accessed and accepted when available. C. The individual must be determined to be disabled using SSI criteria, including individuals over the age of sixty-five (65). The Substantial Gainful Activity (SGA) component of determining disability is not taken into consideration for Working Disabled individuals. D. Countable earnings from all sources must not exceed two hundred fifty percent (250%) of the federal poverty level. Countable unearned income from all sources must not exceed one hundred thirty-five percent (135%) of the federal poverty level. E. Resources must not exceed twenty-four thousand dollars ($24,000) for an individual and twenty-six thousand dollars ($26,000) for a couple. F. The working individual may have Medicare and qualify for Working Disabled coverage. The individual is required to apply for Medicare Part A if premium-free Part A is available to the individual or total income does not exceed one hundred percent (100%) of the federal poverty level. G. Working Disabled individuals who have earnings in excess of one hundred fifty percent (150%) of the federal poverty level must pay a monthly premium that is five percent (5%) of countable earnings as a condition of eligibility. H. Premiums due for a requested retroactive period are payable in full prior to authorizing eligibility for the retroactive period. Premiums due for the month of application and all subsequent months are payable within fifteen (15) days of receiving the invoice for the premiums issued by the Division of Medicaid. Nonpayment of premiums results in ineligibility for the Working Disabled program.