People of any age who have a disability and are working can now get their health insurance through Medicaid by paying a monthly premium.
People in the Medicaid Buy-In Program will have access to the same Medicaid services available to adult Medicaid recipients, which include office visits, hospital stays, X-rays, vision services, hearing services and up to three prescriptions per month. People in the program will also be eligible for attendant services and day activity health services, if they meet the functional requirements for these programs. The monthly premium depends on the amount of unearned and earned income you make.
To Qualify for the Medicaid Buy-In Work requirement:
To be eligible for the Medicaid Buy-In Program, your earnings and FICA contributions must be at least $970 a quarter.
If you already receive disability benefits (SSDI or SSI) from the Social Security Administration, you automatically meet the disability criteria. If you are not already receiving disability benefits from the Social Security Administration, you will need to be evaluated for a disability.
Your countable resources must be equal to or less than the Supplemental Security Income resource limit of $2,000. Your assets alone are considered; your spouse's assets are not counted, and shared assets are assessed at 50%.
Several types of resources are not considered when determining eligibility:
- Retirement-related accounts such as IRAs, 401Ks, Tax Sheltered Annuities (TSAs) and Keoghs that comply with Internal Revenue Service regulations.
- Resources set aside as part of a Texas Health and Human Services Commission-approved Plan to Achieve Self-Support (PASS), as long as the plan is in effect. Any money set aside for a PASS must be identifiable from other funds.
- Income limit: Your countable earned income must be less than $2,042 a month, which is 250 percent of the federal poverty level. All earned income is countable except for the following exclusions:
- Earned income tax credit payments and child tax credit payments.
- Up to $30 of earned income in a month, if it is infrequent or irregular.
- $20 monthly general income exclusion.
- $65 monthly earned income exclusion.
- One-half of remaining earned income.
- Earned income used to pay Impairment-Related Work Expenses (IRWE), including:
- The cost of certain items and services that a person with a disability under age 65 uses to help them work.
- The cost of certain attendant care services, medical devices, equipment, and similar items and services.
- The costs of routine drugs and routine medical services if they are necessary to control the disabling condition, allowing the person to work.
Learn more about the Medicaid Buy-In Program by calling 1-800-252-8263, visiting the program Web site or applying online.
Thank You, MS Advocates!
Congratulations to our Volunteer MS Advocates! Since 2001, they have worked to establish the Medicaid Buy-In Program. Their voices were instrumental in persuading the Texas Legislature to offer this health insurance option to persons with disabilities.
Health insurance is essential for everyone, especially people with MS. For those with a disability, it can be particularly challenging to work and maintain health insurance coverage. Those who stop working typically lose their employer-based insurance benefits. Those who qualify for Social Security Disability Insurance (SSDI) must wait 24 months before qualifying for Medicare health insurance, and often pass that time uninsured. Those who receive SSDI and want to return to work often worry they will earn too much and disqualify from Medicare, leaving them with few options. Thanks to the Medicaid Buy-In program, there is now another choice. Get involved with MS Advocacy.