Medicaid Buy-In

1. Medicaid Buy-In Coming Soon to a County Near You!!!

2. What is Medicaid Buy-In? New form of Medicaid for individuals with disabilities who work Will eliminate Spend-downs Will eliminate Patient Liability Provide Medicaid coverage to individual who receive Social Security Disability Insurance (SSDI)

3. Who is Eligible? All Individuals with Disabilities Meet MOST of the Medicaid eligibility standards MUST BE WORKING!!!!!

4. Basic Medicaid Eligibility ForAged, Blind, & Disabled To qualify for Medicaid, a person must meet basic requirements: be a U.S. citizen or meet Medicaid citizenship requirements; be an Ohio resident have or get a social security number; and Individuals ages 14 to 64 Determined Disabled By Social Security Meet Resource Limitations and Income Restrictions

5. Income & Resource Limitations Individual Countable Monthly Income Under $556 Resources Under $1,500 per Month Couples Countable Monthly Income Under $956 Combined Resources Under $2250

6. What is Considered Income and Resources Income Supplemental Security Income (SSI) Social Security Disability Insurance (SSDI) Unemployment Workers Comp Earned Income Resources Checking Account Savings Account Stocks, Bonds, CD�s Burial Plots over $1500 Additional Houses, Cars, Boats

7. Medicaid Buy-In Work Requirement Individual Must be working Part-Time OR Full-Time Community Based Employment Self-Employment Vocational Assessment (Paid) * Continued coverage for individuals who lose their job while participating in program

8. New Income & Resource Criteria Individual Only !!! Must be working and earning income Meet the income eligibility criteria $2,167 Excludes $20,000 of earned income for the individual, then allows total individual income up to 250% of the federal poverty level Have a maximum resources of $10,000

9. Medicaid Spend-Down A spend-down is a specified amount that an individual would have to pay each month before they would be eligible for Medicaid coverage. Individual income limits for Medicaid id $556. Anything over is considered a spend-down Individual receiving $637 SSDI has a $81 spend-down Individual receiving $637 of SSDI and $606 of earned income has a gross income of $1243 and a a spend-down of $687

10. Patient Liability for Medicaid Waiver Total earned and unearned income under $1179 per month limitation Income of $2,100 per month consumer has to pay $921 per month

11. Free Medicaid Individuals earning under $15,000 receive Medicaid for free Ex: $7.00 x 20 hr/wk = $606 gross per/mo $606 x 12 months = $7,272 Social Security Benefit of $637 per month x 12 months = $7,644 SSDI + Work = 14,916 FREE MEDICAID OR $35,000 per year - $20,000 (exclusion)= $15000

12. Free Medicaid Con�t Social Security Work Incentives Impairment Related Work Expenses (IRWE) Subsidies & Special Conditions Work Expenses (Self-Employed) * Consult Social Security or a Benefit Specialist

13. Medicaid Buy-In over $15,000 Premiums Individuals must pay a premium in order to participate in the Medicaid Buy-In program when their total family income exceeds 150% of the federal poverty level (15K). The premium charged is 7.5% of the difference between 150% FPL and total income. $18,000 (after exclusions) = $112 per month Enrollees who do not pay their premiums for two months in a row will be subject to termination. If they are terminated, they may reapply for MBIWD but they must pay all MBIWD delinquent premiums for the months of coverage before they can be re-enrolled

14. Stopped Working Grace Period Program participants will be allowed a six-month grace period if they lose a job or if their disability improves. This allows individuals time to either find another job, plan for a transition back to regular Medicaid, or in the case of medical improvement plan for a transition off of Medicaid.

15. How to Apply Call the local Jobs and Family Service Office Fill out form JFS 07211 available 4/1/2008 Provide all documentation: Pay stubs, checking, savings, address, Social Security info, ect* OR CALL 440-813-2783