Even before the Affordable Care Act (also known as Obamacare) expanded Medicaid access for hundreds of thousands of people, a little-known program called Medicaid Buy-In allowed people with disabilities who work to qualify for Medicaid benefits even though their incomes might be too high to otherwise obtain Medicaid.
Forty-six states currently offer some form of a Medicaid Buy-In program. Although the rules differ slightly from state to state, in general a person must meet the federal definition of "disabled" and be currently working in order to qualify for a Medicaid Buy-In. Since some people who qualify for a Medicaid Buy-In may also receive Medicare or health insurance from their employer, their Medicaid coverage will supplement services that may not be covered by other forms of insurance and it may also help with premium payments.
States typically charge premiums for Medicaid Buy-In recipients but these costs are almost always lower than what it would cost to purchase health insurance from a private insurance company. In addition, many states have resource limits that prevent people who have a lot of money saved up from qualifying for Buy-In services.
Medicaid Buy-In services may not be for everyone. Under the Affordable Care Act, individuals who earn less than $46,680 a year may receive subsidies to help them pay for private insurance. (A family of four can earn up to $95,400 and receive subsidies.) People with lower incomes can also qualify for premium and co-pay assistance with their private health plans, and some other low-income adults can receive expanded Medicaid (if they live in states that have chosen to expand their Medicaid programs) without having to meet the stringent asset requirements of Medicaid Buy-In programs.
If you are currently working and have a disability, talk with your special needs planner to determine if a Medicaid Buy-In program may be appropriate for you.
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