Feb 21st, 2018

Low Cost Medicaid Coverage for Workers With Disabilities Empowers You to Keep Your Job

Fred London Law 0 Comments Social Security Disability

Less than 50 percent of people with disabilities are covered by Medicaid. Yet, this health insurance option allows workers with disabilities to visit doctors and specialists — a privilege not readily available to the uninsured. Furthermore, Medicaid coverage for workers improves health and financial security.

medicaid coverage for workers

While some employer plans and individual health insurances provide options to workers with disabilities, these plans may come with high costs, plus coverage requirements and limits. Traditional Social Security disability plans require an applicant to not work.

However, the Employed Individuals with Disabilities (EID) program offers health insurance while encouraging individuals to work. This option offers health coverage at low premiums. Depending on your income, premiums range from zero to 55 dollars per month.

Let’s look at how to access this Medicaid coverage for workers with disabilities?

Qualifying for EID

The Maryland Department of Health (MDH) offers Medical Assistance (a.k.a. Medicaid) to workers with disabilities through the EID program. This program covers you when you have no health insurance. It also supplements Medicare plans and private insurance.

However, not every worker with a disability gets approved. You must meet the following criteria to qualify for EID:

1)Be age 18 to 64 years old

2) Be a U.S. citizen or of “qualified alien” status

3) Meet Social Security’s medical criteria for a disability

4) Work for pay

5) Fall under the income limit

6) Meet the resource (asset) limit

Applying for EID

Like traditional Medicaid processes, you retain the right to apply for EID on your own or through professional agencies. The Maryland Department of Health (MDH) or a disability law expert offers assistance in determining if you qualify for this Medicaid coverage for workers with disabilities. They also help with the application process.

To apply for EID:

1) Contact the Eligibility Determination Division (EDD) of the MDH’s Medical Assistance program.

2) Complete the online application or get assistance doing so if you do not have a computer.

3) Print and mail the application to the EDD, including required, supporting documentation.

4) Receive a decision within 30 days (for SSI or SSDI recipients) or 90 days for those new to the system.

5) Appeal the decision, if you are denied. Enjoy the coverage, if approved.

Receiving EID

Medical assistance through EID begins at the beginning of the month you apply. Typically, if you cooperate and provide the documents and information required, you pay no premiums until you are notified of eligibility.

For instance, if you apply on March 10, coverage (once approved) dates back to March 1. However, your first premium is due after you receive your approval letter, even if it arrives the following month or two.

However, if the delay in approval is because you did not get requested information to the EDD, you may be asked to pay premiums for the gap months. In the example above, your premium would date back to March 1. In reverse, you may also be eligible to get medical expenses covered during this period.

Finally, a redetermination is required every six months. This means you must update your online application, print it and resubmit with any new documentation. Saving your application on the computer makes the process quick and painless. With regular attention to these updates, coverage may continue until age 65, if you continue to prove eligible.

EID Coverage

EID covers most medical services, plus some disability services which traditional plans fail to cover. Other than your premium, you may also pay small co-payments for covered services, like prescriptions. If a service is covered and a provider accepts Medical Assistance, you pay nothing more.

For help with EID eligibility, contact us today.

Feb 19th, 2018

Medicaid for Aged, Blind and Disabled

Fred London Law 0 Comments Social Security Disability

When you apply for supplemental security income (SSI), one of the main benefits in addition to disability coverage is Medicaid for medical coverage. Medicaid is a federal health program offered to low income Americans. When you qualify for SSI, the state you live in allocates those payments, and Medicaid is a part of the SSI payments in most states. Indeed, Medicaid is one of the most important parts of the entire SSI program because it provides medical coverage for the aged, blind and disabled.

income requirement for medicaid

The federal agency that administers Medicaid is the Centers for Medicare & Medicaid Services (CMS). Each state submits their Medicaid plan to CMS for approval. Each state’s plan is different, but all states provide Medicaid for at least some of their SSI beneficiaries. CMS receives state plans from the 50 states as well as the District of Columbia, and a plan from the Commonwealth of the Northern Mariana Islands (NMI).

Medicaid is the federal government’s medical assistance program. It is part of the Social Security Act (Title XIX). In most states, the program is called and known as Medicaid. It is called Medi-Cal in California and AHCCS in Arizona, for the Arizona Health Care Cost Containment System.

The Title XIX statute requires that Medicaid coverage be provided to certain mandatory groups in any state that has a Medicaid program, while states have the option to provide Medicaid coverage for other groups. This is the reason why the plans vary so much from state to state.

It can also get confusing because Title XIX also allows for states to provide medical assistance to individuals not eligible for SSI. Although these programs are medical, they are not under the Medicaid umbrella of coverage.

Medicaid is paid according to a cost-sharing between the federal government and states. The federal government pays about half of the administrative costs for each state.

Regarding eligibility, a person must first be in a category that is addressed by a cash assistance program (the mandatory needy disabled with low incomes, optional needy, and those individuals that qualify as medically needy under a Medicaid waiver). You can also be a family member in a family with dependent children that qualify for the Aid to Families with Dependent Children (AFDC) program. If you are not in one of these categories, you cannot get Medicaid.

In most states, your SSI application also serves as your Medicaid application. This allows faster processing of benefits if you do qualify for Medicaid. Upon qualifying, there is retroactive coverage of covered medical expenses that occurred up to three months before you submitted your SSI/Medicaid application if the individual would have been eligible at that time. There are also stipulations for benefits payout should the person die while the application is being processed.

When you’re approved for SSI, Medicaid is automatically granted in most states. A few states use the same SSI criteria, but make their own decisions about Medicaid eligibility:

SSI uses income, resource, and disability criteria to qualify you for both SSI and Medicaid. A few states make their own Medicaid eligibility decisions using the same federal SSI criteria: Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, and Utah. This means that everyone receiving SSI should also qualify for Medicaid, but approval is not automatic and you have to fill out a separate Medicaid form. Finally, several other states have Medicaid criteria that are much stricter than the federal SSI criteria. The federal government does have rules for how restrictive states can be.

Regarding qualifying criteria, you must have proof of your disability and it must meet SSI criteria as outlined in the Blue Book which lists qualifying disabilities.

There is also an income requirement for Medicaid, and you must not exceed the Medicaid monthly income limits. There are rules for what counts as income, and there are also asset limits you must meet.