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.
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.
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 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.