View the Latest: Other Health

What rules apply to states implementing the BBA eligibility group? Can a state impose additional requirements? What are the basic Medicaid buy-in provisions in TWWIIA? Who qualifies for coverage under the basic coverage group? What rules apply to states implementing the TWWIIA basic coverage group? Who qualifies for coverage as part of the medical improvement group? What rules apply to states implementing the medical improvement group? Can a state that has a TWWIIA Medicaid buy-in…

Earnings-Related Incentives What are earned income exclusions for persons on SSI? What is the student earned income exclusion? What is the earned income exclusion that applies to all others on SSI? What are blind working expenses? What is a Plan for Achieving Self–Support (PASS plan)? How does a PASS plan affect my SSI benefit? How can someone set up a PASS plan? What is property essential to self-support? How does someone qualify for continued Medicaid…

Earnings-Related Incentives What is a trial work period? What is the extended period of eligibility? Health Coverage Incentives Can someone on SSDI continue Medicare coverage when they return to work? Can people with disabilities who work buy into Medicare once their eight and a half years of premium-free coverage runs out? Will people with disabilities who return to work be eligible for Part D? Can people with disabilities on SSDI who return to work buy…

Training and Rehabilitation Incentives What are continued payments under a vocational rehabilitation program?  What is the Ticket to Work? Earnings-Related Incentives What is meant by the substantial gainful activity (SGA) limit? What are impairment-related work expenses (IRWEs)? What are “subsidies and special conditions”? What are unincurred business expenses? What are unsuccessful work attempts? What is a Plan for Achieving Self Support (a PASS plan)? Health Coverage Incentives How can people with disabilities obtain or retain…

Can a person with a disability on Medicare and/or Medicaid be employed? Do all work incentives apply to everyone on SSDI and SSI? Editors’ Note: The information presented in this Section regarding SSDI and SSI work incentives is adapted or reprinted from material from the Social Security Administration’s 2004 Red Book, available online at http://www.ssa.gov/work/ResourcesToolkit/redbook.html. Similarly, information presented on Medicare and/or Medicaid coverage options for employed individuals with disabilities is based on information that is…

Congress created Medicare and Medicaid in 1965 to provide health coverage to two fairly distinct groups of Americans: workers who reach age 65 (that is, senior citizens) and certain groups of low-income people. While much has remained constant in Medicare and Medicaid in the past 40 years, both programs have evolved significantly. Collectively, they have come to play a major role in providing health care coverage and long-term services and supports for people of all…

Supplemental Medicaid Coverage for Low-Income Medicare Beneficiaries How does an individual become a dual eligible? How are dual eligibles different from other Medicare beneficiaries? What does it mean to be a primary and/or secondary payor? In 2003, Congress enacted a Medicare reform law that included a prescription drug benefit. How does this law affect dual eligibles? More than 7 million people receive both Medicare and Medicaid; these individuals are called “dual eligibles” or “dual enrollees.”…

Back to the Top What does it mean to be “medically needy”? Thirty-five states plus the District of Columbia operate medically needy programs. The medically needy option allows states to provide Medicaid to certain groups of individuals who are ineligible because of excess income, but who have high medical expenses. States often use the medically needy program to expand coverage primarily to persons who spend down by incurring medical expenses so that their income minus…

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