Medicaid Works is a program for individuals between the ages of 16 and 64 with a disability that allows them to work and keep their Medicaid coverage.
Eligibility
Any individual between the ages of 16 and 64 with a disability who is working can apply for the program. Applicants must meet the Social Security definition of disabled and earn less than 200% of the federal poverty level. A single person cannot have more than $5,000 in personal assets, and a couple cannot have more than $10,000 in personal assets. The spouse's income limit is $3,750.
Household
Size
| 100%
Monthly
| 150%
Monthly
| 200%
Monthly
| 250%
Monthly
|
|---|
1
| $1,330
| $1,995 | $2,660
| $3,325
|
2
| $1,804
| $2,705
| $4,509
| $54,108
|
Substantial Gainful Activity Disabled Individual: $1,690
Substantial Gainful Activity Blind Individual: $2,830
Note: These income limits change in April of each year.
Except for earnings, all applicants must continue to meet the Social Security definition of disability and meet all other requirements of the program. Earnings from work are not considered in determining whether a disability exists.
Frequently Asked Questions about Medicaid Works
Can I qualify for the program if I am not a citizen?
Disabled aliens may be eligible for this program if they meet the definition of a qualified alien. These qualifications can be found in 907 KAR 20:005.
Whose income is counted?
In the Medicaid Works Program, the income of the working disabled individual is counted, and their spouse's income, if applicable, is also counted.
Can I have a retirement fund?
Yes. Any employer or individual retirement plan approved by the Internal Revenue Code is permissible under the program (for example, an individual retirement account).
How do I prove I am working?
A person applying for the Medicaid Works Program must provide proof of employment (for example, pay stubs or written verification from the employer).
If you are self-employed, you will have to provide records (for example, Schedule C forms) to demonstrate employment. For an independent contractor, verification may be provided with a 1099 IRS form as proof of income and employment.
If I am in the program, do I have to let you know when my income or address changes?
Yes. You are required to report all changes in income, name or address to your caseworker within 10 days of the change.
Apply
Can I apply for the program if I already receive Social Security Disability Insurance and Medicare?
Yes. As long as you are working and meet all other eligibility criteria, you can buy into Medicaid with an affordable premium payment under the Medicaid Works program.
Can I apply if I have other health insurance?
If you have other health insurance, you would continue to use that insurance as the primary payer for your medical care. Your other insurance may not cover all the services you need. You can have private or employer health insurance and receive services through Medicaid Works.
What if I stop working after I get into the program?
If you quit or lose your job but plan to return to work, you can continue to receive benefits under the program for six months. If you have not returned to work within six months, you will no longer be in the program. When you get another job, you can reapply.
Where do I go to apply for the program or if I have more questions?
To apply for the program, you may visit the kynect website, call Medicaid Member Services at (855) 459-6328, or the Department for Community Based Services Call Center toll-free at (855) 306-8959.