Is the Working Disabled Medicaid Buy-In Right for You?

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

Answer the questions on this page to see if you might qualify for the Working Disabled Medicaid Buy-In. If so, it’s a good option to consider because it lets you earn a lot more money and pay a low monthly premium, low copayments and no deductible to get Medicaid’s comprehensive coverage.

Note: If you qualify for APA or for SSI’s 1619(b) rule, you automatically get APA-related Medicaid and don’t need to worry about the rules discussed here. Learn more about them in DB101’s SSI and APA article.

Do You Meet the Working Disabled Medicaid Buy-In Program’s Basic Requirements?

To qualify for the Working Disabled Medicaid Buy-In, you must:

  • Be working
  • Be a U.S. citizen or meet specific noncitizen requirements

If you are working and are either a U.S. citizen or a non-citizen who qualifies, the Working Disabled Medicaid Buy-In might be an option for you.

Medicaid’s rules for immigrants:

  • Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
  • Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, they may qualify for private coverage subsidized by the government.
  • Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for all of the same programs that U.S. citizens can get.

Note: You can get Working Disabled Medicaid Buy-In coverage if you are a Native American born in Canada or Mexico who has rights to cross the border.

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for the Working Disabled Medicaid Buy-In, you must have a disability that meets Social Security’s definition of disability. For adults, Social Security says you have a disability if:

  • You have a physical or mental impairment or combination of impairments
  • Your condition has lasted or is expected to last for at least 12 months

Note: For the Working Disabled Medicaid Buy-In, Social Security’s disability rules related to earned income do not apply.

If you currently get a disability benefit like SSI or Social Security Disability Insurance (SSDI), you already meet Social Security’s disability standards.

If not, Social Security, in collaboration with Alaska Disability Determination Services (DDS), will check to see if your disability qualifies. Learn more about the disability determination process in DB101's SSI and APA article.

If you already have a disability determination from Social Security or think that your disability will meet Social Security’s standards, the Working Disabled Medicaid Buy-In might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For the Working Disabled Medicaid Buy-In, you must have less than $10,000 in resources ($15,000 for couples). Some resources don’t count towards the Working Disabled Medicaid Buy-In’s resource limit, like the home you live in and one car.

If your resources are below the limit, the Working Disabled Medicaid Buy-In might be an option for you.

Is Your Income Below the Working Disabled Medicaid Buy-In’s Income Limit?

The Working Disabled Medicaid Buy-In program is designed so that if you have a disability, you can work without worrying that you’ll lose your Medicaid health coverage. That’s why its income limit is a lot higher.

For the Working Disabled Medicaid Buy-In, you must:

Tip: If you live alone and have no unearned income, you could actually have up to $7,673 per month in gross earnings and still qualify for the Working Disabled Medicaid Buy-In. (That's as much as $92,070 per year!)

If your income is low enough and you meet all other requirements, you should sign up for the Working Disabled Medicaid Buy-In, after making sure it is better than any employer-sponsored coverage you could get.

The Working Disabled Medicaid Buy-In’s monthly premium

If you get Working Disabled Medicaid Buy-In coverage, you may need to pay a monthly premium. The amount you pay is based on your income and your family’s income. To learn how much your premium might be, try DB101's Benefits and Work Estimator.

Example

Freddy lives alone, has no unearned income, and makes $5,200 per month at his job. He makes way too much money for income-based or APA-related Medicaid, so he applies for the Working Disabled Medicaid Buy-In program.

When the DPA reviews his application, it says Freddy only has $2,558 in countable income each month, so he easily qualifies for the Working Disabled Medicaid Buy-In. He will have to pay a monthly premium, but it’ll be a lot less than he’d have to pay for private insurance.

How to Sign Up

You can apply for Working Disabled Medicaid Buy-In:

If you use the combined application for services, you can also apply for other benefits at the same time, such as APA, SNAP (formerly Food Stamps), and Alaska Temporary Assistance Program (ATAP). If you apply for Working Disabled Medicaid Buy-In online, you will have to apply for other benefits separately.

Keeping Working Disabled Medicaid Buy-In Coverage

Usually, once you are approved for the Working Disabled Medicaid Buy-In, you will continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your Division of Public Assistance (DPA) office know within 10 days. When you report your changes, the DPA will tell you whether you will continue getting Working Disabled Medicaid Buy-In coverage and if your premium will change.