Working Disabled Medicaid Buy-In

Is the Medicaid-buy-in Right for You?

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

• Have low income, no matter how much you have in Gloss-Assets or whether you have a disability. Learn more about income-based Medicaid-short.
• Have low income, low Assets, and either have a disability or are 65 years old or older. (If you get Adult Public Assistance (APA) benefits, you automatically qualify.) Learn more about APA-related Medicaid-short.
• Have a disability and work, even if your income is higher. The Medicaid-buy-in-short program is explained on this page.

Answer the questions on this page to see if you might qualify for the Medicaid-buy-in-short. 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-short’s comprehensive coverage.

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

PLbAcZl78Busm37IQGeFHjEeNQGTL6bGq8&si=78gYHul6VFNDW1nY

Do You Meet the Medicaid-buy-in-short Program’s Basic Requirements?

To qualify for the Medicaid-buy-in-short, you must:

• Be 18 years old or older
• Be working and earning too much money to get APA-related Medicaid-short
• 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 Medicaid-buy-in-short might be an option for you.

Medicaid-short’s rules for immigrants:

• 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.
• Undocumented immigrants do not qualify for full Medicaid-short coverage, but they may qualify for Medicaid-short coverage for emergency services.

<2026-ACA-immigrants>Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid-short coverage. However, they may qualify for private coverage subsidized by the government.[GM 12/23/2025: Subsidies below 100% FPG for this group end on 1/1/26. Subsidies for almost this entire group at any income level end on 1/1/27. Removing bullet in this context because for purposes of Medicaid info, the remaining subsidies aren't really a substitute for Medicaid anymore.]

Note: You can get Medicaid-buy-in-short 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 Medicaid-buy-in-short, 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 Medicaid-buy-in-short, 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 State 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 Medicaid-buy-in-short might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For the Medicaid-buy-in-short, you must have less than Medicaid-buy-in-asset-limit-individual in Assets (Medicaid-buy-in-asset-limit-couple for couples). Some Assets don’t count towards the Medicaid-buy-in-short’s Gloss-Asset-Limit, like the home you live in and one car.

If your Assets are below the limit, the Medicaid-buy-in-short might be an option for you.

Is Your Income Below the Medicaid-buy-in-short’s Income Limit?

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

For the Medicaid-buy-in-short, you must:

• Have APA-RC-individual-alone per month or less in unearned income, such as SSDI. If you are married, the limit is APA-RC-couple-alone-both-eligible and your spouse's deemed unearned income is also counted.
  
• Have household countable income that is at or below at or below 250% of the Federal Poverty Guidelines (FPG), including other members of your family you live with. That’s $=[Medicaid-buy-in-countable-annual-max-individual]/12 per month if you live alone.
  • Almost all of your unearned income is counted, but less than half of your earned income is counted. For the Medicaid-buy-in-short , your income is counted using SSI’s countable income calculation.

Tip: If you live alone and have no unearned income, you could actually have up to $=[Medicaid-buy-in-annual-gross-limit-individual]/12 per month in gross earnings and still qualify for the Medicaid-buy-in-short. (That's as much as $=[Medicaid-buy-in-annual-gross-limit-individual] per year!)

medicaid_buy_in_countable.xml [GM: Because of the household income aspect of the AK Buy-In, I do not recommend trying to adapt this mini-tool for Alaska.]

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

How to Sign Up

You can apply for the Medicaid-buy-in-short:

• Online, using Link-Health-Insurance-Marketplace or myAlaska.
• By filling out the DPA Application for Services or DPA Medicaid Application for Adults and Children with Long Term Care Needs and submitting it:
  • In person or by mail to any Link-county-human-services-agency
    
  • By email to hss.dpa.offices@alaska.gov, or
    
  • By fax to 1-888-269-6520.
• By phone at 1-800-478-7778.

If you use an application form, you can also apply for other benefits at the same time, such as Adult Public Assistance (APA), Gloss-Food-Stamps, and Gloss-TANF. If you apply for the Medicaid-buy-in-short online, you have to apply for other benefits separately.

Keeping Medicaid-buy-in-short Coverage

Usually, once you are approved for the Medicaid-buy-in-short, you will continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, you need to report within 10 days of when you know about the change. You can report these changes to the Division of Public Assistance (DPA) by calling 1-800-478-7778, by fax to 1-888-269-6520, by email to hss.dpa.offices@alaska.gov, or in person at any Link-county-human-services-agency.

When you report your changes, the DPA will tell you whether you will continue getting Medicaid-buy-in-short coverage and if your premium will change.