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Medi-Cal

WORK INCENTIVES
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Disability Benefits 101 LA DPSS County Coordinator

www.db101.org Roberto Vera 562-908-4338 www.chiip.org www.disabilityrightsca.org www.wid.org www.pacificclinics.org

California Health Incentives Improvement Project
Disability Rights California World Institute on Disability Pacific Clinics of So. Cal

MEDI-CAL & DISABILITY WORK INCENTIVES
SSI’s 1619-b Aged & Disabled, Federal Poverty Level 250% Working Disabled Program

Medically Needy with Share of Cost

A provision to Supplemental Security Income Title XVI (SSI) linked Medi-Cal Allows Working SSI recipients to keep full-scope, NoShare-of-Cost Medi-Cal Medi-Cal remains intact even when earned income reduces SSI payment to $0.00 per month Bottom Line: You won’t “lose” your Medi-Cal if you’re on SSI and you earn income

Earned income threshold in California: For the Blind and/or visually impaired:

$34,324* $37,252*

Threshold can be adjusted on a case-by-case basis http://www.ssa.gov/disabilityresearch/wi/1619b.htm * Subject to change due to California Budget Crisis

Example: SSI’s Earned Income Exclusion SSI Payment Gross earnings /month Earned income exclusion ($65) Unearned income exclusion ($20) Sub Total: Sub Total is divided by 2: Total Countable Income: Subtract from SSI Payment

$845.00 $500.00 - $65.00 -$20.00 $415.00 /2 $208.00 $637.00

Add to Earned Income $1137.00

Expenses Excluded from Countable Income include

Blind Work Expenses (BWE)
Impairment-Related Work Expenses PASS (Plan for Achieving Self Support) Plan Publicly Funded Personal Medical Expenses above State Average
See SSA’s Redbook www.ssa.gov/redbook for more information

All Blind (BWE) and Impairment Related Work Expenses (IRWE) must be verified by Social Security

Provide them with original receipts or canceled checks of the expenses

Aged and Disabled Federal Poverty Level Medi-Cal provides free, full scope Medi-Cal qualified individuals Blind people are also eligible, but must be determined to be disabled according to SSA Definition of Disability Income threshold for a individual is $1,133*
*All $ amounts subject to change

Assets must be < than $2,000 –$3,000 couples
One home and one car are exempt

Assets include: Checking and savings accounts Stocks, Bonds
Trust Deeds Additional autos Recreational vehicles Promissory notes and loans, etc.

MEDI-CAL 250% WORKING DISABLED PROGRAM
(effective April 1, 2000)

Provides choice and opportunity to hundreds of Californians with disabilities who would otherwise be ineligible for Medi-Cal coverage due to earned income and work activity

Earn approximately $55,000 (or more) per year and keep No Share of Cost Medi-Cal A working couple can earn approximately $74,000 (or more) and keep Full Scope, No-Share-of-Cost Medi-Cal

Allows the purchase of full-scope Medi-Cal
Recipient pays a premium Lowest monthly premium is $20 SSI’s Earned Income Calculation applied to earnings
SSA’s NESE standards used for Self Employment calculation

Medical eligibility based according to SSA Disability Determination Guidelines

Earnings can be as little as $20 per week Work activity can be as simple as pet attending, driving, domestic support services, research, light clerical work No minimum earnings criteria for eligibility

Assets: One Home, One Car, < $2,000 < $3,000 per couple

Allows greater than $2000 in an IRA or a Retirement Account

Income Exceptions: Disability income (SDI, SSI, SSDI, STD, LTD, Worker’s Comp., etc.) is excluded

SSI’s countable income calculation is applied to all wages/salaries
Countable Income Cannot Exceed 250 % of FPL $2257/mo for individual, $3036/mo for a couple)
Special countable income circumstances in excess of 250% FPL are negotiable

2009 Poverty Guidelines for the 48 Contiguous States
Monthly Guidelines
Family Size Percent of Poverty

100%
1 2 3 4 5 6 7 8 $902.50 $1,214.17 $1,525.83 $1,837.50 $2,149.17 $2,460.83 $2,772.50 $3,084.17

120%
$1,083.00 $1,457.00 $1,831.00 $2,205.00 $2,579.00 $2,953.00 $3,327.00 $3,701.00

135%
$1,218.33 $1,639.08 $2,059.83 $2,480.58 $2,901.33 $3,322.08 $3,742.83 $4,163.75

150%
$1,353.75 $1,821.25 $2,288.75 $2,756.25 $3,223.75 $3,691.25 $4,158.75 $4,626.25

200%
$1,805.00 $2,428.33 $3,051.67 $3,675.00 $4,298.33 $4,921.67 $5,545.00 $6,168.33

250%
$2,256.25 $3,035.43 $3,814.57 $4,593.75 $5,372.93 $6,152.08 $6,931.25 $7,710.43

Countable Earned Income From:

Countable Earned Income To:

Premium for Eligible Individual

Premium for Eligible Couple

$1 $601 $701 $901 $1,101 $1,301 $1,501 $1,701 $1,901

$600 $700 $900 $1,100 $1,300 $1,500 $1,700 $1,900 $2,100

$20 $25 $50 $75 $100 $125 $150 $175 $200

$30 $40 $75 $100 $150 $200 $225 $275 $300

$2,101
$2,258

$2,257
$3,036

$250
N/A

$375
$375

To begin enrollment, contact the Eligibility Worker County Coordinator may be contacted if EW/Supervisor are unfamiliar with the program.

Completed application should be submitted in person with:

1. Latest SSA award letter confirming medical disability determination is still active

2. Copies of two most recent payroll checks or stubs
3. Copies of two most recent bank statements

Medi-Cal Working Disabled Program is NO SHARE OF COST Medi-Cal Continues the Medicare Part B premium “Buy-In” program for the beneficiary Beneficiaries retain Medicare D “LIS” (Low Income Subsidy)

http://www.cahealthadvocates.org/_pdf/facts/E003-CHAFactSheet.pdf

The Medi-Cal 250% Working Disabled Program provides choice and opportunity to hundreds of Californians with disabilities who would otherwise be ineligible for MediCal coverage due to earned income and work activity

AIDS Project Los Angeles (213) 201-1365 www.apla.org Disability Rights California (213) 427-8747 www.disabilityrightsca.org Department DHCS World Institute on Disability CHIIP Westside Center for Independent Living Disability Benefits 101 (916) 552-9100 www.dhs.ca.gov (510) 763-4100 www.wid.org www.chiip.org (916) 654-2561 www.talentknowsnolimits.inf o (888) 851-9245 www.wcil.org

www.disabilitybenefits101.org/