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Effective: December 1, 2006 |
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03.30.15ar1 - Medical Assistance (MA) for People With a Disability (Archive) |
Archived: July 1, 2008 |
People who are certified as disabled by the Social Security Administration (SSA) or State Medical Review Team (SMRT) have a basis of eligibility for MA. There is no age limit for this basis.
Note: The income and spenddown guidelines in this section apply primarily to people who live in the community. See Long-Term Care (LTC) and Elderly Waiver (EW) for people who live in Long-Term Care Facilities (LTCFs).
Eligibility factors are listed below with any information that is unique for this group. Links to standard program guidelines are included as well.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Other Groups/Bases to Consider.
Application Process (standard guidelines)
Process MA applications within 60 days for people whose eligibility is based on disability.
Follow standard MA guidelines.
Follow standard MA guidelines.
Disability must be verified with SSA or SMRT. See Certification of Disability.
Some people with disabilities may lose their RSDI benefits because their earnings exceed the Substantial Gainful Activity (SGA) level. These people may qualify for continued Medicare coverage for up to 93 months after their RSDI benefit ends. If they continue to have a disabling impairment, SSA continues to consider them disabled and eligible for Medicare, and they therefore meet a disabled basis of eligibility for MA.
Note: Because they have an MA basis of eligibility, do not enroll them in GAMC unless their Medicare extension ends and SMRT determines they are no longer disabled.
Social Security Number (standard guidelines)
Follow standard MA guidelines.
Follow standard MA guidelines.
Follow standard MA guidelines.
Follow standard MA guidelines.
Household Composition (standard guidelines)
Do not count parents' income as available to children of any age who receive Supplemental Security Income (SSI).
Children ages 18-20 who use a disabled basis of eligibility are determined eligible using only their own income. Use a household size of one for these children, and do not deem parental income.
Exception: If a disabled child ages 18-20 lives with a spouse, use a household size of two and deem the spouse's income. If the disabled child has children who live in the home, count them in the household size as well.
Use Method B for income and assets.
Asset Guidelines (standard guidelines)
The asset limit is:
l $3000 for a household of one.
l $6000 for a household of two.
l $200 for each additional household member.
Note: There is no asset limit for children under 21, regardless of their basis of eligibility.
The income limit is 100% FPG.
Deductions/Disregards (standard guidelines)
Use the following Method B deductions in the order given:
1. Disabled widow and widower’s disregard.
2. Widow and widower's disregard.
3. Pickle disregard.
4. Disabled adult children disregard.
5. Income used to fulfill an approved Plan to Achieve Self Support (PASS) for disabled or blind people.
6. Earned income disregard for blind or disabled student children.
7. The first $65 of earned income disregard.
8. Work expense deduction for disabled clients.
9. One-half the remaining earned income.
Spenddowns (standard guidelines)
People with incomes over 100% FPG may be eligible by spending down to 75% FPG.
Follow standard MA guidelines.
People under age 65 who are eligible for MA due to blindness or disability are excluded from managed care enrollment.
Note: People under age 65 who are certified as disabled or blind but who choose another basis of eligibility may voluntarily enroll.
People ages 18 through 64 who are certified blind or disabled and who reside in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, or Washington counties may voluntarily enroll in Minnesota Disability Health Options for people with physical disabilities (MnDHO-PD).
Some adults without children who are certified disabled and who apply for MinnesotaCare may be required to apply for MA. See Disabled Adults Without Children.
Follow standard MA guidelines.
People with blindness or disabilities or who are age 65 or older must use a Method B basis of eligibility for the Medicare Savings Programs, regardless of which method they choose for MA.
People whose eligibility is based on disability may also be eligible for:
l The Medicare Savings Programs if they are Medicare-eligible.
l A waiver of deeming requirements and/or expanded MA services.
Children who are certified disabled may also be eligible as children under 21. See Multiple Bases of Eligibility.
Some disabled children who lost their SSI eligibility under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) may be eligible for MA under a special category.