How Does Medicaid Define Disability?

people with disabilities

If you are wondering whether or not you are eligible for Medicaid through your disability, you have come to the right place. This guide will let you know whether or not you are eligible, and if not through your disability, how else you may be eligible for Medicaid. Let’s start with how Medicaid defines disability.

Are You Eligible for Medicaid Through Your Disability?

There are over 10 million people who are eligible for Medicaid through a disability.

Individuals who are under the age of 65 who are disabled and eligible for Medicaid include children and adults with disabilities they have had since they were born or ones that have acquired through being ill, injured, or trauma.

Eligibility is given to those with certain physical conditions:

  • Brain injuries
  • Quadriplegia
  • Etc.

developmental disabilities

As well as certain developmental and intellectual disabilities:

  • Down syndrome
  • Autism
  • Etc.

And also includes mental illness and behavioral disorders such as bipolar disorder and schizophrenia.

Over 33% of Medicaid beneficiaries who have eligibility through their disability get it through receipt of SSI (Supplemental Security Income). For those who do not know, this is the federal cash assistance program for both the elderly and those with disabilities who are low income.

SSI is available to provide eligibility for federal income support when one’s ability to work is impaired significantly, rather than focusing on functional and/or health status being met. Because of this, many people who deal with multiple chronic conditions may not be able to use their disability for Medicaid eligibility.

How Else Can You Be Eligible for Medicaid?

So if you are not eligible for Medicaid through a disability, what other options do you have for eligibility?

Being Medically Needy

By incurring medical expenses, those who have disabilities and a higher income are able to spend down to a medically needy income level (one that is specified by the state they reside in).

Your Poverty Level

Your poverty level is also a way to be eligible for Medicaid. Every state has the option to cover individuals with disabilities with income (or assets) above the SSI eligibility level.

Working Individuals with Disabilities

States are required to cover specific qualified and severely impaired people who earn enough to otherwise disqualify them from Medicaid. They can allow working, disabled people to buy into Medicaid if desired.

Special Income Level

Lastly, states are able to cover institutionalized people with incomes up to 300% of the SSI benefit rate with the special income level option. Individual states are also able to extend this eligibility to those who receive community and home-based waiver services (as an alternative to institutionalization).

Learning More with At Home Your Way

Interested in learning more about Medicaid and Virginia Medicaid waivers? Check out our site where we share blog posts, resources, and an option to contact us directly!

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