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What to Know About New York’s Medicaid Buy-In Program

Navigating the waters of healthcare can feel overwhelming, especially if you’re living with a disability in New York State. Enter the Medicaid Buy-In Program (MBI-WPD). This state-driven solution allows the purchase of Medicaid coverage and access to essential healthcare services. 

So, get ready to explore this initiative and discover how it could help you or a loved one to secure comprehensive healthcare coverage.

Key Takeaways

  • The Medicaid Buy-In Program (MBI-WPD) is a valuable resource for New York State residents with disabilities, allowing them to access Medicaid coverage.
  • The program’s eligibility hinges on disability status (as determined by the Social Security Administration) and specific income and resource limits.
  • Beneficiaries will still have to cover Medicaid co-pays and deductibles even when enrolled in the program.
  • Applications for the Medicaid Buy-In Program can be made through your local Department of Social Services.

Apply for CDPAP or HHA today

What Is the Medicaid Buy-In Program?

The Medicaid Buy-In Program, also known as the Working People with Disabilities Program (WPD Program), is a lifeline for New Yorkers with disabilities who want to work and earn income without losing access to valuable Medicaid coverage.

Unlike Medicare or the Medicare savings program, which are federally managed health insurance programs, the MBI-WPD is a state-driven initiative that enables those with disabilities to continue receiving essential health care services while working.

Who Is Eligible for the Medicaid Buy-In Program?

If you’re considering applying for the Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) in New York State, you’ll need to meet several key conditions:

  1. State Residency: Firstly, you must be a legal resident of New York State.
  2. Age Requirement: You should be between 16 and 65 years old.
  3. Disability Determination: Your disability must be recognized and defined by the standards of the Social Security Administration.
  4. Work Status: You must be gainfully employed, whether that’s on a full-time or part-time basis.
  5. Income Parameters: You could still qualify even if your gross income goes up to $73,932 for a single individual or $99,636 for a couple.
  6. Asset Limits: Non-exempt assets should not exceed the established Medicaid limit of $30,182 for an individual and $40,821 for a couple’s household.

It’s important to note that retirement accounts are not included in the eligibility assessment for this program. These accounts are considered work-related plans designed to provide income upon retirement. 

Such accounts include but are not limited to, pensions, Individual Retirement Accounts (IRAs), 401(k) plans, and Keogh plans.

Who Determines If I Have a Disability?

Your eligibility for the MBI-WPD is partly determined by your disability status, which is assessed by the Social Security Administration (SSA) during the disability review process. 

The SSA or the State Review Team will review your medical records and any supporting documentation to establish whether your impairment or condition qualifies for the program.

Do I Still Have to Pay Medicaid Co-Pays and Deductibles?

Despite its many benefits, the MBI-WPD program does not exempt its beneficiaries from paying Medicaid co-pays and deductibles. The specific cost of these expenses will depend on the health care services you use. 

Fortunately, many of these costs can be offset through the “spend down” process, whereby medical expenses are subtracted from your countable income to meet Medicaid’s income limit.

How Do I Apply to the Medicaid Buy-In Program?

Contact the Department of Social Services (rather than a Medicaid office) in your local district when you’re ready to apply. After your application has been submitted and reviewed, you will receive a notification about your acceptance or denial.

Helpful Resources

Gain more insights about healthcare and/or the MBI-WPD program and how to apply by visiting the following websites:

The Medicaid Buy-In Program provides a vital healthcare lifeline for New Yorkers with disabilities. It ensures you can receive the health care coverage you need for long-term care, home care services, or personalized medical assistance. 

With this program, better health and peace of mind are within reach, no matter your situation. 

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