By skyforbes 
What are your options if you work and need home healthcare
This has been a long time coming. I’m excited to share that have a job lined up for when I graduate next semester! It pays well and has plenty of room for advancement.
It’s easy to get discouraged and feel disempowered when thinking about how to keep Medicaid when you’re disabled. You might think it’s just a welfare trap and you have to stay poor in order to have adequate healthcare through Medicaid. In many states, it doesn’t have to be like this. And I’ll show you how! Let’s dive in!
Why would someone feel disempowered? You might on first glance think, like I did until about 2 weeks ago, that if you earn too much income or acquire too many resources you’re at risk of losing your benefits. And so, you might plan to make less or spend more than you otherwise would just to keep your benefits. And this makes you feel stuck and hopeless. This sucks, but fear not, there is at least one way out!
In all states, if your net income (after excluding any IRWEs, PASS plans, etc.) remains below the 1619(b) threshold for your state, and your resources stay below $2k you can keep Medicaid. $2k is sadly not much!
However, it’s worth noting that you can put up to $100k in an ABLE account without it counting as a resource. And any expenditures involved in taking care of yourself (dinners, a new tv, an Xbox, etc.) won’t count as income. And for the PA-ABLE account, you can put $27,760 in the account every year (if you meet a few criteria). There are also some tax benefits from using an ABLE account. Of course, this is still non-ideal, but there is something to work with here!
Also, there could be another possibility if you’re lucky and live in a good state. In most states, like Pennsylvania, there are Medicaid buy-in programs. In exchange for a higher resource limit, with these programs, you pay a percentage of your income to keep Medicaid. To see if your state has a buy-in program check out this website.
For Pennsylvania, this program is called Medical Assistance for Workers with Disabilities (MAWD). Your countable income for this program can be up to 250% of the federal poverty line. And your resources can go up to $10,000. And for all these positives, you pay 5% of your income.
It matters that the income is countable. Countable income is calculated by taking your monthly gross income subtracting 65 (85 if all of your income is earned — and not gifted, for example) and dividing it by two. For Pennsylvania 250% FPL of countable income works out to between $65,952–66,432/year pre-tax (depending on if you subtract 65 or 85).
What is interesting for the Pennsylvania program is that new legislation (to go into effect in January) adds a new category for countable income between 250 and 600 percent FPL. Which increases the range of income you can make without losing Medicaid up to $156,120–156,600/year. In exchange, for being in the higher category, you pay 7.5% of your income.
Additionally, once you’re in this higher income category of MAWD, the resource limit goes away. Even if you go back down into the below 250% FPL category, you still have no resource limit. There are, of course, a few restrictions to look out for, but this legislation is a big advancement for disabled people in PA!
Just as a disclosure. There could be mistakes in this post, so I urge you to do your own research. To make this easier, I suggest you contact someone involved in SSA’s Ticket To Work program. This link is great for finding someone to talk to. Ask about Medicaid-buy-in or 1619(b) for your state. And ask if there’s a health lawyer with expertise in Medicaid they could recommend. (My personal go-to in Pennsylvania is the Pennsylvania Health Law Project.)
I wish you all the best! Until next time!