Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.12-002 - MS Policy 28000 - 28070 - Workers with Disabilities and the DCO-950

Current through Register Vol. 49, No. 6, June, 2024
28000
Medicaid Coverage for Workers with Disabilities
MS Manual 07/01/12
The "Ticket to Work and Work Incentives Improvement Act of
				1999" (TWWHA), enacted on December 17,1999, provides states with new options
				for making it possible for people with disabilities to join, or remain in, the
				workplace without fear of losing their Medicare and Medicaid coverage. Arkansas
				elected to provide Medicaid coverage in the "Basic Coverage Group" of TWWIIA.
				Under this group, Medicaid can cover individuals at least 16, but less than 65
				years of age, who, except for earned income, would be eligible to receive
				Supplemental Security Income (SSI). Medicaid for the Workers with Disabilities
				in Arkansas became effective February 1, 2001.
SGA (substantial gainful activity) is not an eligibility factor
				for the Workers with Disabilities category; therefore, persons with
				disabilities may increase their earnings or return to work and either retain or
				obtain Medicaid coverage.
Individuals who lose SSI and SSI related Medicaid, due to
				earnings, are potentially eligible for Medicaid under the Workers with
				Disabilities policy. There is no requirement that an individual must have at
				one time been an SSI recipient to be eligible for Medicaid under this category.
				However, if an individual was not an SSI recipient or a recipient of SSA
				disability, a disability determination must be made by MRT. Although SGA is not
				considered for this determination, the individual's unearned income must be
				under the SSI payment amount for one person.
28010 Extent of Services
MS Manual 07/01/12
Recipients of Medicaid in the Workers with Disabilities
				category will be eligible for the full range of Medicaid services. Cost sharing
				will be assessed at the point of service in the form of co-payments for medical
				visits and prescription drugs (Re.
MS 28045
).
Recipients will also be able to access services available
				through the AAPD Waiver provided the medical criteria for AAPD have been met as
				well as the financial criteria of the Workers with Disabilities category.
				(Refer to
MS 26125
for guidance and procedures
				regarding the medical assessment process.) Applicants will be advised by the
				caseworker that if they accept services from AAPD Waiver providers while their
				applications are pending and are subsequently denied for AAPD Waiver, they will
				be responsible for paying the provider.
28015 Workers with Disabilities Eligibility
			 Criteria
MS Manual 07/01/12
Individuals eligible for Medicaid under the Workers with
				Disabilities program must:
1. Be a
			 resident of the state of Arkansas (Re.
MS
			 2200
).
2. Be a U.S.
			 citizen or qualified alien (Re.
MS3310#3
&
MS 3324
).
3. Be at least 16 years of age but under age
			 65.
4. Furnish a Social Security
			 Number, or apply for one (Re.
MS 1358
).
5. Be working (Re.
MS
			 280201
.
6. Have a
			 disability according to the SSI definition of disability except for SGA (Re. MS
28025
).
7.
			 Have net personal income less than 250% of the poverty level for his/her family
			 size (Re.
MS 28030
). with unearned income below the
			 SSI/SPA for one person.
8. Have
			 countable resources equal to or less than twice the medically needy resource
			 limit for his/her family size. Only the resources of the individual and the
			 spouse will be counted. (Re.
MS 28Q35
1
9. Assign rights to medical support /third
			 party liability (Re.
MS 1350
).