Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 40 - Medicaid for Elders and Adults with Disabilities › Subchapter 15 - Disabled Working Adults › Part 1 - Medicaid Code of Administrative Rules, Section 1373 Medicaid for Working People with Disabilities Program › Section 210-RICR-40-15-1.5 - Community Medicaid Eligibility for Low-income Elders and Adults with Disabilities (EAD)

Current through June 14, 2024
A. Working adults
				  with disabilities who do not qualify for SSI due to excess income may be
				  eligible for initial or continuing Medicaid coverage through the EAD pathway
				  pursuant to Subchapter 05 Part 1 of this Title or as medically needy under Part
				  Subchapter 05 Part 2 of this Chapter. All EAD beneficiaries are entitled to
				  primary care essential benefits and any necessary work supports covered under
				  the Medicaid State Plan or Section 1115 D emonstration Waiver.
B. Working adults with disabilities may
				  obtain initial or continuing eligibility through the following:
1. Work-related protections - Some
				  applicants/beneficiaries may qualify for several of the same special provisions
				  available to applicants and beneficiaries that reduce or protect earned income
				  set forth in Subchapter 00 Part 3 of this Chapter, including but not limited
				  to:
a. PASS Disregard - Income, whether earned
				  or unearned, of a person who is blind or living with a disabling impairment may
				  be excluded if such income is needed to fulfill a Plan for Achieving
				  Self-Support (PASS). This exclusion does not apply to applicants who are age
				  sixty-five (65) or older, unless the applicant was receiving SSI or State
				  Supplemental Payment (SSP) before reaching that age. For additional information
				  on the PASS, see the Federal SSI Regulations at
				   20 C.F.R. §§
													416.1180 through  416.1182.
b. Impairment-Related Work Expenses - Earned
				  income used by a person with disabilities to pay impairment-related work
				  expenses is disregarded. For the disregard to apply, the person must have a
				  disability and be under age sixty-five (65) or have been eligible for and
				  received SSI based on disability for the month before reaching age sixty-five
				  (65). In addition, the following must be met:
(1) The severity of the impairment must
				  require the person to purchase or rent items and services in order to
				  work;
(2) The expense must be
				  reasonable given the nature of the disability or impairment and the type of
				  employment, as determined by the agency;
(3) The expense must be paid in cash
				  (including checks, money orders, credit cards and/or charge cards) by the
				  person and must not be reimbursable from another source, such as Medicare or
				  private insurance; and
(4) The
				  payment for the expense must be made in a month the person receives earned
				  income and anticipated work or worked and used the services or the item
				  purchased, or the person must be working and pay the expense before earned
				  income is received.
(5)
				  Impairment-related work expenses that may qualify for this disregard are
				  described in Federal SSI Regulations at
				   20 C.F.R. §
														416.976.
b. Student Child Earned Income Exclusions
				  (SEIE) - For a student under age twenty-two (22) or a person who is blind or
				  disabled and regularly attending school, a set amount of earned income per
				  month up to a yearly maximum may be excluded. The Federal government determines
				  the monthly and maximum amounts based on variety of factors and adjusts the
				  figures annually to reflect increases in the cost of living. The amount of the
				  exclusion is set by the Federal government and updated on an annual basis. The
				  amount of the exclusion is located in §00-3.1.7(A)(6) of this
				  Chapter.
c. Work-Related Expenses
				  of Blind Persons - Earned income used to meet any expenses reasonably
				  attributable to the earning of the income by a person who is blind and under
				  age sixty-five (65) or received SSI as a blind person for the month before
				  reaching the age of sixty-five (65). Further, expenses may be disregarded if
				  the person has an approved plan for self-support (PASS). The amounts must be
				  reasonable and not exceed the earned income of the blind person or a blind
				  spouse. See references on PASS, including types of expenses that qualify for
				  this disregard in §00-3.3.2(A)(3) of this Chapter.
d. RI Works Under a PASS. In accordance with
				  RI Works Regulations, RI Works payments administered by the RI Department of
				  Human Services under a PASS are excluded. However, RI Works payments unless
				  excluded under a PASS, are countable income.