THE EMPLOYED INDIVIDUALS WITH DISABILITIES EID PROGRAM

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THE EMPLOYED INDIVIDUALS WITH DISABILITIES
(EID) PROGRAM

• Employment and Health Insurance Program
• Presenter CarLa Bryant
• EID Intern Coordinator
• Maryland Department of Disabilities

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Employed Individuals with Disabilities (EID)

• Also known as the Medicaid Buy-In, EID is a work
  incentive that provides Medicaid, for a small
  fee, to people who
• Are disabled and have been approved for SSI or
  Social Security Disability Insurance (SSDI) after
  reaching age 18
• Are U.S. citizens or qualified aliens aged 18
  64
• Are working for pay
• Meet income limits
• Meet resource limits

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Employed Individuals with Disabilities (EID)

• Disability
• You may be eligible for EID if you
• Currently receive SSDI
• Formerly received SSDI or SSI as an adult and
  lost the benefit for reasons other than medical
  improvement
• If you have received SSI or SSDI in the past 7
  years, no proof should be needed (only SS )
• If its been more than 7 years, you may need to
  provide proof (e.g., award letter)
• GOOD NEWS By summer of 2008, a new process
  should be in place so that people who are not
  eligible for SSI or SSDI for reasons other than
  disability may apply for EID.

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Employed Individuals with Disabilities (EID)

• Paid Work
• No minimum level of earnings may be very small,
  but need to be verified
• Must result in income during enrollment period
• Must be subject to state and federal reporting
  and withholding or estimated tax payments
• Need not be competitive (i.e., sheltered workshop
  earnings allowed)

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Employed Individuals with Disabilities (EID)

• Countable Income
• Countable income must be below 300 of federal
  poverty level (FPL)
• 31,200/yr. (2,600/mo.) for an individual (in
  2008)
• 42,000/yr. (3,500/mo.) for a married couple (in
  2008)

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Employed Individuals with Disabilities (EID)

• Only income from individual and spouse is counted
• Not all income is counted, and certain disregards
  (subtractions) apply
• 20/month subtracted from unearned or earned
  income
• 65/month and half the remainder subtracted from
  earnings
• Disability-related expenses needed for work and
  paid by the worker
• Any work-related expenses paid by blind workers
• Premiums paid by the worker for
  employer-sponsored health insurance

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Employed Individuals with Disabilities (EID)

• EXAMPLE
• 220 (monthly unearned income)
• 20 (general income disregard)
• 200 (countable unearned income)
• 4,750 (monthly earned income)
• 65 (earned income disregard)
• 4,685 / 2 2,342.50 (countable earned
  income)
• 200 (countable unearned income)
• 2,342.50 (countable earned income)
• 2,542.50 (total countable income)
• Below 2,600

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Employed Individuals with Disabilities (EID)

• Countable Resources
• Countable resources for individual or couple must
  be below
• 10,000
• Not all resources count. The following are
  excluded
• The home in which the applicant (and spouse) live
• Vehicles owned by the applicant and spouse
• 1st 4,000 in 401(k), 403(b), Keogh and pension
  plans
• Certain burial funds
• Discretionary or special needs trusts
• Others

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Employed Individuals with Disabilities (EID)

• Fees
• Fee is 75 every six months
• If found ineligible, fee is refunded
• Fee may be waived in cases of extreme hardship
  (i.e., paying fee would leave the applicant
  unable to afford food, shelter and medical care)

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Employed Individuals with Disabilities (EID)

• Once Youre Enrolled
• If found eligible, Medicaid is retroactive to the
  1st day of the month the application is received
• EID provides fee for service Medicaid dont
  need to join a managed care organization

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Employed Individuals with Disabilities (EID)

• Provides full coverage for people with no other
  insurance wrap-around (supplemental) coverage
  for those with private insurance or Medicare
• Redetermination every six months Paperwork and
  75 fee for each new 6-month period

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Employed Individuals with Disabilities (EID)

• HOW TO APPLY
• Contact the EID Intern Coordinator at
• 443-514-5034
• 1-800-637-4113
• eid_at_mdod.state.md.us
• An intern will contact you to determine whether
  you may be eligible, take your application, and
  tell you which documents you need to include with
  your application

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Employed Individuals with Disabilities (EID)

• The Dept. of Disabilities and the Dept. of Health
  and Mental Hygiene are partnering on this project
  to help people enroll in EID.

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Medicaid (Medical Assistance)

• What It Pays For
• The recipients full cost for most medical
  expenses, including
• Ambulance and wheelchair van services and
  emergency medical transportation
• Ambulatory surgical care services
• Clinic services
• Diabetic care services (covered by managed care
  program)
• Family planning services and supplies

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Medicaid (Medical Assistance)

• Home health care
• Hospice care
• Hospital services
• Kidney dialysis services
• Lab and X-ray services
• Medical day care services
• Medical equipment
• Medical supplies
• Medicare premiums, deductibles and co-payments
• Mental health treatment, case management and
  rehab. services
• Nurse anesthetist, nurse midwife and nurse
  practitioner services

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Medicaid (Medical Assistance)

• Nursing home services
• Oxygen services and related respiratory equipment
• Personal care services
• Pharmacy services (for those who receive Medicare
  Part D, it reduces out-of-pocket costs)
• Physical therapy
• Physician services (some dental surgery may be
  included)
• Podiatry
• Residential treatment facility services

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Medicaid (Medical Assistance)

• Substance abuse treatment
• Targeted case management for targeted groups
• Transportation to covered services (through local
  health departments)
• Vision care services (eye exams every two years)

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