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Medi-CalWORK INCENTIVES

1

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Disability Benefits 101 www.db101.org

LA DPSS County Coordinator Roberto Vera 562-908-4338

California Health IncentivesImprovement Project www.chiip.org

Disability Rights California www.disabilityrightsca.org

World Institute on Disability www.wid.org

Pacific Clinics of So. Cal www.pacificclinics.org

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MEDI-CAL & DISABILITY

WORK INCENTIVES

SSIs 1619-b

Aged & Disabled, Federal Poverty Level

250% Working Disabled Program

Medically Needy with Share of Cost

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A provision to Supplemental Security Income Title XVI(SSI) linked Medi-Cal

Allows Working SSI recipients to keep full-scope, No-Share-of-Cost Medi-Cal

Medi-Cal remains intact even when earned incomereduces SSI payment to $0.00 per month

Bottom Line: You wont lose your Medi-Cal if youreon SSI and you earn income

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Earned income threshold in California: $34,324*

For the Blind and/or visually impaired: $37,252*Threshold can be adjustedon a case-by-case basis

http://www.ssa.gov/disabilityresearch/wi/1619b.htm

* Subject to change due to California Budget Crisis

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Example: SSIs Earned Income ExclusionSSI Payment $845.00

Gross earnings /month $500.00

Earned income exclusion ($65) - $65.00

Unearned income exclusion ($20) -$20.00

Sub Total: $415.00

Sub Total is divided by 2: / 2

Total Countable Income: $208.00

Subtract from SSI Payment $637.00

Add to Earned Income $1137.00

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Expenses Excluded from Countable Income include

Blind Work Expenses (BWE)

Impairment-Related Work Expenses

PASS (Plan for Achieving Self Support) Plan

Publicly Funded Personal

Medical Expenses above State Average

See SSAs Redbook www.ssa.gov/redbook for more information

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All Blind (BWE) and Impairment Related WorkExpenses (IRWE) must be verified by Social Security

Provide them with original receipts or canceledchecks of the expenses

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Aged and Disabled Federal Poverty Level Medi-Cal provides

free, full scope Medi-Cal qualified individuals

Blind people are also eligible, but must be determined to bedisabled according to SSA Definition of Disability

Income threshold for a individual is $1,133*

*All $ amounts subject to change

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Assets must be < than $2,000$3,000 couples

One home and one car are exempt

Assets include: Checking and savings accounts

Stocks, Bonds

Trust Deeds

Additional autos

Recreational vehicles

Promissory notes and loans, etc.

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MEDI-CAL 250% WORKINGDISABLED PROGRAM

(effective April 1, 2000)

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Provides choice and opportunity to hundreds ofCalifornians with disabilities who would

otherwise be ineligible for Medi-Cal coverage

due to earned income and work activity

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Earn approximately $55,000 (or more) per yearand keep No Share of Cost Medi-Cal

A working couple can earn approximately$74,000 (or more) and keep Full Scope,No-Share-of-Cost Medi-Cal

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Allows thepurchase of full-scope Medi-Cal

Recipient pays a premium

Lowest monthly premium is $20

SSIs Earned Income Calculation applied to earnings

SSAs NESE standards used for Self Employment calculation

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Medical eligibility basedaccording to SSA DisabilityDetermination Guidelines

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Earnings can be as little as $20 per week

Work activity can be as simple as pet attending,driving, domestic support services, research, lightclerical work

No minimum earnings criteria for eligibility

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Assets: One Home, One Car, < $2,000

< $3,000 per couple

Allows greater than $2000 in an IRA or a Retirement Account

Income Exceptions: Disability income (SDI, SSI, SSDI, STD,LTD, Workers Comp., etc.) is excluded

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SSIs countable income calculation is appliedto all wages/salaries

Countable Income Cannot Exceed 250 % of FPL$2257/mo for individual, $3036/mo for a couple)

Special countable income circumstances in excess of

250% FPL are negotiable

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2009 Poverty Guidelines for the

48 Contiguous States

Monthly Guidelines

FamilySize

Percent ofPoverty

100% 120% 135% 150% 200% 250%

1 $902.50 $1,083.00 $1,218.33 $1,353.75 $1,805.00 $2,256.25

2 $1,214.17 $1,457.00 $1,639.08 $1,821.25 $2,428.33 $3,035.43

3 $1,525.83 $1,831.00 $2,059.83 $2,288.75 $3,051.67 $3,814.57

4 $1,837.50 $2,205.00 $2,480.58 $2,756.25 $3,675.00 $4,593.75

5 $2,149.17 $2,579.00 $2,901.33 $3,223.75 $4,298.33 $5,372.93

6 $2,460.83 $2,953.00 $3,322.08 $3,691.25 $4,921.67 $6,152.08

7 $2,772.50 $3,327.00 $3,742.83 $4,158.75 $5,545.00 $6,931.25

8 $3,084.17 $3,701.00 $4,163.75 $4,626.25 $6,168.33 $7,710.43

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Countable Earned

Income From:

Countable Earned

Income To:

Premium for

Eligible Individual

Premium for

Eligible Couple

$1 $600 $20 $30

$601 $700 $25 $40

$701 $900 $50 $75

$901 $1,100 $75 $100

$1,101 $1,300 $100 $150

$1,301 $1,500 $125 $200

$1,501 $1,700 $150 $225

$1,701 $1,900 $175 $275

$1,901 $2,100 $200 $300

$2,101 $2,257 $250 $375

$2,258 $3,036 N/A $375

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To begin enrollment, contact the Eligibility Worker

County Coordinator may be contacted ifEW/Supervisor are unfamiliar with the program.

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Completed application should be submitted in person with:

1. Latest SSA award letter confirming

medical disability determination is still active

2. Copies of two most recent payrollchecks or stubs

3. Copies of two most recent bank statements

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Medi-Cal Working Disabled Program is NO SHAREOF COST Medi-Cal

Continues the Medicare Part B premium Buy-Inprogram for the beneficiary

Beneficiaries retain Medicare D LIS

(Low Income Subsidy)

http://www.cahealthadvocates.org/_pdf/facts/E-003-CHAFactSheet.pdf

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The Medi-Cal 250% Working Disabled

Program provides choice and opportunity to

hundreds of Californians with disabilities

who would otherwise be ineligible for Medi-

Cal coverage due to earned income and

work activity

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AIDS Project Los Angeles (213) 201-1365 www.apla.org

Disability Rights California(213) 427-8747 www.disabilityrightsca.org

Department DHCS (916) 552-9100 www.dhs.ca.gov

World Institute onDisability

(510) 763-4100 www.wid.org

CHIIP (916) 654-2561

www.chiip.org

www.talentknowsnolimits.info

Westside Center forIndependent Living

(888) 851-9245 www.wcil.org

Disability Benefits 101 www.disabilitybenefits101.org/

http://www.apla.org/http://www.pai-ca.org/http://www.dhs.ca.gov/http://www.wid.org/http://www.chiip.org/http://www.wcil.org/http://www.disabilitybenefits101.org/http://www.disabilitybenefits101.org/http://www.disabilitybenefits101.org/http://www.wcil.org/http://www.chiip.org/http://www.wid.org/http://www.dhs.ca.gov/http://www.pai-ca.org/http://www.apla.org/