What is a Medicaid Buy-In?
A Medicaid Buy-In program allows working people with disabilities to pay a premium to participate in their State’s Medicaid program, as though they were purchasing private health care coverage.
The development of Medicaid Buy-In programs by individual States was authorized under the Balanced Budget Act (BBA) of 1997 and the Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999.
A major disincentive for Virginians with disabilities who are willing and able to work is the potential loss of health care coverage (Medicaid) if they earn too much income. Consequently, many individuals either do not seek employment or limit their hours, or actual wage level. A Medicaid Buy-In can permit higher income and resource levels while ensuring continuation of needed health care coverage, thus providing an opportunity and incentive to seek gainful employment.
Early in 2001, state agencies in Virginia initiated a collaborative effort with consumers, providers and advocates to develop a Medicaid Buy-In opportunity.
The Commonwealth of Virginia was awarded a federal Medicaid Infrastructure Grant effective January 1, 2002, to support State development of infrastructures to support the gainful employment of people with disabilities by targeting improvements to the state’s Medicaid Program.
Virginia's Medicaid Buy-In program will be designed to allow working people with disabilities access to comprehensive health care. However, each disabled individual must continue to meet income and resource eligibility requirements.
Employer and consumer involvement is critical to the success of the Medicaid Buy-in and, further, to removing barriers to employment for Virginians with disabilities.