By: Nicholas N. Khayumov

In today’s rapidly evolving legal landscape, navigating the intricacies of Medicaid benefits can be particularly challenging, especially for working individuals with disabilities. As attorneys licensed in New York and experienced in Elder Law and Special Needs Planning, our firm strives to provide clarity and guidance to empower individuals with disabilities to secure the essential Medicaid benefits they need while maintaining their employment. Though this article does not provide legal advice, we will reference some strategies and considerations that can help working people with disabilities obtain Medicaid benefits in the state of New York.

Understanding Medicaid Benefits for Individuals with Disabilities

Medicaid is a vital safety net program designed to provide comprehensive health coverage to individuals with limited financial resources. For individuals with disabilities who wish to remain in the workforce, it’s important to recognize that their income and resources must meet specific criteria to qualify for Medicaid benefits. However, New York offers various pathways to bridge the gap between employment and Medicaid eligibility.

1. Medicaid Buy-In for Working People with Disabilities (MBI-WPD)

New York’s Medicaid Buy-In for Working People with Disabilities (MBI-WPD) program can be a game-changer for individuals who want to work while maintaining their Medicaid benefits. This program allows eligible individuals with disabilities to earn income above traditional Medicaid limits and still qualify for Medicaid coverage. By paying a monthly premium based on income, individuals can access a comprehensive range of Medicaid services, including doctor visits, prescription drugs, and home care services.

2. Utilizing Supplemental Needs Trusts (SNTs) and Pooled Trusts

Supplemental Needs Trusts (SNTs) are powerful tools that can help individuals with disabilities maintain eligibility for means-tested programs like Medicaid while preserving their financial security. SNTs are legal instruments that allow a third party, such as a family member or guardian, to manage funds for the benefit of the individual with a disability.

By placing assets in an SNT, these resources are not counted toward Medicaid eligibility calculations, ensuring the individual can continue to receive Medicaid benefits even as their financial situation improves through employment or other means.

There are various types of SNTs, one of which is a Pooled Trust. Pooled Trusts are managed by nonprofit organizations. The trust funds are invested and managed collectively, while the individual sub-accounts are maintained for each beneficiary.

In the context of Medicaid planning, Pooled Trusts offer several advantages. They allow individuals with disabilities to place their excess income or assets into the trust, which are then used to pay for the supplemental needs that enhance their quality of life, such as recreational activities, travel, and other personal expenses. These trusts are particularly beneficial for those who do not have a family member or guardian to act as a trustee.

3. Earned Income Disregard

In New York, individuals who receive Medicaid benefits may be eligible for the Earned Income Disregard (EID). EID allows recipients to exclude a certain portion of their earned income when determining eligibility for Medicaid. This initiative incentivizes individuals with disabilities to work by minimizing the impact of their earnings on their Medicaid benefits.

4. Work Incentives under Social Security

The Social Security Administration (SSA) offers a range of work incentives, such as the Ticket to Work program, designed to encourage individuals with disabilities to pursue gainful employment. By participating in these initiatives, individuals can engage in substantial work activities while still receiving Medicaid and other essential benefits.

In the ever-changing world of Elder Law and Special Needs Planning, it’s crucial to recognize that the pursuit of employment and financial independence should not come at the cost of essential Medicaid benefits. For working individuals with disabilities in New York, avenues like the Medicaid Buy-In program, Supplemental Needs Trusts, including Pooled Trusts, Earned Income Disregard, and other federal/state work incentives provide some paths to allow individuals to navigate this complex terrain successfully.

Our firm is dedicated to serving individuals with disabilities and committed to empowering and guiding our clients through the intricacies of Medicaid planning, ensuring that they can lead fulfilling lives while securing the essential support they need. If you or a loved one are navigating the intersection of work and Medicaid benefits, don’t hesitate to reach out for comprehensive legal assistance tailored to your or your loved one’s unique circumstances. With the right strategies and professional guidance, the path to both meaningful employment and Medicaid security is well within reach.