AGED, BLIND, AND DISABLED
SSI-Related -- CNIL Medical Coverage
|
Aged, blind, and
persons with disabilities may be eligible for Categorically Needy (CN)
medical if their income and resource standards are the same or lower than
the standards for SSI. People with
income and/or resources above the standards may be eligible for the
Medically Needy (MN) program.
SSI-eligible clients. Persons who
receive federal cash benefits under the Supplemental Security Income (SSI)
program also receive CN medical coverage automatically. The federal Social
Security Administration (SSA) administers the SSI program. The SSI income
standard is the Federal Benefit Rate (FBR). |
|
SSI-RELATED CN Income
Levels (CNIL) standards
Effective January 1, 2009:
|
SSI/CNIL STANDARDS
01/01/09 |
Single Eligible Person |
Couple Both Eligible |
|
|
CNIL INCOME |
674 |
1,011 |
|
|
|
|
FBR (SSI Standard)
* |
674 |
1,011 |
|
|
1/2 FBR* |
337 |
|
|
|
SHARED LVG FBR*
|
449 |
674 |
|
|
SSI RESOURCES |
2000 |
3000 |
|
HEALTHCARE FOR WORKERS WITH
DISABILITIES
|
|
Healthcare for Workers with Disabilities (HWD) is a CN medical program that recognizes the employment
potential of people with disabilities. Under HWD,
people with disabilities (age 16 through 64) can earn more money and
purchase healthcare coverage for an amount based on a sliding income
scale.
HWD has no asset test and the income limits are based on 220
percent of the Federal Poverty level (FPL).
Effective April 1, 2009:
NUMBER OF PERSONS
|
GROSS INCOME LIMIT -
220 % FPL
|
1
|
$1,986
|
2
|
$2,672
|
To be eligible, a person must
meet federal disability requirements, be employed (including
self-employment) full or part time and pay a monthly premium based on
the following formula.
Cost of
enrollment:
We follow a
two-step process to determine the amount of your premium, which will be
billed to you on a monthly basis.
First, we use the following
formula to calculate the monthly premium. We add the following
together for a total amount:
50% of any unearned
income in excess of the medically needy income level (MNIL) - the
current MNIL is $674;
plus
5% of your total
unearned income;
plus
2.5% of your earned
income after deducting $65
Then we compare that amount
to 7.5% of your total income and take the lesser amount.
Example:
A person earns $665 per month and receives $874 SSDI.
Item
|
Calculations
|
Premium
|
|
Income: Monthly Earned income |
$665 |
|
| Monthly
unearned income (Social Security) |
$874 |
|
| Total monthly
income |
$1,539 |
|
|
Premium- Step 1 |
|
|
| 1. Subtract
the MNIL ($674) from unearned
income ($874-$674) |
$200 |
|
| Take 50% of
result (.5 x $200) = $100 and include as part of premium |
$100 |
$100 |
| 2. Calculate
5% of unearned
income (.05 x $874) and include as part of premium |
$43.70 |
$43.70 |
| 3. Subtract
$65 from earned income ($665 - $65) = $600 |
$600 |
|
| Take 2.5% of
the result (.025 x $600) = $15 and include as part of premium |
$15 |
$15 |
|
TOTAL AMOUNT (rounded down) $158 |
|
|
|
|
PREMIUM - Step 2 |
|
|
| Take 7.5% of
total income (.075 x $1,539) |
$115.42 |
$115.42 |
| Take the
lesser amount found in Step 1 and Step 2 & round down |
|
$115.00 |
|
ACTUAL PREMIUM $115 |
|
For comments or questions regarding Eligibility, email
contact us
Page modified: November 2009
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