Section 640(d) of the Omnibus Budget Reconciliation Act of 1989 (OBRA 89) makes coverage of certain Medicare Beneficiaries who are entitled to enroll for Medicare Part A premiums a mandatory Medicaid coverage group. Under this provision, states must cover individuals who are Qualified Disabled and Working Individuals. The South Carolina Medicaid program began covering these individuals in July 1990.

A Qualified Disabled Working Individual is an individual:

• Who has not attained the age of 65;
• who has lost entitlement to premium free Medicare Part A under section 226 of the Social Security Act solely because his/her earnings exceeded the Substantial Gainful Activity (SGA) amount;
• who continues to have the same disability;
• whose income does not exceed 200 percent of the federal poverty level
  ($1,805 monthly for an individual and $2,429 for a couple);
• whose resources do not exceed twice the SSI resource limit ($4,000 for an individual and $6,000 for a couple); and
• who is not otherwise eligible for Medicaid.

The non-financial requirements are:

• Must be a citizen or legally admitted alien;
• Must be a resident of South Carolina;
• Must furnish a Social Security number or apply for one if he/she does not already have a number; and
• Must assign rights to medical benefits or support to the State and cooperate with the State in obtaining such medical benefits or support.

Individuals who meet these requirements are entitled to payment of the Medicare Part A premium only. They are not entitled to regular Medicaid benefits and will not receive a Medicaid card.