Section 4733 of the Balanced Budget Act of 1997 created an optional coverage group for working disabled individuals with family income below 250% of the Federal Poverty Level (FPL). This provision enabled states to provide the full range of Medicaid services to working disabled individuals with relatively high income. South Carolina adopted this option in its 1998 Appropriations Act. The South Carolina Medicaid program began covering these individuals effective October 1, 1998.
A person who may qualify for the Working Disabled program must:
- Be under age 65
- Be totally and permanently disabled according to the Supplemental Security Income (SSI) definition of disability
- Be a South Carolina resident
- Be a United States citizen or Lawful Permanent Resident Alien
- Have a Social Security number or verify one has been applied for
- Assign rights to medical support
- Be working--have earned income
The income eligibility determination is a two-step process.
1. The first step determines if the family's total net income, after certain deductions, is at or must be less than 250% of the Federal Poverty Level for a family of that size.
2. The second step determines if the individual's unearned income is equal to or less than 100% of the Federal Poverty Level for an individual.
The applicant's countable resources must be below the $7,080 SSI resource limit for an individual.
250% Of Poverty Level
March 1, 2013
|Family Size||Monthly Income||Annual Income|
|Each Additional Member||$838||$10,056|
For each additional family member, add $10,056 to the annual income.
Divide by 12 and round up to the next whole dollar for the monthly income.
Individuals who meet these requirements are eligible for the full range of Medicaid covered services and may also be eligible to participate in a waiver services program if a slot is available. Contact your local Community Long Term Care (CLTC) office.