MBIWD

Is the Medicaid Buy-In for Workers with Disabilities (MBIWD) Right for You?

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

• Get Supplemental Security Income (SSI) benefits or qualify for SSI’s 1619(b) rule, which helps people who used to get SSI. In either case, you automatically get Medicaid coverage and don’t need to worry about the rules discussed here. Learn more in DB101’s SSI article.
• Have low income, no matter how much you have in resources or whether you have a disability. Learn more about income-based Medicaid.
• Have a disability and work, even if your income is higher. MBIWD is explained on this page.

Answer the questions on this page to see if you might qualify for MBIWD. If so, it’s a good option to consider because it lets you earn a lot more money and pay a low monthly premium, low copayments and no deductible to get Medicaid’s comprehensive coverage.

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Do You Meet MBIWD’s Basic Requirements?

To qualify for MBIWD, you must:

• Be 16 – 64 years old
• Be working
• Be a U.S. citizen or meet specific noncitizen requirements

If you are 16 – 64 years old, working, and are either a U.S. citizen or a non-citizen who qualifies, MBIWD might be an option for you.

Medicaid’s rules for immigrants:

• Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
• Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, they may qualify for private coverage subsidized by the government.
• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for all of the same programs that U.S. citizens can get.

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for MBIWD, you must have a disability that meets Social Security’s definition of disability. For adults, Social Security says you have a disability if:

• You have a physical or mental impairment or combination of impairments
• Your condition has lasted or is expected to last for at least 12 months

Note: For MBIWD, Social Security’s disability rules related to earned income do not apply.

If you currently get a disability benefit like Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you already meet Social Security’s disability standards.

If not, Ohio’s Division of Disability Determination will check to see if your disability qualifies for MBIWD.

If you already have a disability determination from Social Security or think that your disability will meet Social Security’s standards, MBIWD might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For MBIWD, you must have less than $14,848 in resources.

Some resources don’t count towards MBIWD’s resource limit, like the home you live in and one car. Additionally, if your disability began before you turned 26, the money you put into an ABLE account won't be counted by the MBIWD program. Learn more about ABLE accounts.

If your resources are below the limit, MBIWD might be an option for you.

Is Your Income Below MBIWD’s Income Limit?

MBIWD is designed so that if you have a disability, you can work without worrying that you’ll lose your Medicaid health coverage. That’s why its income limit is a lot higher.

For MBIWD, you must both:

• Have $37,890 per year or less in total unearned income, such as SSDI, and
• Have countable income that is at or below $57,650 per year. For MBIWD eligibility,
  • Almost all of your unearned income is counted, but less than half of your earned income is counted. The way your income is counted for MBIWD is very similar to SSI’s countable income calculation.
  • Only your income is counted, not the income of other household members.

Tip: Depending on your unearned income, you could actually earn up to $116,320 per year and still qualify for MBIWD.

If your income is low enough and you meet all other requirements, you should sign up for MBIWD, after making sure it is better than any employer-sponsored coverage you could get.

How to Sign Up

You can apply for MBIWD:

• Online (make sure to specify that you are applying for MBIWD), or
• By filling out the combined application form (available in other languages) and the MBIWD Addendum form and submitting them to your County Department of Job and Family Services (CDJFS) office.

For help with your application, visit or call your local County Department of Job and Family Services (CDJFS) office or call the Ohio Medicaid Consumer Hotline at 1-800-324-8680 or 1-800-292-3572 (TTY).

Staying on MBIWD

Usually, once you are approved for MBIWD, you will continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your County Department of Job and Family Services (CDJFS) office know or report the changes online. When you report your changes, the county will tell you whether you will continue getting MBIWD and if your premium will change.