Health care coverage
For adults who have a disability or are Blind
This information describes Medical Assistance eligibility requirements for adults ages 21 through 64 who have a disability or are Blind. There are different rules for people under age 21. Also, if you work, you may be eligible for Medical Assistance for Employed Persons with Disabilities.
This information does not cover all program rules.
Apply to see if you qualifyMedical Assistance Rules for people under age 21 Medical Assistance for Employed Persons with DisabilitiesHow much does coverage cost?
For some people, the only cost is copays for some services. Depending on your income, there may be a monthly premium or spenddown.
Copays and premiumsSpenddownsWhen can my coverage start?
After you are approved, coverage may:
- Go back to the first day of the month we get your application
- Go back three months from the month we get your application
- Begin the month after you are approved, or pay your first premium if you have one
Call your county or Tribal office if you have questions about when coverage can start.
Who is considered disabled or Blind?
To be considered a person with a disability or Blind for Medical Assistance you must be certified disabled through the Social Security Administration or the State Medical Review Team.
[Learn about determining if you have a disability]What is the income limit?
The income limit and whose income is counted depend on your age and who lives with you. People who receive home and community-based waiver services or nursing home services may have different income rules.
Income limits Home and community-based waiver services Nursing home servicesIf my income is more than the limit, can I still get coverage?
Some people who have more income than the Medical Assistance income limit can qualify using a spenddown. A spenddown lets you deduct certain medical expenses from your income. Medical Assistance will pay for covered services after your income is at or below the income limit after deducting these medical expenses.
More about spenddownsCan I get coverage if I have a house or car?
Yes, homes and cars are generally not counted toward the asset limit.
Asset limitsCan I get coverage if I have savings, a retirement account or other assets?
Yes, but you will have an asset limit. Retirement accounts may be considered differently than other assets.
Asset limitsWhat is the Asset Verification Service?
The Asset Verification Service is a secure database that we use to electronically verify financial accounts that may be counted as assets for certain applicants and enrollees. Adults who are age 65 or older, Blind or who have a disability must authorize use of the Asset Verification Service (AVS) to be eligible for Medical Assistance, including Medical Assistance for Employed Persons with Disabilities, or the Medicare Savings Programs.
[AVS] Medical Assistance for Employed Persons with Disabilities [Medicare Savings Programs]What if I have Medicare or other health insurance?
You may still get coverage. You must tell us if you:
- Have other health insurance
- Medical Assistance may be able to help pay the cost of your Medicare or other insurance so you can keep that coverage.
- Could be covered under someone else's insurance
- Could get coverage through an employer or military service