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Materials & Resources
Eligibility
Flow Chart for MaineCare (Medicaid) Workers with Disabilities Option
Person enters MaineCare system if he or she fits in to one or more eligibility
categories and meets certain asset and income tests.
- Is person considered disabled according to Social Security criteria, and does person have earnings? If YES, go to 2. | If NO, go to 14.
- Has disabled person paid SS taxes for enough years, and is not now working, or is the person a disabled dependent of someone who paid the SS taxes? If YES, go to 13. | If NO, go to 3.
- Is countable income over $674 per month? If YES, go to 4. | If NO, go to 11.
- Is countable income over $684 per month? If YES, go to 5. | If NO, go to 10.
- Is countable income over $908 per month? If YES, go to 6. | If NO, go to 9.
- Is countable unearned income over $908, or all countable income over $2,269 per month ($3,065 for a couple)? If YES, go to 7. | If NO, go to 8.
- Not eligible for MaineCare Workers with Disabilities option. Return to the CHOICES CEO website or return to top of flow chart.
- Eligible for continued MaineCare through the Workers with Disabilities option. Person pays $10 to $20 monthly premium if countable income exceeds $1,362 per month. Return to the CHOICES CEO website or return to top of flow chart.
- Eligible for MaineCare through the SSI-Related Program. Person gets MaineCare only, no other payments. If there is an increase in earned income due to a job, go to 5.
- Eligible for MaineCare through the State Supplemental Program. In addition to MaineCare, can get $10 State Supplemental check and in some cases, subsidized room and board. If there is an increase in earned income due to a job, go to 5.
- Eligible for MaineCare through the SSI Cash Program. BFI provides MaineCare. Person also gets $10 State Supplement check. Person can also apply to social security for SSI Cash. If there is an increase in earned income due to a job, go to 12.
- Eligible for continued MaineCare through the SSA 1619(b) program. If person loses eligibility for SSI Cash due only to earnings, continued MaineCare eligibility is through 1619(b) income limits, and thus move from it to the MaineCare Workers with Disabilities option (upper income limit was $32,403 in 2011). If there is an increase in earned income due to a job, go to 5.
- May be eligible for the SSDI program, and for Medicare, if person receives SSDI payments, those and any other SS payments are considered countable as unearned income, which affects eligibility for the MaineCare Program. Continue with flow chart or return to the CHOICES CEO website or return to top of flow chart.
- Not eligible for MaineCare Workers with Disabilities option. Person may be eligible under another non-disability category. Return to the CHOICES CEO website or return to top of flow chart.
