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services before their 18th birthday. Section 301 allows the youth to retain benefits (SSI & Medicaid) while he/she participates in approved vocational rehabilitation program www.socialsecurity.gov    

New to Medicaid

Child did not qualify for SSI under 18 due to family income, at age 18, may qualify for SSI and Medicaid as an adult single head of household

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Appendix D: Healthy & Ready to Work National Insurance continued

Public Health Insurance: Continued Medicaid Eligibility

While Working: Section 1619(b)

* Still meets SSI criteria,

* Needs Medicaid in order to work; and

* Gross earned income is insufficient to pay for other supports

Medical Assistance for Workers with Disabilities (MAWD)

* Worker could opt to buy-in and receive Medicaid benefits

adultBasic for Uninsured

* Meets income eligibility

* See Appendix G

Private Health Insurance: Continued Benefits via Family Plan

Adult Disabled Dependent Child - Depending on Company and Policy

* May continue on family plan if dependent for life

* Be on family plan prior to turning 18

* Annual re-certification - disability & dependent

Student Status - Depending on Company and Policy

* Proof of college class load each semester (often requires full-time status)

* Ages 18 - 22, sometimes older

* Annual re-certification

Private Health Insurance: Youth Pays Premium

Options to buy Private Insurance Health Care Benefits:

* College - student plan

* Employed - group plan

* Self-pay - single plan


Concern: What happens if health status changes and affects continuous employment or attending school? There is no safety-net or ease on/off for health benefits

Tip Sheet Developed by: Patti Hackett & Glen Gallivan, Ocala, FL

The opinions expressed herein do not necessarily reflect the policy or position nor imply official endorsement of the funding agency or working partnerships.

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Banner resource information:

Health Insurance Portability and Accountability Act (HIPAA) US DEPARTMENT OF LABOR www.dol.gov/dol/topic/health-plans/portability.htm Consumer Hot Line 1(877)881-6388 or www.insurance.state.pa.us

HIPAA - The Health Insurance Portability and Accountability Act

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