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VA MEDICAID WORKS - Employment Considerations

Potential participants in Virginia's MEDICAID WORKS program should consider the employment-related provisions below as they relate to your specific circumstances.

Note that Supplemental Security Income (SSI) benefits lead to substantial initial income eligibility differences (see below) between Individuals Not Receiving SSI at Initial Eligibility Determination and SSI Recipients at Initial Eligibility Determination. However, after enrollment, all participants are subject to the same ongoing income eligibility requirements.

Individuals Not Receiving SSI at Initial Eligibility Determination

If you do not receive SSI at the time of initial eligibility determination in MEDICAID WORKS but are employed, you may not be financially eligible for participation in the program. Even a part-time minimum-wage job would be likely to make your countable income (earned plus unearned) more than the program's very low initial income eligibility limit of 80% Federal Poverty Level (FPL).

If you are currently unemployed but want to participate in MEDICAID WORKS, it may be advisable to try to obtain a documented job offer but not actually begin employment until after you receive notice that you are eligible for enrollment in the program.

SSI Recipients at Initial Eligibility Determination

If you do receive SSI at the time of initial eligibility determination and are employed before enrollment in MEDICAID WORKS, it does not matter what your current countable income is, even if it is substantially greater than the program's initial income eligibility limit of 80% Federal Poverty Level (FPL). All SSI recipients, even those who get Medicaid coverage because of the SSI 1619(b) work incentive, are considered to meet the MEDICAID WORKS income requirements and no evaluation of income is necessary for the initial eligibility determination.

Also See:

Virginia MEDICAID WORKS - Overview

Virginia MEDICAID WORKS - Agreement

Virginia MEDICAID WORKS - Blindness and Disability

Virginia MEDICAID WORKS - Cost Sharing and Premium Payment

Virginia MEDICAID WORKS - Entitlement and Enrollment

Virginia MEDICAID WORKS - Financial Eligibility

Virginia MEDICAID WORKS - Good Cause Exceptions

Virginia MEDICAID WORKS - Non-Financial Eligibility

Virginia MEDICAID WORKS - Safety Net

Source

Some information for this topic was drawn from Section M0320.211 of the Department of Social Services (DSS) Medicaid Manual.

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