Adults With Disabilities
Medicaid Benefits
Medicaid benefits provide the healthcare you need when you are living with a disability, along with access to helpful resources. People who experience disabilities can get Medicaid in different ways. Your type of Medicaid may be different from the type of Medicaid someone else gets.
Your Medicaid type appears on your Benefits Decision Notice (BDN). You may get Medicaid through one of these categories:
- Medicaid Programs for Working People with Disabilities: If you have a disability and are an employed adult between the ages of 19 and 64, or you are 65 or older and still working, you may be eligible for a Medicaid program that supports your ability to work.
- Medicaid for Elders and Adults with Disabilities (EAD): If you are an adult with a disability and receive Supplemental Security Income (SSI), you automatically qualify for Medicaid. You may also be eligible for Medicaid if your income is too high for Medicaid, but you have high monthly healthcare expenses.
- Medicaid Long-Term Services and Supports (LTSS): If you are a Rhode Island adult and have a disability or chronic healthcare needs, you may be eligible for Medicaid long-term services and supports (LTSS). Eligibility for LTSS considers the income and assets of you and your spouse. You must also meet eligibility requirements for the medical level of care you need.
You may be eligible for Medicaid through one of two programs for working people with disabilities. If you’re enrolled in one of these programs, you have access to all standard Medicaid benefits. Learn more about the health services that Medicaid covers.
Some people enrolled in these programs also need long-term services and supports (LTSS). If you are eligible for LTSS, you can receive these services too.
Medicaid programs for working people with disabilities include:
Ticket to Work (ages 16-64)
Ticket to Work (TTW) provides full Medicaid benefits to adults between the ages of 16 and 64 who meet Medicaid requirements for eligibility based on a disability. You must have proof of active paid employment. If you get Medicaid through TTW, you may pay a monthly premium based on how much money you make. Learn more about the Ticket to Work program.
Sherlock Plan (age 65 and older)
If you are at least 65, meet Medicaid requirements for eligibility based on a disability, and have proof of active paid employment, you may get Medicaid through the Sherlock Plan. Your eligibility for this program also depends on your income and assets. If you get Medicaid through the Sherlock Plan, you may pay a monthly premium based on how much money you make. Learn more about the Sherlock Plan.
If you need long-term care, Medicaid pays for Long Term Services and Supports (LTSS). Depending on your needs, LTSS can include care in your home, or in assisted living, shared living, or nursing home facilities.
You can choose how you get LTSS benefits. Your options include:
- Managed long-term care through the Program for All Inclusive Care for the Elderly (PACE).
- Fee-for-service, where Medicaid directly pays the bills for your LTSS.
- Self-direction (Personal Choice), where you can choose who provides your care and when. With Personal Choice manage your service budget, how much your caregivers are paid (within certain limits), and you decide the type of training they receive. Visit MyOptionsRI to learn more about Personal Choice.
If you don’t qualify for Medicaid LTSS, you may still be able to get help with daily activities in your home or get other services. Visit MyOptionsRI to connect with services and support you may need to live independently, wherever you choose.
Click here to learn about other programs and resources to help keep you or your loved ones healthy.