To be eligible for the Basic Medicaid Buy-In program, a working individual between the ages of 16-64 must have a disability that meets the
medical criteria for Supplemental Security Income (SSI) established by the federal Social Security Administration, but have too much income to qualify for SSI.

Individuals with incomes under $26,800 or 150% of the poverty level pay no premiums; individuals with incomes of 150-250% of poverty will pay premiums calculated at 3% of earned income and 7.5% of unearned income.

Medicaid Buy-In enrollees who are later determined to be medically improved on a Continuing Disability Review but who retain a severe medical impairment can still qualify if they are working 40 hours per month or more.

According to the state law enacting the program, it was supposed to begin April lst. It was part of the Health Care Reform Act, signed by Governor Pataki on Jan. 25, 2002. About 20,000 state residents are expected to participate in the program.

The Governor also announced $150,000 in state grant awards to various organizations to assist state residents in applying to the program.
Education and outreach to New Yorkers with disabilities and the various provider and governmental groups that serve or support them should be available by mid-spring to support the program's implementation date of July 1, 2003

In recognition of staffing shortages and workload issues at many local Departments of Social Services, local DSS offices will be playing a more limited role during the first 9-12 months of the program's 'interim' implementation (July 1, 2003 to April 1, 2004). During that period, local
social services staff will be responsible for taking applications and, upon ensuring that each application has been completely filled out and that the necessary supporting documentation has been attached, send it on to the state Department of Health's Bureau of Medicaid Eligibility Operations. Interagency state staff comprised largely of Department of Health, Office of Mental Health and Office of Mental Retardation and Developmental Disabilities personnel will then, during this 'interim' period of July 1, 2003 and April 2004, process each application for the Buy-In.

Applications must demonstrate the applicant has both a job and a verifiable disability (SSI and SSDI status will be adequate, VA or Workers
Compensation disability status will require more documentation). State staff will then make a disability determination, issue a letter verifying the
applicant's acceptance or denial into the Medicaid Buy-In program and then enter eligible individuals' information into the appropriate state and local databases. This process will typically take 45 days for most applications, up to 90 for those needing additional corroboration.

Individuals who apply in July and are successfully enrolled into the Medicaid Buy-In program during the 1-3 months of expected processing time can expect that Medicaid will cover their medical expenses retroactively back to the July 1 start date.

Due to delays in the establishment of an automated premium collection and tracking system, the Governor has provided for a moratorium on premium payments to be paid by enrollees until April 2004, when the system is expected to be operational.

Local Social Service Departments will be taking over full responsibility for taking and processing applications and enrolling individuals into the Medicaid Buy-In program on April 2004. At that time, Buy-In enrollees earning between 150-250% of the Federal Poverty Level will be expected to begin paying premiums to retain their Medicaid.

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