Revision 19-4; Effective December 1, 2019

 

All regular non-financial MEPD policies apply to MBI, except those specifically identified in this chapter.

Non-financial requirements apply only to an MBI applicant/recipient, even if there are other household members.

 

M-3100 Age

Revision 11-4; Effective December 1, 2011

 

MBI has no age limit.

 

M-3200 Disability

Revision 19-4; Effective December 1, 2019

 

All persons applying for the Medicaid Buy-In (MBI) program must meet the Supplemental Security Income definition of disability. If the person does not have an established Social Security Administration disability determination, request the determination from HHSC's Disability Determination Unit. Follow normal MEPD policy for disability determinations. For MBI, the disability requirement also applies to persons age 65 or older.

The MBI program allows an exception to the requirement that the person be unable to engage in any substantial gainful activity (SGA). For purposes of MBI, a person who is able to engage in SGA still might meet disability requirements because SGA is disregarded in deciding whether the person meets the definition of disabled for MBI.

Related Policy
Disability, D-1400
Requesting a Decision from the Disability Determination Unit (DDU), D-2300

 

M-3300 Household of One

Revision 15-4; Effective December 1, 2015

 

Being a household of one means an applicant/recipient is not penalized for assets owned by the spouse. For example, if one member of a couple applies for the MBI program, only the assets of the applicant are considered when determining eligibility for the program. If both an applicant/recipient and spouse own the asset, only half of the asset is considered owned by each spouse. If the person applying for the MBI program is a minor and lives with his or her parents, the assets of the parents are not considered the minor's assets. Consider an MBI recipient/applicant a household of one, regardless of the living arrangement or age. Do not deem income or resources. Do not consider support and maintenance. If an applicant lives with a spouse who is eligible for Medicaid, the applicant and spouse are each considered a household of one.