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MEDICAL SERVICES POLICY MANUAL, SECTION B
B 300 Aid to the Aged, Blindand Disabled(AABD) Eligibility Groups
B-325 Qualified Disabled and Working Individuals (QDWI) MS Manual 07/01/20 This group consists of individuals who are blind or have a disability and who lost Medicare Part A entitlement solely due to the individual’s earnings that reached or exceeded the Substantial Gainful Activity (SGA) amount. Individuals who are 65 years of age or older will not qualify as a QDWI. The QDWI income limit is 200% of the Federal Poverty Levels (FPL). QDWI’s are eligible only for payment of their Medicare Part A-Hospital Insurance premium. Refer to MS F-190. B-326 Medicare Savings Programs - Comparison Chart Refer to Health Care Procedures manual for more information. MS Manual 01/01/22
B-330 Workers with Disabilities MS Manual 03/22/25 This group consists of individuals who: • Have a disability; • Are working at the time of application (Refer to Glossary for definition of working.); • Are at least sixteen (16) years of age, but less than sixty-five (65) years of age; and • Except for earned income, would be income eligible to receive Supplemental Security Income (SSI). If an individual was not an SSI or SSA disability recipient, a disability determinationmust be made by the DHS Medical Review Team (MRT). Refer to MS F-122. Substantial Gainful Activity (SGA) is not considered for the disability determination. In addition, the individual’s total unearned income (minus the twenty dollar ($20) general exclusion) must be under the SSI payment amount for one (1) person to qualify for this group. Recipients will be able to access services through Community Employment Support (CES) or ARChoices Waiver, provided that the medical criteria for ARChoices or CES have been met as well as the financial criteria of the Workers with Disabilities group. Refer to MS C-240 for guidance regarding the medical assessment process. If applicants accept services from ARChoices or CES Wavier providers while their applications are pending and are subsequently denied for ARChoices or CES Waiver, they will be responsible for paying the provider. Recipients of Health Care in the Workers with Disabilities category will be eligible for the full range of Health Care services.