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(MRG) UPDATED: JUNE 2010 48 CATEGORICAL FACTORS MEDICAID BUY-IN PROGRAM FOR WORKING PEOPLE WITH DISABILITIES Eligibility under the Medicaid Level The MBI-WPD program is the most advantageous program for an A/R who is found to meet the eligibility requirements for both Medicaid without a spenddown and the MBI-WPD program. This is because a person in the MBI-WPD program can medically improve without an adverse impact on eligibility while A/Rs who are in receipt of Medicaid under the Aid to Disabled program will lose such eligibility in the event they have medical improvement. In situations where the A/R is found to be eligible for Medicaid without a spenddown AND the MBI-WPD program, the A/R is encouraged to choose the most advantageous program, and must be given a copy of the Explanation of the MBI-WPD Program and have all questions answered regarding the program and its eligibility requirements so that he/she may make an informed choice between the two programs. Substantial Gainful Activity (SGA) and Transition to MBI-WPD New Medicaid applicants: If the gross earnings from work, minus Impairment Related Work Expenses (IRWES) (See INCOME IMPAIRMENT RELATED WORK EXPENSES) are greater than the SGA level (See CATEGORICAL FACTORS SUBSTANTIAL GAINFUL ACTIVITY and REFERENCE SUBSTANTIAL GAINFUL ACTIVITY), and the individual does not have acceptable certification of disability, a disability determination must be performed by the State Disability Review Team for the MBI- WPD program. If the gross earnings from work minus IRWES are less than the SGA level, the A/R is encouraged to participate in the MBI-WPD program, or the Medicaid Aid to the Disabled program, whichever is most beneficial. Medicaid renewals: If a certified disabled Medicaid A/R who is not participating in the MBI-WPD program reports an increase in income and the earnings from work minus IRWEs are greater than SGA, the individual must be transitioned to the MBI-WPD program.