Medicaid Programs For Working People With Disabilities The Medicaid Programs for Working People with Disabilities is for people who fall within two categories: Ticket to Work for ages 16-64 Sherlock Plan for ages 65 and older Ticket to Work Sherlock Plan Age 16 – 64 65+ Income Limit None 250% FPL Asset Limit None $10,000 individual / $20,000 couple People eligible for either program are entitled to: the full scope of Medicaid medical benefits; Long-term services and supports home and community-based services; and services needed to start or continue their employment. Click here to view and download our "Medicaid Programs For Working People With Disabilities" brochure. What is Ticket to Work (TTW)? Overview In July 2023, the Rhode Island General Assembly passed legislation to expand Rhode Island’s Medicaid Buy In Program for the Working Disabled. The expanded Medicaid Buy In Program is called Ticket to Work (TTW). TTW provides the same medical coverage as the Sherlock Plan. However, TTW is different because there is no income or asset limit. Under the new TTW Medicaid for the Working Disabled Program, you may now earn and save more money. TTW Program Eligibility To be found eligible for TTW, a person must: Be between the ages of 16-64 (inclusive); and Currently meet the Medicaid requirements for eligibility based on a disability. Individuals who meet this disability requirement are not required to be unable to work; and Have proof of active, paid employment such as a pay stub or current quarterly U.S. Internal Revenue Service (IRS) tax statement (for those who are self-employed). Some participants may be required to pay a monthly premium based on their income, calculated as a percentage of the Federal Poverty Level (FPL). Please see the table below for more information. Income Monthly Premium 0 - <150% FPL No premium 150 - <185% FPL $61.00 185 - <200% FPL $77.00 200 - <250% FPL $92.00 250 - <300% FPL $110 300 - <350% FPL $130 350 - <400% FPL $150 400 - <450% FPL $170 450 - <500% FPL $190 500 - <550% FPL $210 550 - <600% FPL $230 600 - <650% FPL $250 650 - <700% FPL $270 700 - <750% FPL $290 750 - <800% FPL $310 800 - <850% FPL $330 850 - <900% FPL $350 900%+ FPL $370 For information on the Federal Poverty Level, please visit: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines Sherlock Plan Program Eligibility To be found eligible for the Sherlock Plan, a person must: Be at least 65 years of age; and Currently meet the Medicaid requirements for eligibility based on a disability. Individuals who meet this disability requirement are not required to be unable to work; and Have proof of active, paid employment such as a pay stub or current quarterly U.S. Internal Revenue Service (IRS) tax statement (for those who are self-employed); and Have countable earned net income no greater than 250% of the FPL. Countable income is defined as the total earned income remaining after all SSI-related disregards are applied; and Have countable assets no greater than $10,000 (for an individual) or $20,000 (for a couple). Medical savings accounts or retirement accounts are not counted as a resource; approved items that are necessary for an individual to remain employed are also not counted as a resource (i.e., wheelchair accessible van). Some participants may be required to pay a monthly premium based on their income, calculated as a percentage of the FPL. Please see the table below for more information. Income Monthly Premium 0 - <150% FPL No premium 150 - <185% FPL $61.00 185 - <200% FPL $77.00 200 - <250% FPL $92.00 For information on the FPL, please visit: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines More on How Sherlock and TTW Eligibility Rules Work Together If you are enrolled in the Sherlock Plan as of September 2024, you will automatically be transitioned into TTW. Your benefits will be the same as they are under Sherlock. The premiums for the two programs are the same for people with income levels under 250% FPL, which is the maximum Sherlock income level. If you are already enrolled in TTW and nearing age 65, you will automatically be evaluated to determine your eligibility to transition to the Sherlock Plan after turning 65 years of age. How Do I Apply for TTW or Sherlock Plan? Option 1: Follow these instructions to get the application online. Go to the DHS website. Click on the “Apply Now” tab. Click "Overview". Download the“DHS-2 Application for Assistance”. Option 2: Call the DHS call center, (855) 697- 4347, if you think you may be eligible. If your situation indicates that you may be eligible, you will be directed to your local DHS office. Option 3: Visit a DHS regional office to fill out and submit a paper DHS-2 application. Click here to view a list of locations. Submit Forms: You can mail your completed DHS-2 form to the address below: RI Department of Human Services P.O. Box 8709 Cranston, RI 02920-8787 Forms can also be put in the secure Drop Boxes located at DHS regional offices.