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.

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

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

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. 

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.