250% Working Disabled Program

The 250% Working Disabled Program (250% WDP) provides full-scope Medi-Cal to working disabled individuals with countable income below 250% of the federal poverty limit (FPL).

All other programs must be explored before the 250% WDP is evaluated (i.e., Modified Adjusted Gross Income (MAGI) MC, Non-MAGI MC, Pickle, etc.) The 250% WDP must be evaluated at Intake, Redetermination (RD), for former Social Security Income (SSI) recipients and when a client asks about the program.

Definitions

Child

A child must be unmarried and not the head of a household and either under age 18, or under age 22 and be a student regularly attending school, college, or training that is designed to prepare him/her for a paying job.

Family Income

Net non-exempt “Family Income” is used in the 250% FPL test and includes:

The client’s own income, except for disability income and earnings retained in a separate account.
The spouse’s income, if the spouse has income above a certain SSI threshold
If the applicant is a child, the parental income is deemed until the child reaches 18 years of age

Note: “Family Income” does NOT include the income of a child in the home, unless the child is the applicant of the 250% WD Program.

In-Kind Support and Maintenance (ISM)

In-Kind Support and Maintenance of food or shelter given to applicant or received by him/her because it was paid for by someone having no legal responsibility to provide them. Shelter includes room, rent, gas, electricity, water, sewer and garbage collection services.

Presumed Maximum Value (PMV)

Presumed Maximum Value is 1/3 of the SSI payment rate (but not the combined SSI/SSP payment) plus $20 dollars.

Substantial Gainful Activity (SGA)

Substantial Gainful Activity means work that involves doing significant and productive physical or mental duties, and is done, or intended, for pay or profit (SGA is not applicable to the 250% WD Program).

Spousal/Parental Deeming

When a portion of the ineligible spouse’s income is provided to the spouse/child(ren).

SSI/SSP

The Federal Supplemental Security Income (SSI) program provides a monthly cash benefit to eligible aged, blind and disabled persons who meet the program’s income and resource requirements. In California, the SSI payment is augmented with a State Supplemental Payment (SSP) grant.

Value of the One -Third Reduction (VTR)

Value of the one-third reduction is 1/3 of the SSI payment (not the combined SSI/SSP payment).