Revision 19-4; Effective December 1, 2019

All persons applying for the Medicaid Buy-In (MBI) program must meet the Supplemental Security Income definition of disability. If the person does not have an established Social Security Administration disability determination, request the determination from HHSC's Disability Determination Unit. Follow normal MEPD policy for disability determinations. For MBI, the disability requirement also applies to persons age 65 or older.

The MBI program allows an exception to the requirement that the person be unable to engage in any substantial gainful activity (SGA). For purposes of MBI, a person who is able to engage in SGA still might meet disability requirements because SGA is disregarded in deciding whether the person meets the definition of disabled for MBI.

Related Policy

Disability, D-1400
Requesting a Decision from the Disability Determination Unit (DDU), D-2300